The MR-Linac Technical Feasibility Protocol

NCT ID: NCT04351204

Last Updated: 2024-02-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-22

Study Completion Date

2026-07-01

Brief Summary

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Radiation therapy is predominantly based on a Computed Tomography (CT) scan obtained during the treatment planning phase. During the course of radiotherapy, however, both the tumor and organs at risk (OAR) are variable in position, shape and size between fractions, and during beam delivery within one treatment fraction. Around the clinical target volume (CTV) a safety margin (Planning Target Volume, PTV) is created to account for these geometric uncertainties to ensure that the tumor receives the prescribed dose.

Direct integration of imaging at the linear accelerator enables daily monitoring of patient positioning, tumor position, and alterations in patient anatomy. Image guided radiotherapy (IGRT) enables the detection and immediate correction of such deviations and increases the precision of delivery.

Adaptive radiotherapy has become an important strategy for serially modifying dose distributions in a manner that can substantially reduce OAR dose and subsequent toxicity, while maintaining adequate target coverage. Current adaptive protocols rely upon a standard CT-based workflow and (cone-beam) CT-based image guidance.

Magnetic Resonance Imaging (MRI) has superior soft-tissue contrast over CT and seems a very promising modality to integrate in the radiation treatment process, facilitating better visualization of the tumor and OAR during treatment.

Detailed Description

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The proposed protocol aims to determine feasibility of multiple new techniques and software for MR-guided adaptive radiation therapy. For each proposed technique feasibility has to be determined individually. A secondary aim is to prospectively collect data from cohorts of patients treated at the MRL and report on acute toxicity.

By including multiple parallel cohorts, the protocol will accelerate the technical development of MR-guided adaptive radiotherapy and the evidence-based introduction of the MRL into clinical practice.

Conditions

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Tumors at All Sites Which Will Receive Radiotherapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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MRL

radiotherapy on MR linac

Group Type OTHER

radiotherapy

Intervention Type RADIATION

multiple new techniques and software for MR-guided adaptive radiation therapy.

Interventions

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radiotherapy

multiple new techniques and software for MR-guided adaptive radiation therapy.

Intervention Type RADIATION

Other Intervention Names

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MR Linac

Eligibility Criteria

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Inclusion Criteria

* Patient, age ≥ 18 years, treated with radiation therapy on the MRL.
* WHO performance 0-2.
* Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

* Contra-indications for an MRI examination.
* Patient is pregnant.
* Claustrophobia.
* Patients \>140 kg and/or a body width \> 60 cm.
* Patients with any other clinically significant medical condition which, in the opinion of the treating physician, makes it undesirable for the patient to participate in the study or which could jeopardize compliance with study requirements or severe psychiatric illness/social situation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Elekta Limited

INDUSTRY

Sponsor Role collaborator

The Netherlands Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marlies Nowee, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

The Netherlands Cancer Institute

Locations

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Netherlands Cancer Institute

Amsterdam, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Marlies Nowee, MD, PhD

Role: CONTACT

+31 20 512 9111

Uulke vd Heide, PhD

Role: CONTACT

+31 20 512 9111

Facility Contacts

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Marlies Nowee, MD, PhD

Role: primary

+31 20 512 9111

Uulke vd Heide, PhD

Role: backup

+31 20 512 9111

References

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Bujold A, Craig T, Jaffray D, Dawson LA. Image-guided radiotherapy: has it influenced patient outcomes? Semin Radiat Oncol. 2012 Jan;22(1):50-61. doi: 10.1016/j.semradonc.2011.09.001.

Reference Type RESULT
PMID: 22177878 (View on PubMed)

De Los Santos J, Popple R, Agazaryan N, Bayouth JE, Bissonnette JP, Bucci MK, Dieterich S, Dong L, Forster KM, Indelicato D, Langen K, Lehmann J, Mayr N, Parsai I, Salter W, Tomblyn M, Yuh WT, Chetty IJ. Image guided radiation therapy (IGRT) technologies for radiation therapy localization and delivery. Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):33-45. doi: 10.1016/j.ijrobp.2013.02.021. Epub 2013 May 7. No abstract available.

Reference Type RESULT
PMID: 23664076 (View on PubMed)

Acharya S, Fischer-Valuck BW, Kashani R, Parikh P, Yang D, Zhao T, Green O, Wooten O, Li HH, Hu Y, Rodriguez V, Olsen L, Robinson C, Michalski J, Mutic S, Olsen J. Online Magnetic Resonance Image Guided Adaptive Radiation Therapy: First Clinical Applications. Int J Radiat Oncol Biol Phys. 2016 Feb 1;94(2):394-403. doi: 10.1016/j.ijrobp.2015.10.015. Epub 2015 Oct 17.

Reference Type RESULT
PMID: 26678659 (View on PubMed)

McPartlin AJ, Li XA, Kershaw LE, Heide U, Kerkmeijer L, Lawton C, Mahmood U, Pos F, van As N, van Herk M, Vesprini D, van der Voort van Zyp J, Tree A, Choudhury A; MR-Linac consortium. MRI-guided prostate adaptive radiotherapy - A systematic review. Radiother Oncol. 2016 Jun;119(3):371-80. doi: 10.1016/j.radonc.2016.04.014. Epub 2016 May 6.

Reference Type RESULT
PMID: 27162159 (View on PubMed)

Vestergaard A, Hafeez S, Muren LP, Nill S, Hoyer M, Hansen VN, Gronborg C, Pedersen EM, Petersen JB, Huddart R, Oelfke U. The potential of MRI-guided online adaptive re-optimisation in radiotherapy of urinary bladder cancer. Radiother Oncol. 2016 Jan;118(1):154-9. doi: 10.1016/j.radonc.2015.11.003. Epub 2015 Nov 26.

Reference Type RESULT
PMID: 26631646 (View on PubMed)

Other Identifiers

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NL 65953.031.18

Identifier Type: REGISTRY

Identifier Source: secondary_id

N18BREL

Identifier Type: -

Identifier Source: org_study_id

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