Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy (IMPT) in Recurrent Rectal Cancer

NCT ID: NCT04827732

Last Updated: 2025-09-29

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-04

Study Completion Date

2024-11-18

Brief Summary

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The purpose of this trial is to determine the maximum tolerated dose (MTD) of hypofractionated IMPT for the reirradiation of locoregionally recurrent rectal cancer.

Detailed Description

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Conditions

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Recurrent Rectal Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Level 1: Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy (IMPT)

* Radiotherapy will consist of five fractions, delivered once daily, with pencil beam scanning proton beam therapy using the defined dose in dose level 1 (30 Gy).
* The use of Intensity Modulated Radiation Therapy (IMRT) with photon beam therapy is permitted at the discretion of the treating investigator in order to avoid extended treatment delays due to logistical reasons (e.g. machine downtime).

Group Type EXPERIMENTAL

Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy

Intervention Type RADIATION

When feasible it is strongly recommended that radiotherapy begin on a Monday

MEVION S250i Hyperscan and Adaptive Aperture Proton Therapy Machine

Intervention Type DEVICE

-The device that will administer the IMPT

Dose Level 2: Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy (IMPT)

* Radiotherapy will consist of five fractions, delivered once daily, with pencil beam scanning proton beam therapy using the defined dose in dose level 2 (35 Gy).
* The use of Intensity Modulated Radiation Therapy (IMRT) with photon beam therapy is permitted at the discretion of the treating investigator in order to avoid extended treatment delays due to logistical reasons (e.g. machine downtime).

Group Type EXPERIMENTAL

Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy

Intervention Type RADIATION

When feasible it is strongly recommended that radiotherapy begin on a Monday

MEVION S250i Hyperscan and Adaptive Aperture Proton Therapy Machine

Intervention Type DEVICE

-The device that will administer the IMPT

Dose Level 3: Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy (IMPT)

* Radiotherapy will consist of five fractions, delivered once daily, with pencil beam scanning proton beam therapy using the defined dose in dose level 3 (40 Gy).
* The use of Intensity Modulated Radiation Therapy (IMRT) with photon beam therapy is permitted at the discretion of the treating investigator in order to avoid extended treatment delays due to logistical reasons (e.g. machine downtime).

Group Type EXPERIMENTAL

Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy

Intervention Type RADIATION

When feasible it is strongly recommended that radiotherapy begin on a Monday

MEVION S250i Hyperscan and Adaptive Aperture Proton Therapy Machine

Intervention Type DEVICE

-The device that will administer the IMPT

Dose Level -1: Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy (IMPT)

* Radiotherapy will consist of five fractions, delivered once daily, with pencil beam scanning proton beam therapy using the defined dose in dose level -1 (25 Gy).
* The use of Intensity Modulated Radiation Therapy (IMRT) with photon beam therapy is permitted at the discretion of the treating investigator in order to avoid extended treatment delays due to logistical reasons (e.g. machine downtime).

Group Type EXPERIMENTAL

Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy

Intervention Type RADIATION

When feasible it is strongly recommended that radiotherapy begin on a Monday

MEVION S250i Hyperscan and Adaptive Aperture Proton Therapy Machine

Intervention Type DEVICE

-The device that will administer the IMPT

Interventions

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Hypofractionated Pencil-Beam Scanning Intensity-modulated Proton Therapy

When feasible it is strongly recommended that radiotherapy begin on a Monday

Intervention Type RADIATION

MEVION S250i Hyperscan and Adaptive Aperture Proton Therapy Machine

-The device that will administer the IMPT

Intervention Type DEVICE

Other Intervention Names

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IMPT

Eligibility Criteria

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Inclusion Criteria

* History of biopsy-proven adenocarcinoma of the rectum, anus or rectosigmoid junction of any stage now with recurrent disease in the pelvis
* One prior course of radiation therapy to the pelvis for rectal cancer
* ECOG performance status 0-2
* At least 18 years of age
* Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
* Able to understand and willing to sign an IRB-approved written informed consent document.

Exclusion Criteria

* Patients with pre-existing radiosensitizing conditions, such as connective tissue disorders (i.e. lupus, scleroderma) and genetic mutations (i.e. ataxia-telangiectasia)
* A history of other malignancy with the exception of malignancies for which all treatment was completed at least 2 years before registration and the patient has no evidence of disease, basal cell or squamous cell carcinoma of the skin that were treated with local resection only, or carcinoma in situ of the cervix. Patients with history of prostate cancer treated without radiotherapy and no evidence of disease are eligible
* More than one prior course of radiation to the pelvis for rectal cancer
* Prior radiation to the pelvis for disease other than rectal cancer
* Tumor in the rectum/colon requiring radiation therapy to the full circumference of the rectum/colon.
* Current treatment with any investigational agents.
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, or unstable angina pectoris
* Pregnant and/or breastfeeding. Women of childbearing potential must have a negative urine or serum pregnancy test within 14 days of study entry.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Waters, M.D.

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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http://www.siteman.wustl.edu

Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

Other Identifiers

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202103218

Identifier Type: -

Identifier Source: org_study_id

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