Postoperative Hypofractionated Radiation in Cervical and Endometrial Tumours: Phase II Study

NCT ID: NCT05857631

Last Updated: 2025-04-15

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

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-29

Study Completion Date

2029-05-25

Brief Summary

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The primary aim of the trial is to investigate the late effects of hypofractionated external radiation (39 Gy in 13 fractions) in patients requiring post-operative radiation for early-stage cervical and endometrial cancers.

Detailed Description

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This is a phase II prospective study that will be accruing patients with post operative cervical or endometrial cancer requiring adjuvant pelvic radiation.

External beam radiotherapy (Intensity modulated radiotherapy/arc technique) will be delivered to pelvis to a dose of 39 Gray (Gy) in 13 fractions at 3 Gy per fraction, delivered once daily over 2.5 - 3 weeks. Treatment will be delivered with Intensity Modulated Radiotherapy (IMRT) under image guidance. Patients for whom concurrent chemotherapy is indicated (as per adverse risk features) will receive concurrent weekly cisplatin (40mg/m2) based on standard institutional protocol. All patients with post-operative cervical cancer will receive vaginal brachytherapy after the completion of external beam radiation. Patients with endometrial cancer with certain pre defined risk factors will also receive vaginal brachytherapy. The dose of vaginal brachytherapy will be 6 Gy high dose rate brachytherapy delivered as two different fractions, one week apart. Patients will be evaluated by the concerned investigators on a weekly basis during radiation therapy and all the toxicities will be documented according to the CTCAE V 5.0.

Patients will be followed up 3 monthly for the first 2 years, then 6 monthly from years 2 - 5, and annually thereafter. CTCAE version 5 will be used for toxicity grading at each follow-up. Quality of life assessment will be performed at baseline prior to the start of radiation and on follow-up at pre-specified times using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and Cervix - 24 (CX24) for cervical cancer patients and Endometrium 24 (EN24) for endometrial cancer patients.

Conditions

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Cervical Cancer Endometrial Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single-arm, open-label phase II trial investigating the cumulative incidence of late grade ≥2 gastro-intestinal or genito-urinary toxicities in patients receiving adjuvant hypofractionated external beam radiotherapy to the pelvis for post-operative cervical or endometrial cancer.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Hypofractionated Image guided External Beam Radiation

Adjuvant hypofractionated external beam radiotherapy for post operative patients with cervical or endometrial cancer.

Group Type EXPERIMENTAL

Hypofractionated Image guided External Beam Radiation Therapy (EBRT)

Intervention Type RADIATION

External beam radiotherapy to pelvis:

Post operative hypofractionated external beam radiotherapy with intensity modulated/arc technique, to a dose of 39 Gy in 13 fractions, at 3 Gy per fraction, delivered once daily, 5 days a week, over 2.5-3 weeks.

Cisplatin

Intervention Type DRUG

Patients who require adjuvant chemotherapy along with radiation, based on predefined risk features, will receive 5 cycles of cisplatin on a weekly basis with a dose of 40 mg/m2 by IV infusion over a period of 1 hour 2-4 hours prior to start of EBRT.

Vaginal brachytherapy

Intervention Type RADIATION

Vaginal brachytherapy, two fractions of 6 Gy each, delivered 1 week apart.

Interventions

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Hypofractionated Image guided External Beam Radiation Therapy (EBRT)

External beam radiotherapy to pelvis:

Post operative hypofractionated external beam radiotherapy with intensity modulated/arc technique, to a dose of 39 Gy in 13 fractions, at 3 Gy per fraction, delivered once daily, 5 days a week, over 2.5-3 weeks.

Intervention Type RADIATION

Cisplatin

Patients who require adjuvant chemotherapy along with radiation, based on predefined risk features, will receive 5 cycles of cisplatin on a weekly basis with a dose of 40 mg/m2 by IV infusion over a period of 1 hour 2-4 hours prior to start of EBRT.

Intervention Type DRUG

Vaginal brachytherapy

Vaginal brachytherapy, two fractions of 6 Gy each, delivered 1 week apart.

Intervention Type RADIATION

Other Intervention Names

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Radiotherapy Chemotherapy Brachytherapy

Eligibility Criteria

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Inclusion Criteria

1. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
2. Histologically confirmed diagnosis of cervical cancer post hysterectomy with intermediate or high-risk features, requiring adjuvant EBRT ± concurrent chemotherapy OR histologically confirmed diagnosis of endometrial cancer post hysterectomy requiring adjuvant (chemo)radiotherapy to pelvis with/without vaginal brachytherapy.

Exclusion Criteria

1. Patients with macroscopic residual disease (R+ resection) postoperatively
2. Patients requiring extended field radiotherapy (patients with involved para-aortic lymph nodes in cervical or endometrial cancer)
3. Patients treated with chemotherapy for any prior malignancy at any time
4. Patients treated with pelvic radiation previously
5. Patients with human immunodeficiency virus infection
6. Any preexisting medical conditions that may interfere with the assessment of genitourinary or gastrointestinal toxicity (This includes patients with irritable bowel syndrome, subacute intestinal obstruction, anal incontinence, hemorrhoids precluding analysis of gastro-intestinal toxicities, urinary incontinence, recurrent urinary tract infections)
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Tata Memorial Centre

OTHER

Sponsor Role lead

Responsible Party

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Prachi Mittal, MD, Radiation Oncology

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dr. Prachi D Mittal, MD

Role: PRINCIPAL_INVESTIGATOR

Tata Memorial Hospital

Locations

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Advanced Centre for Treatment Research and Education in Cancer (ACTREC)

Navi Mumbai, Maharahstra, India

Site Status RECRUITING

Tata Memorial Hospital

Mumbai, Maharashtra, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Dr. Prachi D Mittal, MD

Role: CONTACT

+91 9004938871

Facility Contacts

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Prachi Mittal, MD

Role: primary

+912224177000 ext. 7033

Prachi Mittal, MD

Role: primary

+912224177000 ext. 7033

Other Identifiers

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CTRI/2023/02/050123

Identifier Type: REGISTRY

Identifier Source: secondary_id

3910

Identifier Type: -

Identifier Source: org_study_id

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