Radical Radiotherapy Versus Radical Surgery for UTUC

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

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-01

Study Completion Date

2029-12-30

Brief Summary

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This study is a prospective cohort study, and the proposed plan is to recruit 30 patients with radical radiotherapy for renal pelvic ureteral cancer, according to the actual clinical situation, enrolling the same period of time to choose the operation of the elderly, combined with the risk of anaesthesia or regional lymph node metastasis of the patients, initially tentatively set at 60. The patients were divided into the surgery group and radiotherapy group according to the actual choice of treatment. In the control group, standard nephroureterectomy was used, and in the experimental group, stereotactic body radiation therapy (SBRT) or moderately segmented radical radiotherapy was used.

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Detailed Description

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1\) No lymph node metastasis Choose SBRT radiotherapy as much as possible Tumour PTV 50Gy/10f; if the tumour is close to the intestine, the radiotherapy dose can be appropriately reduced 40-50Gy/8-10f; to ensure intestinal safety 2）With regional lymph node metastasis Renal pelvis tumour: tumour PGTV 62.5Gy/25f; for tumour larger than 3cm P-SBRT radiotherapy is feasible, SBRT 18-24Gy/3-4f; Affected kidney + para-abdominal aorta + common iliac lymph node drainage area 47.5Gy/25f; metastatic lymph nodes 62.5Gy/25f.

3\) Routinely segmented normal tissue limits are as follows: Contralateral kidney V20\<15% Dmean 15Gy Duodenum Dmax\<50Gy Jejunum/ileum/colon V50\<5% Dmax\<52Gy Spinal cord Damx \<40Gy Liver At least 700cc volume should receive a dose \<25Gy

SBRT segmentation Normal tissue limits are as follows:

Duodenum Dmax\<32Gy; V18\<5cc Jejunum/ileum/colon Dmax\<35Gy; V19.5\<5cc Stomach Dmax\<32Gy; V18\<5cc (4) Short-term efficacy judgement: 1 month after radiotherapy to review imaging, short-term efficacy based on RECIST1.1 criteria, partial remission (PR partial regression) or complete remission (CR complete regression); disease-free survival is defined as the period after treatment to the emergence of recurrence in the radiotherapy field, intra-urethral recurrence (except bladder recurrence) or Regional lymph node metastases at first recurrence.

Conditions

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Renal Pelvis Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Radical surgery group

Patients undergo radical nephroureterectomy

Radical nephroureterectomy

Intervention Type OTHER

Radical nephroureterectomy

Radical radiotherapy cohort

Patients undergo radical radiotherapy with stereotactic body radiation therapy (SBRT) or moderately segmented radiotherapy

Radical radiotherapy

Intervention Type RADIATION

Radical radiotherapy with stereotactic body radiation therapy (SBRT) or moderately segmented radiotherapy

Interventions

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Radical nephroureterectomy

Intervention Type OTHER

Radical radiotherapy

Radical radiotherapy with stereotactic body radiation therapy (SBRT) or moderately segmented radiotherapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Uroepithelial carcinoma of the renal pelvis or ureter supported by clinical symptoms, imaging, histopathology, urocytology, or fluorescence in situ hybridisation (FISH), or those who satisfy FISH positivity despite the absence of pathology or the patient's refusal to be punctured and who are judged to have a renal pelvic or ureteral carcinoma by an imaging physician and a urologist on the basis of CTU or MRU or PETCT; No distant metastases were detected on full screening; Patients who are unable to undergo surgical treatment due to poor general condition, inability to be anaesthetised or to tolerate surgery, or refusal to undergo surgery; patients who are over 70 years old; or patients who are less than 70 years old combined with underlying diseases or the presence of regional lymph node metastasis, etc. who are otherwise unable to undergo radical surgery; Expected survival ≥ 6 months; Willingness and ability to comply with trial and follow-up procedural arrangements; voluntarily agree to participate in the study and sign an informed consent form.

Exclusion Criteria

* Previous abdominopelvic radiotherapy; Other serious, uncontrolled concomitant disease that may affect adherence to the protocol or interfere with interpretation of results; Other malignancies within 5 years prior to the start of study dosing, with the exception of malignancies that can be expected to resolve with treatment (including, but not limited to, adequately treated thyroid cancer, cervical cancer in situ, basal or squamous cell skin cancer, or ductal carcinoma in situ of the breast treated by radical surgery); estimated that patients' adherence to participation in this clinical study was insufficient.

Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No