Contribution of Multicenter Expertise and Deformable Fusion Software for Re-irradiations With Curative Intent

NCT ID: NCT06668038

Last Updated: 2024-10-31

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-01

Study Completion Date

2029-02-01

Brief Summary

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We propose to evaluate the contribution of a standardized process combining,

* a validation of re-irradiation indications by a group of multi-professional experts (radiotherapists and physicists) and,
* a collective validation of the accumulation of doses on all the organs of the anatomical region concerned obtained using deformable fusion software (MiM) allowing the accumulation of doses in terms of Equivalent Dose 2 Grays (EQD2).

The primary objective of this study is to determine the rate of patients for whom this process has changed the treatment plan.

Detailed Description

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Recent clinical data confirm the possibility and clinical benefit of delivering a second irradiation with curative intent even if the commonly accepted maximum doses to OARs had been reached during the first irradiation.

However, there is no consensus on acceptable doses to AORs in a re-irradiation context. The difficulty of making decisions and validating dosimetry may limit access to treatment. Re-irradiations are therefore carried out according to local experience and equipment, resulting in territorial inequality.

MiM software is an innovative software dedicated to images registration and dose summation. It allows the EQD2 doses of the various irradiations to be cumulated.

Recruitment and inclusion step: For each included patient (signed consent form), the center provides an initial opinion concerning the indication for re-irradiation with curative intent (Opinion 1).

Indication and pre-dosimetric study step:

* If re-irradiation with curative intent Is not feasible according to the center: timages of the 1st irradiation and recent diagnosis images will be sent to Centre Léon Bérard (CLB), merged into MIM by physicists, and the indication is discussed in a multidisciplinary meeting (Opinion 2).
* If re-irradiation with curative intent is feasible according to the center: CT + RT structures+doses of 1st irradiation and dosimetric scan of the 2nd irradiation will be sent to CLB, merged into MIM. Multidisciplinary meeting will deliver the Opinion 3 with dosimetric instructions for the new irradiation, in particular OARs doses constraints.

Study withdrawal if the indication for re-irradiation is not validated.

Cumulative doses validation step:

CT + RT structures+doses of the planned re-irradiation will be sent to CLB and EQD2 doses will be summed into MIM. If cumulative doses are accepted by consensus, multidisciplinary meeting will deliver the Opinion 4. Otherwise the center will have to do a new planimetry.

Patients for whom re-irradiation with curative intent has been declared possible will be followed for 2 years according to standard practices, approximately every 3 months and analyzed for tolerance and efficiency.

Conditions

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Re-irradiation Radiotherapy

Keywords

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Re-irradiation Radiotherapy Equivalent dose 2 grays Feasibility Cumulative doses

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Multidisciplinary and multicenter validation of re-irradiation with curative intent

Validation by a multicenter group of multi-professional experts (radiotherapists and physicists) of:

* re-irradiation indication
* EQD2 cumulated doses using MiM

Group Type EXPERIMENTAL

Multidisciplinary and multicenter validation of re-irradiation with curative intent

Intervention Type OTHER

Validation in multidisciplinary and multicenter meeting of re-irradiation indication after review of technical data (images, structures and doses) of 1st irradiation and recent diagnosis images of the lesion to be irradiated, merged using MIM.

In case of re-irradiation validation, validation in multidisciplinary and multicenter meeting of cumulated doses after review of EQD2 doses summation using MIM.

Interventions

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Multidisciplinary and multicenter validation of re-irradiation with curative intent

Validation in multidisciplinary and multicenter meeting of re-irradiation indication after review of technical data (images, structures and doses) of 1st irradiation and recent diagnosis images of the lesion to be irradiated, merged using MIM.

In case of re-irradiation validation, validation in multidisciplinary and multicenter meeting of cumulated doses after review of EQD2 doses summation using MIM.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years when signing the consent form
* Re-irradiation with desired curative intent (≥ 50 Gy EQD2), with volume to be irradiated totally or partially included in a previous irradiation field:

* Oligo-metastases or oligo-progression (\< 5 metastases in less than 3 sites)
* Second non-metastatic cancer
* Isolated local recurrence
* Life expectancy \> 6 months
* Dated and signed informed consent
* Affiliation to a social security scheme or equivalent

Exclusion Criteria

* Indication of intracranial, prostate, rectum or esophagus re-irradiation
* Diagnosis of multi-metastatic cancer
* PS ECOG ≥ 2
* Impossibility to interrupt current treatment with a tyrosine kinase inhibitor or other systemic treatment (excluding hormonal therapy) which may potentiate the rays effects (duration of wash-out according to treatment instructions)
* Pregnant or breastfeeding women
* Tutorship or curatorship or deprivation of liberty
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Leon Berard

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marie-Pierre SUNYACH

Role: PRINCIPAL_INVESTIGATOR

Centre Leon Berard

Cécile LAUDE

Role: PRINCIPAL_INVESTIGATOR

Centre Leon Berard

Locations

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Institut de Cancerologie de L'Ouest

Angers, , France

Site Status

Ch Bourg En Bresse

Bourg-en-Bresse, , France

Site Status

Centre Georges Francois Leclerc

Dijon, , France

Site Status

Chu Grenoble Alpes

Grenoble, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Aphp Marseille Chu Timone Et Hopital Nord Marseille

Marseille, , France

Site Status

Centre Antoine Lacassagne

Nice, , France

Site Status

Institut de Cancerologie de L'Ouest

Saint-Herblain, , France

Site Status

Centre Marie Curie

Valence, , France

Site Status

Centre de Radiotherapie Du Beaujolais

Villefranche-sur-Saône, , France

Site Status

Countries

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France

Central Contacts

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Marie-Pierre SUNYACH, MD

Role: CONTACT

Phone: 0426556778

Email: [email protected]

Facility Contacts

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Augustin MERVOYER

Role: primary

Vardouhie KARAHISSARLIAN-ROBIN

Role: primary

Etienne MARTIN

Role: primary

Camille VERRY

Role: primary

Marie-Pierre SUNYACH

Role: primary

Laeticia PADOVANI

Role: primary

Jérôme DOYEN

Role: primary

Augustin MERVOYER

Role: primary

Jean-Baptiste GUY

Role: primary

Cécile LAUDE

Role: primary

Other Identifiers

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ADERE (ET23-390)

Identifier Type: -

Identifier Source: org_study_id