Same-session MR-only Simulation and Treatment With MRI-guided Adaptive Palliative RadioTherapy

Washington University School of Medicine20 enrolled

Overview

This proposed study is unique in that patients will not undergo computed tomography (CT) simulation at any point during their treatment course and will instead have same-session magnetic resonance (MR)-only simulation and treatment planning, on-table, using the adaptive radiotherapy (ART) workflow. In this manner, patients requiring urgent treatment could initiate treatment as early as the day of initial radiation oncology consultation.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Malignancy Metastasis Hemoptysis Gastrointestinal Bleeding Pelvic Bleeding Superior Vena Cava Syndrome

Interventions

Volumetric MR imagingDEVICE

This will most frequently be supine with arms positioned so not in the way of treatment beams.

Radiation therapyRADIATION

-Standard of care

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of malignancy (biopsy proven or high clinical suspicion with urgent/emergent clinical indications for palliative RT) * Requires delivery of palliative radiation therapy for the treatment of painful metastasis, hemoptysis, gastrointestinal bleeding, pelvic bleeding, or superior vena cava syndrome/bulky mediastinal disease. * At least 18 years of age. * Able to understand and willing to sign an IRB-approved written informed consent document. Exclusion Criteria: * Pregnant. Patients of childbearing potential must have a negative pregnancy test within 14 days of study entry. * Medical contraindication to undergoing MR imaging.

Outcomes

Primary Outcomes

Feasibility of Same-session MRI-only Simulation as Defined as More Than 70% of Patients Receiving at Least 70% of Their Scheduled Treatment Fractions on the First On-table Attempt for Each Respective Fraction.

Time frame: Completion of enrollment (approximately 29 months)