This study will evaluate the role of SBRT with the aim to reproduce high dose rate brachytherapy (HDR BT) dose distribution by means of external beam radiotherapy in the radical treatment in patients with LACC. The study will employ devices to accurately reproduce pelvic anatomy and mitigate target motion and will make use of real-time online tracking.
This is a phase I/II feasibility study of hypofractionated, image-guided Volumetric Modulated Arc Therapy (VMAT) Stereotactic Body Radiotherapy (SBRT) to LACC with the aim to reproduce HDR BT dose distribution by means of external beam radiotherapy in the radical treatment in patients with LACC. The study will employ devices to accurately reproduce pelvic anatomy and mitigate target motion and will make use of real-time online tracking. Eligible patients who consent to participate in the current study will receive 4 image-guided SBRT sessions to a prescription of 7 Gray per fraction to the LACC (HR-CTV) following whole pelvis external beam radiotherapy. SBRT will start within one week after whole pelvis external beam radiotherapy. The study will enroll a total of 30 patients. After treatment, patients will be followed-up at 1 month, at 3 months (+/- 1 week), at 6 months (+/- 4 weeks), and then every 6 months (+/- 6 weeks) until the end of the 3rd year, then annually until the 5th year. The equivalence of outcome and toxicity will be measured by comparing the data obtained in the study to literature data regarding the standard modality of brachytherapy. Patients' oncological outcomes, toxicity and quality of life data will be reported.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
SBRT to reproduce HDR BT dose distribution in non-operated patients LACC
Champalimaud Foundation
Lisbon, Portugal
RECRUITINGDosimetric Feasibility of SBRT boost
Fulfillment of protocol dosimetrical endpoints and constraints
Time frame: through study completion, an average of 3 year
reproducibility of SBRT boost
anatomical accuracy will be confirmed with image guided (CBCT) and online tracking will guarantee a limit of 2mm threshold
Time frame: Accuracy of treatment delivery will be measured during the 15 minutes of treatment delivery time
Inter/intra fractional target motion
3D deviations recorded in CBCT images and electromagnetic recording
Time frame: during the 15 minutes of treatment delivery time
Adverse Events
Treatment related side effects based on CTCAE V5.0
Time frame: through study completion, an average of 3 years
Local control
Free from loco-regional relapse
Time frame: through study completion, an average of 3 years
Quality of life metrics
Change from baseline in European Organisation for Research and Treatment of Cancer quality of life questionnaire C30
Time frame: through study completion, an average of 3 years
Quality of life metrics
Change from baseline in European Organisation for Research and Treatment of Cancer quality of life questionnaire N24
Time frame: through study completion, an average of 3 years
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Distant Relapse
Free from distant relapse
Time frame: through study completion, an average of 3 years