High Dose Radiotherapy for Palliation (Hi-D)

August 10, 2026 updated by: British Columbia Cancer Agency

A Prospective Study of High Dose Radiotherapy for Palliation: Hi-D

Palliative radiation is effective for controlling or preventing symptoms such as pain, bleeding, dyspnea, and cord compression. Recently, studies have shown that additional dose escalation may result in superior local control. The investigators propose a phase II single arm trial to evaluate a novel high-dose radiation regimen, which will be 27 Gray in 3 fractions with dose escalation within the tumour (Hi-D).

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is being done to see if a new palliative radiotherapy technique can prevent growth or shrink tumors that are bigger than 5cm, for a longer period of time than traditional palliative radiotherapy. The main outcome the investigators are measuring is called "local control"- this refers to how long the treatment is able to stop a cancer from growing. With traditional palliative radiotherapy, radiation is given in smaller doses over multiple, (usually 5 or 10) treatments (called fractions), and the radiation is spread evenly around the tumor. Radiation dose is measured in Gray (Gy). Generally, standard of care/traditional palliative radiotherapy is given as 20 Gy in 5 fractions or 30 Gy in 10 fractions. The new palliative radiotherapy technique the investigators are testing gives a similar radiation dose overall of 27 Gy but gives much higher doses per fraction in only 3 fractions and uses cutting edge technology to concentrate most of the radiation to the center of the tumor. This means that compared to traditional palliative radiotherapy, there is a higher amount of radiation dose that the participant's body and the particularly the center of the tumor is receiving over a shorter period of time. This means a more aggressive treatment for the participants cancer but can also cause an increased risk for side effects. However, because the investigators will concentrate the high doses of radiation only in the center of the tumor, nearby organs do not get too close to the high doses and are spared. The investigators expect that this technique will be as safe as traditional palliative radiotherapy and have a longer duration of effectiveness (longer local control) compared to the older techniques.

Study Type

Interventional

Enrollment (Estimated)

21

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • British Columbia
      • Vancouver, British Columbia, Canada

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

5.1. Inclusion Criteria

Subjects must meet all of the following criteria to be eligible for participation in this study:

  • Age 18 or older.
  • Able to provide informed consent
  • Patient has histologically confirmed solid tumour malignancy
  • ECOG performance status 0 - 2
  • Life Expectancy > 6 months
  • Locally advanced or metastatic disease with 1-3 target lesions larger than 5cm in minimum dimension, with no more than 2 target lesions in a single organ; patients can have any number of non-target lesions
  • A history and physical exam, including ECOG performance status, performed within 6 weeks prior to trial enrollment
  • Not suitable for or declined curative-intent treatment
  • Subject has had a CT chest, abdomen and pelvis or PET-CT within 8 weeks prior to enrollment, and with 12 weeks of treatment
  • MRI spine for patients receiving RT to vertebral or paraspinal metastases
  • Patient is judged able to:
  • Maintain a stable position during therapy
  • Tolerate immobilization device(s) that may be required to deliver radiation safely

5.2. Exclusion Criteria

Subjects are excluded from the study if any of the following criteria apply:

  • Hematologic malignancy
  • Disease limited to intracranial sites
  • Serious medical co-morbidities precluding radiotherapy
  • Prior radiation to target lesion that precludes delivery of repeat radiation. All such cases should be discussed with the local and study PIs.
  • Pregnant people

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: High-Dose RT
27Gy in 3 fractions with boost
standard dose RT
high-dose RT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Local Control
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up
to determine the length of time from treatment to tumor growth, recurrence, or progression at radiated sites achieved when using high-dose palliative radiotherapy
4 years, with 2 years of accrual and 2 years of follow up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall Survival
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up.
Time from treatment to death from any cause, or date of last follow-up, whichever occurs first.
4 years, with 2 years of accrual and 2 years of follow up.
Progression-Free Survival
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up
Time from treatment to disease progression at any site or death.
4 years, with 2 years of accrual and 2 years of follow up
Side Effects
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up.
determine side effects from the proposed radiotherapy treatment
4 years, with 2 years of accrual and 2 years of follow up.
Local treatment-free survival
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up
Defined as time from treatment to progression beyond next line of local therapy or death from any cause or date of last follow-up, whichever occurs first.
4 years, with 2 years of accrual and 2 years of follow up
systemic intensification-free survival
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up
Time from treatment to progression beyond next line of systemic therapy or death from any cause or date of last follow-up, whichever occurs first
4 years, with 2 years of accrual and 2 years of follow up
Patient reported Quality of Life
Time Frame: 4 years, with 2 years of accrual and 2 years of follow up.
Patient reported quality of life as measured by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire
4 years, with 2 years of accrual and 2 years of follow up.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Wei Liu, MD, FRCPC, BC Cancer - Vancouver

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 1, 2027

Primary Completion (Estimated)

July 1, 2030

Study Completion (Estimated)

August 31, 2030

Study Registration Dates

First Submitted

November 24, 2025

First Submitted That Met QC Criteria

December 5, 2025

First Posted (Actual)

December 18, 2025

Study Record Updates

Last Update Posted (Actual)

August 12, 2026

Last Update Submitted That Met QC Criteria

August 10, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • Hi-D

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.