Sim-Free Ethos: Feasibility of Same-Day Phantom-Based Adaptive Palliative Radiotherapy (SPRINT)

November 3, 2026 updated by: University Health Network, Toronto

A Prospective, Phase II, Single-Arm Feasibility Study of Same-Day, Simulation-Free, Phantom-Based Online Adaptive Palliative Radiation

This study evaluates same-day, simulation-free adaptive palliative radiotherapy using an online adaptive radiotherapy platform. The study will assess whether image-guided adaptive radiotherapy can be safely and feasibly delivered within a single day for patients requiring palliative radiation treatment. Participants will receive either a single radiation fraction (8 to 20 Gy) or a hypofractionated regimen (25 to 40 Gy in 3 to 5 fractions), based on clinical requirements. The complete treatment workflow, including consultation, consent, adaptive planning, and treatment delivery, will be completed on the same day. The primary outcome is feasibility, defined as successful generation and delivery of a clinically acceptable adaptive treatment plan on the day of consultation. Secondary outcomes include workflow efficiency, acute toxicity, patient-reported outcomes, patient satisfaction, treatment tolerability, and dosimetric comparison between adaptive plans and standard institutional SBRT benchmarks. Approximately 40 participants will be enrolled and followed for up to 12 months.

The study hypothesizes same-day, simulation-free online adaptive palliative radiotherapy is feasible and safe, allowing timely delivery of clinically acceptable treatment plans without compromising treatment quality or patient experience.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
40

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • 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 Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5G 2M9
        • Princess Margaret Cancer Center
        • Contact:

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

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adults aged 18 years or older
  • ECOG performance status of 0 to 2 at baseline
  • Patients who are candidates for palliative radiotherapy
  • Patients must have lesions suitable for treatments within the prescribed dose range
  • Patients who are able to provide informed consent
  • Patients who are available for follow-up for at least one month after treatment (interested individuals will be asked in person)

Exclusion Criteria:

  • Prior radiotherapy precluding safe re-irradiation
  • Pregnancy
  • Comorbidities that can increase radiation risk (such as scleroderma or ataxia-telangiectasia)
  • Inability to tolerate supine positioning for approximately thirty minutes

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: Supportive Care
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Same-Day Simulation-Free Adaptive Palliative Radiotherapy
Radiation: Simulation-Free Online Adaptive Palliative Radiotherapy

Phantom-Based online adaptive radiotherapy delivered without a conventional simulation appointment. Treatment planning is generated using image-guided adaptive workflows on the day of consultation to enable same-day delivery of palliative radiotherapy. Radiation dose ranges from 8 to 20 Gy in a single fraction or 25 to 40 Gy delivered in 3 to 5 fractions, according to lesion location, target size, and normal tissue constraints.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Feasibility of Same-Day Simulation-Free Adaptive Palliative Radiotherapy
Time Frame: Baseline through 12 months

Defined as the proportion of participants for whom a clinically acceptable adaptive radiotherapy plan meeting predefined clinical goal variations is successfully generated and delivered on the same day as consultation. Feasibility will be expressed as a proportion with an exact 95% confidence interval. A success rate of ≥85% will be considered evidence that same-day adaptive radiotherapy is implementable in clinical practice.
Baseline through 12 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Workflow Duration
Time Frame: Day of treatment

Time required to complete the simulation-free adaptive radiotherapy workflow, including consultation, consent, treatment planning, and treatment delivery. Workflow interruptions and causes of delays will also be documented.
Day of treatment
Acute Treatment-Related Toxicity
Time Frame: Baseline through 12 months

Incidence and severity of treatment-related adverse events assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 6.0. Toxicities will be summarized by grade, higher grades indicate worse outcomes
Baseline through 12 months
Change in Pain Severity
Time Frame: Baseline through 12 months

Pain will be assessed using the Brief Pain Inventory-Short Form (BPI-SF). Scales ranging from 0 to 10, where 0 indicates no pain/no interference and 10 indicates the worst pain imaginable or complete interference with daily activities. Higher scores indicate worse pain and greater pain-related interference. Changes in pain scores and analgesic use will be evaluated over time.
Baseline through 12 months
Change in Quality of Life
Time Frame: Baseline through 12 months

Quality of life will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Palliative Care (EORTC QLQ-C15-PAL). For the Global Quality of Life and Functional Scales, higher scores indicate better quality of life or functioning. For the Symptom Scales, higher scores indicate greater symptom burden and worse outcomes.
Baseline through 12 months
Patient Satisfaction With Same-Day Adaptive Radiotherapy
Time Frame: Day of treatment

Patient satisfaction will be assessed using a study-specific questionnaire evaluating treatment tolerability, comfort, communication, and overall experience with the same-day adaptive radiotherapy process.
Day of treatment

Collaborators and Investigators

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

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University Health Network, Toronto

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)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 3, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 9, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 25-6037

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.

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