3-Dimensional Conformal Radiation Therapy in Treating Patients With Bladder Cancer Who Have Undergone Transurethral Resection of the Bladder

August 23, 2013 updated by: Institute of Cancer Research, United Kingdom

Image Guided Dose Escalated Adaptive Bladder Radiotherapy

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue.

PURPOSE: This phase I trial is studying the side effects and best dose of 3-dimensional conformal radiation therapy in treating patients with bladder cancer who have undergone transurethral resection of the bladder.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

OBJECTIVES:

Primary

  • To determine the maximum-tolerated dose of external-beam radiotherapy delivered as a tumor boost in patients who have undergone prior transurethral bladder resection for muscle-invasive carcinoma of the bladder.

Secondary

  • To document progression-free survival and overall survival of these patients.
  • To evaluate patterns of recurrence and bladder preservation rates following dose-escalated radiotherapy in these patients.
  • To determine the impact of acute and late toxicity on quality of life in these patients.
  • To assess the use of gold seeds for tumor boost delineation in these patients.
  • To evaluate the use of virtual cystoscopy tumor localization in these patients.
  • To assess coverage of the phase II radiotherapy boost volume on the daily cone-beam images.
  • To assess coverage of the phase III radiotherapy volume on cone-beam images with selected adaptive strategy.
  • To evaluate the use of diffusion-weighted MRI (dwMRI) scans in assessing response to radiotherapy.

OUTLINE: This is a dose-escalation study.

Patients undergo a rigid cystoscopy and gold-seed insertion, if clinically appropriate. Approximately 3-5 seeds are inserted into the bladder wall to demarcate the maximum extent of visible tumor or tumor bed via a customized introducer. All patients undergo 3-dimensional conformal radiotherapy once daily, 5 days per week during weeks 1 and 4-7 and once daily, 4-6 days per week during weeks 2 and 3, using a combination of image-guided radiotherapy techniques and a partial bladder radiotherapy boost.

Patients complete quality-of-life questionnaire QOL-30 at baseline, 1 and 3 months, and then annually after completion of study treatment.

After completion of study treatment, patients are followed up at 4, 8, and 12 weeks, every 6 months for 3 years, and then annually for 2 years.

Study Type

Interventional

Enrollment (Anticipated)

60

Phase

  • Phase 1

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

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

DISEASE CHARACTERISTICS:

  • Histologically confirmed invasive bladder carcinoma, including the following cellular types:

    • Adenocarcinoma
    • Transitional cell carcinoma
    • Squamous cell carcinoma

  • Clinical stage G1-3, pT2a-4 disease

    • Localized disease
    • No bone or visceral metastases
    • No lymph node metastases
  • Has undergone maximal transurethral resection of the bladder tumor and planning to receive radical radiotherapy

PATIENT CHARACTERISTICS:

  • WHO performance status 0-1
  • Hemoglobin > 10 g/dL
  • WBC > 3,000/mm^3
  • Platelet count > 150,000/mm^3
  • Creatinine < 120 μmol/L
  • Bilirubin < 1.5 times upper limit normal (ULN)
  • AST < 1.5 times ULN
  • Alkaline phosphatase < 1.5 times ULN
  • Not pregnant
  • No inflammatory bowel disease or other significant small bowel disease
  • Physically fit for radical radiotherapy
  • No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule

  • No other malignancy within the past 2 years except adequately treated basal cell carcinoma of the skin or adequately treated carcinoma in situ of the cervix uteri

    • Prior superficial transitional cell carcinoma of the bladder allowed

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior pelvic surgery
  • No bilateral hip replacements compromising accurate radiotherapy planning
  • No prior radiotherapy to the pelvis

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
  • Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Maximum-tolerated dose

Secondary Outcome Measures

Outcome Measure
Progression-free survival
Overall survival
Quality of life
Bladder preservation rates
Acute and late toxicity and safety profile
Tumor boost volumes delineated with and without gold seeds
Dose-volume histogram analysis of PTV2 and PTV3 coverage
Change in diffusion coefficient between pre- and post-radiotherapy dwMRI scans

Collaborators and Investigators

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

Sponsor

Institute of Cancer Research, United Kingdom

Investigators

  • Principal Investigator: Robert A. Huddart, MD, Royal Marsden NHS Foundation Trust

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

May 1, 2009

Primary Completion (Anticipated)

April 1, 2016

Study Registration Dates

First Submitted

May 14, 2010

First Submitted That Met QC Criteria

May 14, 2010

First Posted (Estimate)

May 17, 2010

Study Record Updates

Last Update Posted (Estimate)

August 26, 2013

Last Update Submitted That Met QC Criteria

August 23, 2013

Last Verified

February 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CDR0000671670
  • ICR-IDEAL
  • EU-21035
  • CCR-3217
  • MREC-09/H0801/40

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.

Clinical Trials on Bladder Cancer

Clinical Trials on diffusion-weighted magnetic resonance imaging

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Ukraine

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe