Individual Approach in Gynecological Cancer Brachytherapy

July 15, 2026 updated by: Institute of Oncology Ljubljana

Development and Assessment of Individual 3D Printed Applicators in MRI Guided Gynecological Brachytherapy

MRI guided adaptive brachytherapy (BT) represents the gold standard in the treatment of gynecological cancers. Commercially available standard MRI compatible applicators for BT of gynecological cancers don't always allow for optimal target volume coverage. Three-dimensional (3D) printed technology enables versatile possibilities of improvement of standard applicators and development of novel applicators with better coverage of the target volume. The purpose of this study is to implement and assess 3D printing technology as an instrument for designing and manufacturing applicators for individualized BT of gynecological cancers.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Patients with locoregionally gynecological cancers will be included in this single-institution, non-randomized, one-arm study. All patients will receive 45-50 Gy external beam radiotherapy (EBRT) with intensity-modulated radiotherapy/volumetric-modulated arc therapy (IMRT/VMAT) technique, 1.8-2 Gy/fraction +/- concurrent cisplatin based chemotherapy. First BT with commercially available standard applicators (tandem with ring +/- parallel needles or vaginal cylinder) will be carried out. MRI with applicator in situ will be performed, high-risk clinical target volume (CTV-HR) and organs at risk (OAR) will be delineated and treatment planning will be conducted. In the case of large gynecological cancer and suboptimal target coverage at BT (V100 ≤ 90%, D98 ≤ 80%, D90 ≤ 100%, D100 ≤ 60%) a preplan will be performed as the basis for the 3D applicator modelling. The next BT application will be performed with an individually designed 3D printed applicator. Dose-volume characteristics of the following treatment plans will be compared: the preplan, the plan with standard and the plan with individual 3D printed applicator.

The primary objective of the study is to determine the improvement of dose-volume parameters with the use of 3D printed individual applicators in advanced gynecological cancer.

Study Type

Interventional

Enrollment (Actual)

50

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 Locations

  • Slovenia
      • Ljubljana, Slovenia, 1000
        • Institute of Oncology Ljubljana

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 to 85 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • patients with locally advanced gynecological cancer (cervical, uterine, vaginal, vulvar cancer) eligible for treatment with brachytherapy
  • squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma, histologically proven
  • patients fit for regional or general anesthesia
  • signed written informed consent

Exclusion Criteria:

  • regional or general anesthesia contraindications
  • contraindications for MRI

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: Individualized 3D-Printed Brachytherapy Applicator
Participants with gynecological cancer and suboptimal target volume coverage using standard brachytherapy applicators receive MRI-guided brachytherapy using an individually designed 3D-printed applicator. Treatment plans generated with the standard and individualized applicators are compared within the same participant.
Device: Individualized 3D-Printed Brachytherapy Applicator
An individualized MRI-compatible brachytherapy applicator is designed based on the participant's anatomy, tumor location, high-risk clinical target volume, and preliminary treatment plan. The applicator is manufactured using 3D-printing technology and may include an add-on cap for oblique needles, an individualized Vienna-type applicator, or an individualized vaginal cylinder for intracavitary and interstitial brachytherapy. The aim is to improve target volume coverage while respecting dose constraints for organs at risk.
Other Names:
  • individual applicator

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Improvement in High-Risk Clinical Target Volume Coverage
Time Frame: During brachytherapy treatment planning, before delivery of the planned brachytherapy dose
Dose-volume parameters for the high-risk clinical target volume (HR-CTV) will be compared between treatment plans generated with a standard brachytherapy applicator and an individualized 3D-printed applicator within the same participant. Evaluated parameters include D90, D98, D100, and V100. The absolute and relative improvement achieved with the individualized applicator will be reported.
During brachytherapy treatment planning, before delivery of the planned brachytherapy dose
Number of Participants With Grade 3 or Higher Treatment-Related Toxicity
Time Frame: From the first brachytherapy procedure through 60 months after completion of treatment
Treatment-related toxicity involving the bladder, rectum, bowel, and vagina will be assessed using the Common Terminology Criteria for Adverse Events, version 3.0. The number and percentage of participants with new or worsening grade 3 or higher toxicity will be reported. Vaginal stenosis will be evaluated separately in accordance with the study protocol.
From the first brachytherapy procedure through 60 months after completion of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Dose to Organs at Risk
Time Frame: During brachytherapy treatment planning, before delivery of the planned brachytherapy dose
Dose-volume parameters for organs at risk will be compared between treatment plans generated with the standard and individualized 3D-printed applicators. Evaluated organs include the bladder, rectum, sigmoid colon, and small bowel. Parameters include D2cc, D0.1cc, and maximum dose, expressed in gray.
During brachytherapy treatment planning, before delivery of the planned brachytherapy dose
Local Tumor Control
Time Frame: From completion of treatment through 60 months
Local control is defined as the absence of persistent or recurrent disease at the anatomical site of the tumor identified on baseline magnetic resonance imaging. Local control will be assessed by clinical and gynecological examinations and by magnetic resonance imaging. The number and percentage of participants with local control will be reported.
From completion of treatment through 60 months

Collaborators and Investigators

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

Sponsor

Institute of Oncology Ljubljana

Investigators

  • Principal Investigator: Helena Barbara Zobec Logar, MD, Brachytherapy Department, Institute of Oncology Ljubljana, Slovenia

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 (Actual)

May 1, 2016

Primary Completion (Estimated)

January 1, 2030

Study Completion (Estimated)

January 1, 2030

Study Registration Dates

First Submitted

March 1, 2018

First Submitted That Met QC Criteria

March 14, 2018

First Posted (Actual)

March 15, 2018

Study Record Updates

Last Update Posted (Actual)

July 16, 2026

Last Update Submitted That Met QC Criteria

July 15, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ERID-KESOPKR/63

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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