Body Composition and Setup Errors in Radiotherapy (BODY-SET)

June 23, 2026 updated by: Chaoxing Liu, Shijiazhuang People's Hospital

The Impact of Body Composition on Setup Errors in Patients Undergoing Radiotherapy With Thermoplastic Mask Immobilization: A Single-Center Prospective Cohort Study

This single-center prospective cohort study investigates the association between body composition parameters and setup errors in 120-150 patients receiving radiotherapy with thermoplastic mask immobilization. Body composition (skeletal muscle mass, body fat percentage, phase angle, fat-free mass) will be measured using bioelectrical impedance analysis at baseline and at fraction 20. Setup errors (six degrees of freedom) will be recorded via daily cone-beam computed tomography. The primary outcome is the association between baseline body composition and setup errors. Secondary outcomes include the relationship between body composition changes during radiotherapy and setup error evolution, and identification of threshold values for clinically significant setup error increases. This study will provide evidence on whether body composition-beyond BMI-predicts radiotherapy setup accuracy, potentially enabling personalized immobilization and image-guided strategies.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Radiotherapy is a cornerstone of cancer treatment, with approximately 50-70% of patients requiring radiotherapy during their disease course. Accurate patient positioning is essential for ensuring adequate target volume coverage while sparing organs at risk. Thermoplastic masks are among the most commonly used immobilization devices; however, setup reproducibility varies considerably among patients. Previous studies have demonstrated that patients with BMI ≥24 kg/m² exhibit significantly greater setup errors across multiple directions in breast, cervical, and thoracic cancers compared with normal-weight patients. However, BMI is a crude anthropometric measure that cannot distinguish between fat and muscle mass-two tissue types with fundamentally different mechanical properties that may affect mask fit and positional reproducibility. Bioelectrical impedance analysis (BIA) provides a non-invasive, convenient method for measuring body composition parameters, including skeletal muscle mass (SMM), body fat percentage (BFP), phase angle (PhA), and fat-free mass (FFM). Phase angle, in particular, reflects cell membrane integrity and cellular mass, and has been validated as a sensitive marker of muscle quality and nutritional status in cancer patients. However, the value of BIA-derived body composition parameters in predicting radiotherapy setup errors has not been systematically explored. This study is a single-center, prospective observational cohort study conducted at the Department of Radiation Oncology, Shijiazhuang People's Hospital, China. A total of 120-150 patients with pathologically confirmed malignancies receiving radical or adjuvant intensity-modulated radiotherapy (≥25 fractions) with thermoplastic mask immobilization will be enrolled. Body composition parameters will be measured using BIA at baseline (T0) and at fraction 20 (T1). Setup errors (six degrees of freedom: Tx, Ty, Tz, Rx, Ry, Rz) will be recorded via cone-beam computed tomography (week 1: 3 times; thereafter: weekly). The primary outcome is the association between baseline body composition parameters and setup errors. Secondary outcomes include the relationship between body composition changes and setup error evolution, and identification of threshold values for clinically significant setup error increases. Data will be analyzed using multiple linear regression and generalized estimating equations. Results will be disseminated through peer-reviewed publications and conference presentations.

Study Type

Observational

Enrollment (Estimated)

150

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 Contact Backup

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

Sampling Method

Probability Sample

Study Population

Patients with pathologically confirmed malignancies receiving radical or adjuvant intensity-modulated radiotherapy at Shijiazhuang People's Hospital.

Description

Inclusion Criteria:

  • Pathologically confirmed malignancy
  • Age ≥18 years
  • Receiving radical or adjuvant intensity-modulated radiotherapy (IMRT) with planned ≥25 fractions
  • Immobilized with thermoplastic mask
  • ECOG Performance Status 0-2
  • Willing and able to provide written informed consent

Exclusion Criteria:

  • Metal implants (pacemaker, artificial joints) affecting bioelectrical impedance analysis (BIA) measurements
  • Severe edema or ascites
  • Inability to cooperate with immobilization or CBCT scanning
  • Radiotherapy interruption >5 fractions
  • Pregnancy or lactation

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

Cohorts and Interventions

Group / Cohort
High Muscle Mass Group
Patients with skeletal muscle mass above the sex-specific median
Low Muscle Mass Group
Patients with skeletal muscle mass below the sex-specific median

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
setup errors
Time Frame: Through study completion, an average of 6 months.
Six-degree-of-freedom setup errors (Tx, Ty, Tz, Rx, Ry, Rz) measured by cone-beam computed tomography (CBCT).
Through study completion, an average of 6 months.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Skeletal Muscle Mass
Time Frame: Baseline and fraction 20 (approximately 4 weeks after baseline)
Change in skeletal muscle mass (SMM) from baseline (T0) to radiotherapy fraction 20 (T1), measured by multi-frequency bioelectrical impedance analysis (BIA). SMM is expressed in kilograms (kg).
Baseline and fraction 20 (approximately 4 weeks after baseline)
Change in Body Fat Percentage
Time Frame: Baseline and fraction 20 (approximately 4 weeks after baseline).
Change in body fat percentage (BFP) from baseline (T0) to radiotherapy fraction 20 (T1), measured by multi-frequency bioelectrical impedance analysis (BIA). BFP is expressed as a percentage (%).
Baseline and fraction 20 (approximately 4 weeks after baseline).
Change in Phase Angle
Time Frame: Baseline and fraction 20 (approximately 4 weeks after baseline)
Change in phase angle (PhA) from baseline (T0) to radiotherapy fraction 20 (T1), measured by multi-frequency bioelectrical impedance analysis (BIA). PhA is expressed in degrees (°).
Baseline and fraction 20 (approximately 4 weeks after baseline)
Change in Fat-Free Mass
Time Frame: Baseline and fraction 20 (approximately 4 weeks after baseline)
Change in fat-free mass (FFM) from baseline (T0) to radiotherapy fraction 20 (T1), measured by multi-frequency bioelectrical impedance analysis (BIA). FFM is expressed in kilograms (kg).
Baseline and fraction 20 (approximately 4 weeks after baseline)

Collaborators and Investigators

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

Sponsor

Shijiazhuang People's Hospital

Investigators

  • Principal Investigator: Chaoxing Liu, Dr, Shijiazhuang People's Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

July 1, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

March 31, 2027

Study Registration Dates

First Submitted

June 18, 2026

First Submitted That Met QC Criteria

June 23, 2026

First Posted (Actual)

June 30, 2026

Study Record Updates

Last Update Posted (Actual)

June 30, 2026

Last Update Submitted That Met QC Criteria

June 23, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SJZPH-RO-2026-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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