CArdiac STereotactic Radiation Treatment for Ablation of ventRicular Tachycardia (CASTAR)
The investigator-initiated, CArdiac Stereotactic radiation Treatment for Ablation of ventRicular tachycardia (CASTAR) study will be conducted in patients with ventricular tachycardia (VT) which is either refractory to antiarrhythmic medication therapy in maximal dose or to catheter ablation or with contraindications to antiarrhythmic medication or catheter ablation.
The study is a non-randomized, multicenter, interventional study of cardiac SBRT, for which a total dose of 25 Gy will be delivered in a single fraction using volumetric modulated arc therapy (VMAT). The aim of the CASTAR study is to assess the feasibility and the safety of cardiac SBRT for the treatment of VT. Secondary objectives are efficacy, toxicity and QoL of cardiac SBRT for Ventricular tachycardia .
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
The study will be conducted at multiple centers across Belgium. Twenty patients will be enrolled to the study. Interim analyses are planned to be performed when the first five or ten subjects have been treated. Participation in the study will comprise a screening period, where screening assessments must be completed before starting treatment. Eligible, consenting patients will then undergo SBRT, which is limited to a single dose delivery on one day. During SBRT, patients are closely monitored in accordance with the DEGRO guidelines for radiotherapy in patients with ICDs (Gauter-Fleckenstein 2015). After SBRT, patients will be closely monitored during a 3-5 days hospitalization. The post-treatment phase will start after patients are discharged from the hospital. Patients will be followed on regular basis to assess safety and efficacy of SBRT treatment.
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
-
-
Belgium
-
Antwerp, Belgium, Belgie, 2610
- Nábor
- ZAS Augustinus
-
Kontakt:
- Ines Joye, PhD
- Telefonní číslo: +32 3 443 37 37
- E-mail: ines.joye@zas.be
-
Vrchní vyšetřovatel:
- Ines Joye, PhD
-
Edegem, Belgium, Belgie, 2600
- Nábor
- UZA
-
Kontakt:
- Johan Saenen, PhD
- Telefonní číslo: + 32 3 821 53 16
- E-mail: johan.saenen@uza.be
-
Vrchní vyšetřovatel:
- Johan Saenen, PhD
-
-
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Patients over the age of 18 with structural heart disease
- Patients with ventricular tachycardia requiring intervention (e.g. an electrical shock or anti-tachycardia pacing via an Implantable Cardioverter Defibrillator (ICD)) which cannot be managed with medication or catheter ablation, or where there are contraindications to treatment with medication or catheter ablation.
- Contraindications may exist due to comorbidities or due to the type or severity of the disease.
- Informed consent to participate has been obtained from the patient or from his or her legal representative.
Exclusion Criteria:
- Lack of evidence that the ventricular tachycardia is triggered by myocardial scarring (based on MRI, CT EAM).
- Any contraindication to radiosurgery (e.g. inability to precisely define the target volume due to imaging artefacts caused by an LVAD)
- Pregnancy
- Previous radiotherapy that prevents the safe delivery of the dose.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: N/A
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Experimentální: SBRT
A single radiation dose of 25 Gy is delivered to the VT target. |
Stereotactic body radiation therapy (SBRT): a single radiation dose of 25 Gy is delivered to the VT target. |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Feasibility of SBRT for the treatment of ventricular tachycardia
Časové okno: Day of SBRT treatment (Day 1)
|
Feasibility will be assessed as the successful implementation and completion of cardiac SBRT without interruption of treatment. SBRT consists of a single fraction of 25 Gy delivered to the ventricular tachycardia target. |
Day of SBRT treatment (Day 1)
|
|
Safety of SBRT for the treatment of ventricular tachycardia.
Časové okno: From SBRT treatment through 31 days after SBRT
|
Safety will be assessed by the incidence and severity of adverse events related to radiotherapy following cardiac SBRT. Adverse events will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0. |
From SBRT treatment through 31 days after SBRT
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Change in ventricular tachycardia burden following SBRT
Časové okno: 6 months before SBRT through 6 months after SBRT
|
The ventricular tachycardia (VT) burden will be assessed by the number of VT episodes recorded by ECG and implantable cardioverter-defibrillator (ICD) readouts. The number of VT episodes during the 6 months following SBRT will be compared with the number during the 6 months preceding SBRT. A 6-week blanking period immediately following SBRT will be taken into account in the analysis of VT recurrences. |
6 months before SBRT through 6 months after SBRT
|
|
Time from SBRT to first VT recurrence
Časové okno: From SBRT through 36 months after treatment
|
Time from SBRT treatment to the first documented recurrence of ventricular tachycardia, as determined from ICD readouts. A 6-week blanking period following SBRT will be considered in the analysis of VT recurrence. |
From SBRT through 36 months after treatment
|
|
Time from SBRT to first sustained ventricular tachycardia or ICD shock
Časové okno: From SBRT through 36 months after treatment
|
Time from SBRT treatment to the first occurrence of sustained ventricular tachycardia or the first appropriate ICD shock during follow-up. |
From SBRT through 36 months after treatment
|
|
Time from SBRT to first ventricular tachycardia storm
Časové okno: From SBRT through 36 months after treatment
|
Time from SBRT treatment to the first occurrence of a ventricular tachycardia storm during follow-up. |
From SBRT through 36 months after treatment
|
|
Change in the number of electrical storms following SBRT
Časové okno: 6 months before SBRT through 6 months after SBRT
|
The number of electrical storms occurring following SBRT will be compared with the number occurring before SBRT treatment. |
6 months before SBRT through 6 months after SBRT
|
|
Change in anti-tachycardia pacing and ICD shocks following SBRT
Časové okno: 6 months before SBRT through 6 months after SBRT
|
The number of anti-tachycardia pacing (ATP) interventions and ICD shocks following SBRT will be compared with the number occurring before SBRT treatment. |
6 months before SBRT through 6 months after SBRT
|
|
Change in anti-arrhythmic medication use following SBRT
Časové okno: From baseline through 36 months after SBRT
|
Anti-arrhythmic medication use will be assessed during follow-up. The type and dosage of anti-arrhythmic drugs will be collected to evaluate changes in the need for anti-arrhythmic treatment following SBRT. |
From baseline through 36 months after SBRT
|
|
Overall survival following SBRT
Časové okno: From SBRT through 36 months after treatment
|
Overall survival will be assessed from the date of SBRT treatment until death from any cause. |
From SBRT through 36 months after treatment
|
|
Incidence of heart transplantation following SBRT
Časové okno: From SBRT through 36 months after treatment
|
The number and proportion of participants requiring heart transplantation during follow-up will be assessed. |
From SBRT through 36 months after treatment
|
|
Incidence of cardiac arrhythmic mortality following SBRT
Časové okno: From SBRT through 36 months after treatment
|
The number and proportion of participants who die from a cardiac arrhythmic cause during follow-up will be assessed. |
From SBRT through 36 months after treatment
|
|
Incidence of cardiac non-arrhythmic mortality following SBRT
Časové okno: From SBRT through 36 months after treatment
|
The number and proportion of participants who die from a cardiac non-arrhythmic cause during follow-up will be assessed. |
From SBRT through 36 months after treatment
|
|
Incidence and severity of acute radiation-related adverse events
Časové okno: Through 90 days after SBRT
|
The incidence and severity of adverse events related to radiotherapy will be assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0. Acute adverse events are defined according to the time period specified in the protocol. |
Through 90 days after SBRT
|
|
Incidence and severity of late radiation-related adverse events
Časové okno: The protocol defines late adverse events as those occurring more than 90 days after starting radiotherapy.
|
The incidence and severity of late adverse events related to radiotherapy will be assessed and graded according to NCI CTCAE version 5.0. |
The protocol defines late adverse events as those occurring more than 90 days after starting radiotherapy.
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Onemocnění převodního systému srdce
- Kardiovaskulární choroby
- Patologické procesy
- Srdeční choroba
- Arytmie, srdeční
- Tachykardie
- Patologické stavy, příznaky a symptomy
- Tachykardie, ventrikulární
- Vyšetřovací techniky
- Terapeutika
- Chirurgické postupy, operativní
- Radioterapie
- Stereotaxické techniky
- Neurochirurgické postupy
- Radiochirurgie
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