- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07593261
MRI-Guided Adaptive Radiotherapy for Limited Peritoneal Metastases (MARACAS Trial). (MARACAS)
MARACAS: A Phase II Trial of MRI-guided Adaptive Stereotactic RAdiotherapy in oligometastatiC Patients With Peritoneal Spread.
This prospective phase II study evaluates the efficacy and safety of MRI-guided stereotactic body radiotherapy (MRIgSBRT) in patients with oligometastatic peritoneal carcinomatosis from gastrointestinal or gynecological tumors. Eligible patients with up to 5 MRI-visible peritoneal lesions and PCI ≤20 will be treated with MRIgSBRT using a hybrid MRI-linear accelerator with online adaptive planning and real-time tumor tracking.
The primary endpoint is radiologic response rate according to RECIST 1.1 criteria. Secondary endpoints include overall survival, progression-free survival, local control, chemotherapy-free survival, and treatment-related toxicity. The study aims to assess MRIgSBRT as a safe and non-invasive treatment option for selected patients with limited peritoneal metastatic disease.
Studieoversigt
Status
Intervention / Behandling
Detaljeret beskrivelse
Peritoneal carcinomatosis (PC) represents a frequent metastatic pattern in gastrointestinal and gynecological malignancies and is associated with poor prognosis and limited therapeutic options. Although cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) may improve outcomes in selected patients, many patients are not candidates for surgery because of recurrent disease, comorbidities, or poor performance status.
MRI-guided stereotactic body radiotherapy (MRIgSBRT) allows highly conformal radiation delivery with online adaptive planning and real-time tumor tracking, potentially improving treatment precision and sparing surrounding organs at risk in anatomically complex abdominal sites.
This prospective single-center phase II study will evaluate MRIgSBRT in patients with oligometastatic peritoneal carcinomatosis with up to 5 MRI-visible lesions and PCI ≤20. Treatment will be delivered using a hybrid MRI-linear accelerator with adaptive planning according to daily anatomical variations.
The primary endpoint is radiologic response rate according to RECIST 1.1 criteria. Secondary endpoints include overall survival, progression-free survival, local control, chemotherapy-free survival, and treatment-related toxicity assessed according to CTCAE v5.0.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
- Navn: Luca Boldrini
- Telefonnummer: +390630158195
- E-mail: luca.boldrini@policlinicogemelli.it
Studiesteder
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Roma, Italien, 000168
- Gemelli ART (Advanced Radiation Therapy)-Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Kontakt:
- Luca Boldrini
- Telefonnummer: +390630155701
- E-mail: luca.boldrini@policlinicogemelli.it
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Ledende efterforsker:
- Luca Boldrini
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age ≥18 years
- ECOG performance status 0-2
- Life expectancy ≥6 months
- Up to 5 MRI-visible peritoneal nodules
- PCI ≤20
- No prior radiotherapy in the same abdominal region within 6 months
- Signed informed consent
- History of prior CRS and/or HIPEC
Exclusion Criteria:
- Diffuse peritoneal carcinomatosis
- Psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule (those conditions should be discussed with the patient before registration in the trial)
- Significant comorbidities (such as: severe cardiac or coagulative disease, moderate or severe
- restrictive/obsiructive lung deficit, severe cognitive impairment, moderate and severe renal and hepatic impairment.
- Pregnancy or breastfeeding
- MRI contraindications (e.g., pacemaker, severe claustrophobia)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Eksperimentel: MRI-guided SBRT
Patients with oligometastatic peritoneal carcinomatosis will receive MRI-guided stereotactic body radiotherapy (MRIgSBRT) delivered with a hybrid MRI-linear accelerator using online adaptive planning and real-time tumor tracking.
Treatment dose will range from 30 to 50 Gy in 5 fractions according to clinical judgment and organ-at-risk constraints.
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Patients will receive MRI-guided stereotactic body radiotherapy (MRIgSBRT) delivered using a hybrid MRI-linear accelerator with online adaptive planning and real-time tumor tracking.
Treatment will consist of 30-50 Gy delivered in 5 fractions according to clinical judgment, target characteristics, and organ-at-risk constraints.
Daily adaptive replanning may be performed to account for anatomical changes and optimize dose delivery in patients with oligometastatic peritoneal carcinomatosis.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Radiological Response Rate (RR)
Tidsramme: Up to 12 months after completion of MRIgSBRT
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RR: The response rate will be calculated as the proportion of patients achieving a complete or partial radiological response out of the total number of evaluable patients according to RECIST 1.1 criteria
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Up to 12 months after completion of MRIgSBRT
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Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Luca Boldrini, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 26983
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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