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 .
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
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.
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Ilmoittautuminen
Vaihe
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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-
Belgium
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Antwerp, Belgium, Belgia, 2610
- Rekrytointi
- ZAS Augustinus
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Ottaa yhteyttä:
- Ines Joye, PhD
- Puhelinnumero: +32 3 443 37 37
- Sähköposti: ines.joye@zas.be
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Päätutkija:
- Ines Joye, PhD
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Edegem, Belgium, Belgia, 2600
- Rekrytointi
- UZA
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Ottaa yhteyttä:
- Johan Saenen, PhD
- Puhelinnumero: + 32 3 821 53 16
- Sähköposti: johan.saenen@uza.be
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Päätutkija:
- Johan Saenen, PhD
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
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.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
|---|---|
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Kokeellinen: 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. |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Feasibility of SBRT for the treatment of ventricular tachycardia
Aikaikkuna: Day of SBRT treatment (Day 1)
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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)
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Safety of SBRT for the treatment of ventricular tachycardia.
Aikaikkuna: From SBRT treatment through 31 days after SBRT
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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
|
Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Change in ventricular tachycardia burden following SBRT
Aikaikkuna: 6 months before SBRT through 6 months after SBRT
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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
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Time from SBRT to first VT recurrence
Aikaikkuna: From SBRT through 36 months after treatment
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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
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Time from SBRT to first sustained ventricular tachycardia or ICD shock
Aikaikkuna: 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
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|
Time from SBRT to first ventricular tachycardia storm
Aikaikkuna: 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
Aikaikkuna: 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
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Change in anti-tachycardia pacing and ICD shocks following SBRT
Aikaikkuna: 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
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Change in anti-arrhythmic medication use following SBRT
Aikaikkuna: From baseline through 36 months after SBRT
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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
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Overall survival following SBRT
Aikaikkuna: From SBRT through 36 months after treatment
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Overall survival will be assessed from the date of SBRT treatment until death from any cause. |
From SBRT through 36 months after treatment
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Incidence of heart transplantation following SBRT
Aikaikkuna: From SBRT through 36 months after treatment
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The number and proportion of participants requiring heart transplantation during follow-up will be assessed. |
From SBRT through 36 months after treatment
|
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Incidence of cardiac arrhythmic mortality following SBRT
Aikaikkuna: From SBRT through 36 months after treatment
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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
Aikaikkuna: From SBRT through 36 months after treatment
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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
Aikaikkuna: Through 90 days after SBRT
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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
|
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Incidence and severity of late radiation-related adverse events
Aikaikkuna: The protocol defines late adverse events as those occurring more than 90 days after starting radiotherapy.
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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.
|
Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Opiskelun aloitus
Ensisijainen valmistuminen (Arvioitu)
Ensisijainen valmistuminen
Opintojen valmistuminen (Arvioitu)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
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Avainsanat
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- Sydämen johtamisjärjestelmän sairaus
- Sydän-ja verisuonitaudit
- Patologiset prosessit
- Sydänsairaudet
- Rytmihäiriöt, sydän
- Takykardia
- Patologiset tilat, merkit ja oireet
- Takykardia, kammio
- Tutkintatekniikat
- Terapeuttiset lääkkeet
- Kirurgiset toimenpiteet, operatiivinen
- Sädehoito
- Stereotaksiset tekniikat
- Neurokirurgiset toimenpiteet
- Radiokirurgia
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Muut tutkimustunnusnumerot
- CTO22012GZA
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