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 .
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Description détaillée
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.
Type d'étude
Type d'étude
Inscription (Estimé)
Inscription
Phase
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Belgium
-
Antwerp, Belgium, Belgique, 2610
- Recrutement
- ZAS Augustinus
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Contact:
- Ines Joye, PhD
- Numéro de téléphone: +32 3 443 37 37
- E-mail: ines.joye@zas.be
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Chercheur principal:
- Ines Joye, PhD
-
Edegem, Belgium, Belgique, 2600
- Recrutement
- UZA
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Contact:
- Johan Saenen, PhD
- Numéro de téléphone: + 32 3 821 53 16
- E-mail: johan.saenen@uza.be
-
Chercheur principal:
- Johan Saenen, PhD
-
-
Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
|---|---|
|
Expérimental: 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. |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Feasibility of SBRT for the treatment of ventricular tachycardia
Délai: 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.
Délai: 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
|
Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in ventricular tachycardia burden following SBRT
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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.
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Début de l'étude
Achèvement primaire (Estimé)
Achèvement primaire
Achèvement de l'étude (Estimé)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladie du système de conduction cardiaque
- Maladies cardiovasculaires
- Processus pathologiques
- Maladies cardiaques
- Arythmies cardiaques
- Tachycardie
- Conditions pathologiques, signes et symptômes
- Tachycardie ventriculaire
- Techniques d'investigation
- Thérapeutique
- Procédures chirurgicales, opératoires
- Radiothérapie
- Techniques stéréotaxiques
- Procédures neurochirurgicales
- Radiochirurgie
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- CTO22012GZA
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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