Reirradiation and Total Ablative Strategies for Recurrent Gynecologic Cancer (Regynera-RT)
REGYNERA(Dia)TION: An Ambispective International Multicenter Patient Registry of Reirradiation and Total Ablative Strategies for Recurrent Gynecologic Malignancies
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
This study is a non-interventional patient registry designed to describe real-world outcomes after reirradiation and total ablative strategies in recurrent gynecologic malignancies. Eligible participants are adults with histologically confirmed uterine, cervical, vaginal, vulvar, ovarian, fallopian tube, primary peritoneal, or other rare gynecologic malignancy; documented prior radiotherapy; and recurrent or progressive disease for which reirradiation and/or a local ablative treatment strategy has been delivered, is ongoing, or is planned according to local multidisciplinary decision-making.
The registry has an ambispective cohort structure. Historical retrospective participants are entered from medical records and treatment-planning data after local approval. Ambispective follow-up participants were treated before registry activation but remain under follow-up, allowing subsequent outcomes and adverse events to be captured prospectively where permitted. Prospective registry participants are enrolled before or at the time of reirradiation or total ablative strategy decision-making. Participation does not mandate, delay, prohibit, or modify any clinically indicated treatment, imaging, or follow-up.
The registry will capture a common core dataset across participating centers, including demographics, performance status, primary tumor site and histology, primary treatment, prior radiotherapy details, recurrence anatomy, disease extent, number and site of active foci, treatment modality, dose and fractionation, equivalent dose metrics, systemic therapy timing, surgery or other metastasis-directed therapy, response at approximately 3 and 6 months, progression pattern, survival status, acute and late adverse events, severe morbidity, fistula events, and patient-reported outcomes where implemented. Recommended extended data domains include cumulative dose assessment, organ-at-risk metrics, imaging response method, molecular markers, systemic therapy sequencing, dosimetric data, and quality-of-life or symptom questionnaires.
The primary registry endpoint is radiographic progression-free survival after reirradiation/total ablative strategy. Key safety analyses will describe grade 3 or higher treatment-related genitourinary, gastrointestinal, vaginal, soft-tissue, neurologic, vascular, or bone adverse events and fistula events within 24 months and during longer follow-up. Secondary analyses will describe complete response, overall survival, local, regional, and distant progression, freedom from oligometastatic or polymetastatic progression, and disease-site-specific outcomes when adequate sample size and event numbers are reached.
研究の種類
研究の種類
入学 (推定)
入学
連絡先と場所
研究連絡先
研究連絡先
- 名前:Mateusz Bilski, MD, PhD
- 電話番号:048 84 535 99 10
- メール:mateusz.bilski@affidea.com
研究連絡先のバックアップ
- 名前:Paulina Kleban, MGR
- 電話番号:048 84 535 99 10
- メール:paulina.kleban@affidea.com
研究場所
-
-
Lublin Voivodeship
-
Zamość、Lublin Voivodeship、ポーランド、22-400
- 募集
- Affidea Nu-med Center of Oncological DIagnostics and Therapy
-
コンタクト:
- Mateusz Bilski, MD, PhD
- 電話番号:048 84 535 99 10
- メール:mateusz.bilski@affidea.com
-
コンタクト:
- Paulina Kleban, MGR
- 電話番号:048 84 535 99 10
- メール:paulina.kleban@affidea.com
-
-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- - Age 18 years or older at the time of reirradiation or prospective enrollment.
- Histologically confirmed gynecologic malignancy, including uterine, cervical, vaginal, vulvar, ovarian, fallopian tube, primary peritoneal, or rare gynecologic primary.
- Documented prior radiotherapy delivered as part of previous treatment.
- Recurrent or progressive disease for which reirradiation and/or total ablative strategy has been delivered, is ongoing, or is planned according to local multidisciplinary decision-making.
- Recurrence or progression documented by imaging, clinical examination, pathology, and/or multidisciplinary tumor board assessment according to institutional practice.
- Availability of minimum essential data, including prior radiotherapy information, date of reirradiation or planned reirradiation, disease extent at reirradiation, and at least one follow-up, outcome, or survival-status record for retrospective patients.
- For prospective patients, written informed consent where required by local regulations and ethics approval.
Exclusion Criteria:
- No evidence of prior radiotherapy.
- No reirradiation or clinically meaningful local ablative radiotherapy component delivered or planned.
- Insufficient minimum data preventing assignment of reirradiation date, disease extent, or survival/follow-up status.
- Exclusively polymetastatic disease with more than 5 active non-regional lesions treated without a meaningful local reirradiation or total ablative component, unless included in an exploratory non-core substudy approved by the steering committee.
- Prospective refusal of consent when consent is required by local law or ethics approval.
研究計画
研究はどのように設計されていますか?
デザインの詳細
グループ/コホートの数
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
|
Historical Retrospective Cohort
Patients treated with reirradiation and/or total ablative strategies before registry activation at a participating site.
Baseline, prior radiotherapy, recurrence, treatment exposure, response, toxicity, progression, and survival data are abstracted retrospectively from medical records and treatment-planning systems according to local approval.
|
Observed standard-of-care radiotherapy delivered in a previously irradiated patient or to a target region overlapping with or clinically affected by prior radiotherapy.
Modalities may include brachytherapy, external-beam radiotherapy, stereotactic body radiotherapy, proton therapy, intraoperative radiotherapy, or combinations.
Dose and fractionation are selected by the treating team.
Observed standard-of-care curative-intent or ablative-intent treatment strategy directed at all visible active disease sites when technically feasible and clinically appropriate.
This may include radiotherapy, surgery, ablation, metastasis-directed therapy, systemic therapy, or combinations, as selected by the treating multidisciplinary team.
|
|
Ambispective Follow-Up Cohort
Patients treated before registry activation who remain under follow-up.
Baseline, prior treatment, recurrence, and reirradiation data may be collected retrospectively, while subsequent imaging, response, adverse events, fistula events, progression, survival, and patient-reported outcomes may be collected prospectively where permitted
|
Observed standard-of-care radiotherapy delivered in a previously irradiated patient or to a target region overlapping with or clinically affected by prior radiotherapy.
Modalities may include brachytherapy, external-beam radiotherapy, stereotactic body radiotherapy, proton therapy, intraoperative radiotherapy, or combinations.
Dose and fractionation are selected by the treating team.
Observed standard-of-care curative-intent or ablative-intent treatment strategy directed at all visible active disease sites when technically feasible and clinically appropriate.
This may include radiotherapy, surgery, ablation, metastasis-directed therapy, systemic therapy, or combinations, as selected by the treating multidisciplinary team.
|
|
Prospective Registry Cohort
Patients enrolled before or at the time of the reirradiation or total ablative strategy decision.
Treatment is not assigned by the registry and is selected by the treating multidisciplinary team according to routine clinical practice.
Registry data are collected prospectively according to the protocol follow-up schedule.
|
Observed standard-of-care radiotherapy delivered in a previously irradiated patient or to a target region overlapping with or clinically affected by prior radiotherapy.
Modalities may include brachytherapy, external-beam radiotherapy, stereotactic body radiotherapy, proton therapy, intraoperative radiotherapy, or combinations.
Dose and fractionation are selected by the treating team.
Observed standard-of-care curative-intent or ablative-intent treatment strategy directed at all visible active disease sites when technically feasible and clinically appropriate.
This may include radiotherapy, surgery, ablation, metastasis-directed therapy, systemic therapy, or combinations, as selected by the treating multidisciplinary team.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Radiographic Progression-Free Survival
時間枠:From treatment start to progression or death, up to 5 years
|
Time from the start of reirradiation and/or total ablative strategy to first radiographic disease progression at any site or death from any cause, whichever occurs first.
Progression will be assessed using routine clinical imaging and investigator assessment according to local practice.
|
From treatment start to progression or death, up to 5 years
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Severe Treatment-Related Adverse Events
時間枠:From treatment start through 24 months and longer follow-up, up to 5 years
|
Incidence of grade 3 or higher treatment-related genitourinary, gastrointestinal, vaginal, soft-tissue, neurologic, vascular, bone, or other clinically relevant adverse events after reirradiation and/or total ablative strategy, graded according to the version of CTCAE used at the participating site.
|
From treatment start through 24 months and longer follow-up, up to 5 years
|
|
Overall Survival
時間枠:From treatment start to death or last follow-up, up to 5 years
|
Time from the start of reirradiation and/or total ablative strategy to death from any cause.
Participants alive at last follow-up will be censored at the last known alive date.
|
From treatment start to death or last follow-up, up to 5 years
|
|
Fistula Events
時間枠:From treatment start through 24 months and long-term follow-up, up to 5 years
|
Incidence of new or worsening fistula events, including anatomical type, timing, suspected relationship to treatment, management, surgical intervention, and resolution or persistence.
|
From treatment start through 24 months and long-term follow-up, up to 5 years
|
|
Complete Response
時間枠:From treatment completion through 5 years, with response assessed at approximately 3 and 6 months after treatment completion and during scheduled follow-up.
|
Proportion of participants with disappearance of all treated measurable active disease sites and no new disease, assessed by routine imaging and/or clinical assessment.
|
From treatment completion through 5 years, with response assessed at approximately 3 and 6 months after treatment completion and during scheduled follow-up.
|
|
Local Recurrence-Free Survival
時間枠:From treatment completion to local progression or death, up to 5 years
|
Time from completion of reirradiation and/or total ablative strategy to local recurrence or progression in the treated region, or death.
|
From treatment completion to local progression or death, up to 5 years
|
|
From treatment completion to local progression or death, up to 5 years
時間枠:From treatment completion to regional progression or death, up to 5 years
|
Time from treatment completion to regional nodal recurrence or progression, or death.
|
From treatment completion to regional progression or death, up to 5 years
|
|
Distant Metastasis-Free Survival
時間枠:From treatment completion to event or last follow-up, up to 5 years
|
Time from completion of reirradiation and/or total ablative strategy to distant metastatic progression or death from any cause.
|
From treatment completion to event or last follow-up, up to 5 years
|
|
Freedom From Oligometastatic Reccurence/Progression
時間枠:From treatment completion to event or last follow-up, up to 5 years
|
Time to new oligometastatic recurrence or oligometastatic progression after reirradiation and/or total ablative strategy, assessed according to investigator review and local imaging practice.
|
From treatment completion to event or last follow-up, up to 5 years
|
|
Freedom From Polymetastatic Recurrence/Progression
時間枠:From treatment completion to polymetastatic progression, up to 5 years
|
Time from completion of reirradiation and/or total ablative strategy to development of polymetastatic progression, typically defined as more than 5 new and/or regrowing non-regional lesions.
|
From treatment completion to polymetastatic progression, up to 5 years
|
|
Pattern of First Failure
時間枠:From treatment completion to first progression, up to 5 years
|
Distribution of first progression pattern after reirradiation and/or total ablative strategy, classified as local, regional, distant, oligometastatic, polymetastatic, or mixed progression according to investigator assessment.
|
From treatment completion to first progression, up to 5 years
|
その他の成果指標
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Pelvic Exenteration-Free Survival
時間枠:From treatment completion to pelvic exenteration or death, up to 5 years.
|
Time from completion of reirradiation and/or total ablative strategy to pelvic exenteration or death, assessed in selected pelvic recurrence cohorts where applicable.
|
From treatment completion to pelvic exenteration or death, up to 5 years.
|
|
Systemic Therapy-Free Survival
時間枠:From treatment completion to initiation or escalation of systemic therapy, up to 5 years.
|
Time from completion of reirradiation and/or total ablative strategy to initiation or escalation of systemic anticancer therapy, assessed as an exploratory endpoint where clinically applicable.
|
From treatment completion to initiation or escalation of systemic therapy, up to 5 years.
|
協力者と研究者
スポンサー
スポンサー
出版物と役立つリンク
一般刊行物
- Andratschke N, Willmann J, Appelt AL, Alyamani N, Balermpas P, Baumert BG, Hurkmans C, Hoyer M, Langendijk JA, Kaidar-Person O, van der Linden Y, Meattini I, Niyazi M, Reynaert N, De Ruysscher D, Tanadini-Lang S, Hoskin P, Poortmans P, Nieder C. European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re-irradiation: definition, reporting, and clinical decision making. Lancet Oncol. 2022 Oct;23(10):e469-e478. doi: 10.1016/S1470-2045(22)00447-8.
- Mulani J, Jain J, Gupta A, Swamidas J, Paul S, Mittal P, Gurram L, Chopra S. Dose Accumulation for Multicourse Gynecological Reirradiation: A Methodological Narrative and Clinical Examples. Int J Radiat Oncol Biol Phys. 2022 Aug 1;113(5):1085-1090. doi: 10.1016/j.ijrobp.2022.04.046. Epub 2022 May 7.
- Ling DC, Vargo JA, Burton SA, Heron DE, Beriwal S. Salvage Curative-Intent Reirradiation Stereotactic Body Radiation Therapy for Isolated Pelvic and/or Paraortic Recurrences of Gynecologic Malignancies. Pract Radiat Oncol. 2019 Nov;9(6):418-425. doi: 10.1016/j.prro.2019.05.012. Epub 2019 May 28.
- Ling DC, Vargo JA, Glaser SM, Kim H, Beriwal S. Outcomes after definitive re-irradiation with 3D brachytherapy with or without external beam radiation therapy for vaginal recurrence of endometrial cancer. Gynecol Oncol. 2019 Mar;152(3):581-586. doi: 10.1016/j.ygyno.2018.12.022. Epub 2018 Dec 29.
- Lee LJ, Alban GM, Cheng T, Buzurovic I, Pretz J, Singer L, King MT. Clinical outcomes and dosimetric predictors of toxicity for re-irradiation of vaginal recurrence of endometrial cancer. Brachytherapy. 2022 May-Jun;21(3):263-272. doi: 10.1016/j.brachy.2021.12.010. Epub 2022 Jan 22.
- Bockel S, Espenel S, Sun R, Dumas I, Gouy S, Morice P, Chargari C. Image-Guided Brachytherapy for Salvage Reirradiation: A Systematic Review. Cancers (Basel). 2021 Mar 11;13(6):1226. doi: 10.3390/cancers13061226.
- Critelli P, Pezzulla D, Lillo S, Arpa D, Scricciolo M, Di Carlo C, Argenone A, Borzillo V, Marsella AR, Tamburo M, Di Franco R, Di Marzo A, Settineri N, Mondello S, Macchia G, Belgioia L, Cerrotta A, Pontoriero A. Outcomes and toxicity in re-irradiation of gynecologic cancer: Systematic review of the Italian association of radiation and clinical oncology (AIRO). Gynecol Oncol. 2023 Dec;179:33-41. doi: 10.1016/j.ygyno.2023.10.016. Epub 2023 Oct 30.
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- REGYNE(RA)DIATION
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。