Stereotactic Body Radiotherapy Boost Versus Simultaneous Integrated Boost to Pelvic Nodes Among Patients Receiving Radical Chemoradiation in Carcinoma Cervix
調査の概要
状態
条件
詳細な説明
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Karun Kamboj, MD
- 電話番号:9416613389
- メール:karunkamboj04@aiims.edu
研究場所
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National Capital Territory of Delhi
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Delhi、National Capital Territory of Delhi、インド、110049
- 募集
- All India Institute of Medical Sciences
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コンタクト:
- Karun Kamboj, MD
- 電話番号:9416613389
- メール:karunkamboj04@aiims.edu
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コンタクト:
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主任研究者:
- Karun Kamboj, MD
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Delhi、National Capital Territory of Delhi、インド、110049
- 募集
- Karun Kamboj
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コンタクト:
- Dr. KARUN KAMBOJ, MD
- 電話番号:9416613389
- メール:karunkamboj04@aiims.edu
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New Delhi
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New Delhi、New Delhi、インド、110029
- 募集
- National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
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コンタクト:
- Karun Kamboj, MD
- 電話番号:4112 9416613389
- メール:karunkamboj04@aiims.edu
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参加基準
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
説明
Inclusion Criteria:
- Patients with stage IIIC cervical cancer
- No previous pelvic radiation therapy or surgery
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
Exclusion Criteria:
- Patients with stage I or stage II or stage IV disease.
- Patients with prior malignancies or active autoimmune diseases
- Uncontrolled medical comorbidity
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
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Stereotactic Body Radiotherapy (SBRT) boost to involved pelvic lymph nodes (14 Gy in 2 fractions)
The experimental arm Stereotactic Body Radiotherapy (SBRT) boost regimen will consist of two fractions of 700 cGy each total of 14Gy in 2 fractions, delivered at 1st and 2nd week of the treatment.In the proposed protocol, the pelvic field dose will be delivered as 45 Gy in 25 fractions, while the nodal boost will be delivered as SBRT 14 Gy in 2 fractions, typically at the first and second weeks of treatment, subject to plan evaluation and organ-at-risk constraints. This sequencing is consistent with the concept of combining broad pelvic coverage with ablative focal escalation. Patients will be immobilized supine with an abdominopelvic thermoplastic shell, and simulation will be performed using contrast-enhanced planning CT with MRI and PET-CT fusion where available. Bladder and bowel preparation will be standardized before simulation and treatment to improve reproducibility and reduce interfraction variation. |
Experimental Arm: Stereotactic Body Radiotherapy Boost to Involved Pelvic Lymph Nodes Participants in the experimental arm will receive definitive radical chemoradiation for stage IIIC carcinoma cervix with a stereotactic body radiotherapy (SBRT) boost to the radiologically involved pelvic lymph node(s).
The purpose of this intervention is to intensify the dose to gross nodal disease while maintaining acceptable doses to nearby organs at risk, including bowel, rectum, bladder, sigmoid, spinal cord, kidneys, femoral heads, duodenum, and active bone marrow.
The SBRT boost is integrated with standard pelvic external beam radiotherapy and concurrent chemotherapy, followed by brachytherapy as per institutional curative protocol.
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アクティブコンパレータ:Conventional nodal boost by Simultaneous Integrated Boost (SIB)to involved pelvic lymph nodes)
Patients in the standard arm will receive conventional radical chemoradiation for locally advanced carcinoma cervix with pelvic external beam radiotherapy and concurrent weekly cisplatin, followed by brachytherapy.
Pelvic radiotherapy will be delivered to a dose of 45 Gy in 25 fractions over 5 weeks, using IMRT/VMAT or fixed-field technique, with standard contouring of elective pelvic target volumes and gross disease.
The nodal boost will be delivered as a conventional Simultaneous Integrated Boost (SIB) to the involved pelvic node(s) during the course of external beam radiotherapy.
A total dose of 55 Gy or 57.5 Gy in 25 fractions, delivered in a simultaneous integrated manner according to nodal size, location, and institutional planning constraints.
Treatment will be planned with appropriate image guidance, and organs at risk will be respected according to predefined dose constraints.
Toxicity will be monitored during treatment and follow-up, and graded using CTCAE version 5.0.
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Patients in the standard arm will receive radical chemoradiation with pelvic external beam radiotherapy to 45 Gy in 25 fractions over 5 weeks, along with a simultaneous integrated boost to involved pelvic node(s) to a total dose of 55 Gy or 57.5 Gy in 25 fractions, delivered in a simultaneous integrated manner according to nodal size, location, and institutional planning constraints.
Concurrent weekly cisplatin 40 mg/m² will be administered during external beam radiotherapy, subject to adequate renal function and treatment tolerance.
After completion of external beam treatment, patients will receive brachytherapy as per institutional protocol, using intracavitary or interstitial technique depending on residual disease and anatomy.
Treatment will be planned with appropriate image guidance, and organs at risk will be respected according to predefined dose constraints.
Toxicity will be monitored during treatment and follow-up, and graded using CTCAE version 5.0.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Incidence of grade 3 or higher treatment-related adverse events
時間枠:30 days
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The primary outcome measure is the incidence of grade 3 or higher treatment-related adverse events, specifically acute gastrointestinal and genitourinary toxicity, assessed within 30 days of completion of treatment using CTCAE version 5.0.
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30 days
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Grade 3 or higher acute gastrointestinal and genitourinary toxicity
時間枠:6 months
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Incidence of grade 3 or higher acute gastrointestinal and genitourinary toxicity, assessed at 6 months of completion of external-beam chemoradiation, using CTCAE version 5.0.
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6 months
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Dosimetric comparison
時間枠:6 months
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The dosimetric comparison of organs at risk during treatment planning.
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6 months
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Local control
時間枠:6 months
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The local control with clinical examination or radiologic response
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6 months
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
詳しくは
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