3-Dimensional Conformal Radiation Therapy in Treating Patients With Bladder Cancer Who Have Undergone Transurethral Resection of the Bladder
Image Guided Dose Escalated Adaptive Bladder Radiotherapy
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue.
PURPOSE: This phase I trial is studying the side effects and best dose of 3-dimensional conformal radiation therapy in treating patients with bladder cancer who have undergone transurethral resection of the bladder.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
OBJECTIVES:
Primary
- To determine the maximum-tolerated dose of external-beam radiotherapy delivered as a tumor boost in patients who have undergone prior transurethral bladder resection for muscle-invasive carcinoma of the bladder.
Secondary
- To document progression-free survival and overall survival of these patients.
- To evaluate patterns of recurrence and bladder preservation rates following dose-escalated radiotherapy in these patients.
- To determine the impact of acute and late toxicity on quality of life in these patients.
- To assess the use of gold seeds for tumor boost delineation in these patients.
- To evaluate the use of virtual cystoscopy tumor localization in these patients.
- To assess coverage of the phase II radiotherapy boost volume on the daily cone-beam images.
- To assess coverage of the phase III radiotherapy volume on cone-beam images with selected adaptive strategy.
- To evaluate the use of diffusion-weighted MRI (dwMRI) scans in assessing response to radiotherapy.
OUTLINE: This is a dose-escalation study.
Patients undergo a rigid cystoscopy and gold-seed insertion, if clinically appropriate. Approximately 3-5 seeds are inserted into the bladder wall to demarcate the maximum extent of visible tumor or tumor bed via a customized introducer. All patients undergo 3-dimensional conformal radiotherapy once daily, 5 days per week during weeks 1 and 4-7 and once daily, 4-6 days per week during weeks 2 and 3, using a combination of image-guided radiotherapy techniques and a partial bladder radiotherapy boost.
Patients complete quality-of-life questionnaire QOL-30 at baseline, 1 and 3 months, and then annually after completion of study treatment.
After completion of study treatment, patients are followed up at 4, 8, and 12 weeks, every 6 months for 3 years, and then annually for 2 years.
연구 유형
연구 유형
등록 (예상)
등록
단계
단계
- 1단계
연락처 및 위치
연구 장소
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England
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Sutton, England, 영국, SM2 5PT
- 모병
- Royal Marsden - Surrey
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연락하다:
- Contact Person
- 전화번호: 44-20-8661-3457
- 이메일: robert.huddart@icr.ac.uk
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-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
DISEASE CHARACTERISTICS:
Histologically confirmed invasive bladder carcinoma, including the following cellular types:
- Adenocarcinoma
- Transitional cell carcinoma
- Squamous cell carcinoma
Clinical stage G1-3, pT2a-4 disease
- Localized disease
- No bone or visceral metastases
- No lymph node metastases
- Has undergone maximal transurethral resection of the bladder tumor and planning to receive radical radiotherapy
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Hemoglobin > 10 g/dL
- WBC > 3,000/mm^3
- Platelet count > 150,000/mm^3
- Creatinine < 120 μmol/L
- Bilirubin < 1.5 times upper limit normal (ULN)
- AST < 1.5 times ULN
- Alkaline phosphatase < 1.5 times ULN
- Not pregnant
- No inflammatory bowel disease or other significant small bowel disease
- Physically fit for radical radiotherapy
- No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
No other malignancy within the past 2 years except adequately treated basal cell carcinoma of the skin or adequately treated carcinoma in situ of the cervix uteri
- Prior superficial transitional cell carcinoma of the bladder allowed
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior pelvic surgery
- No bilateral hip replacements compromising accurate radiotherapy planning
- No prior radiotherapy to the pelvis
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 마스킹: 없음(오픈 라벨)
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
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최대 허용 용량
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2차 결과 측정
2차 결과 측정
결과 측정 |
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무진행 생존
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전반적인 생존
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삶의 질
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Bladder preservation rates
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Acute and late toxicity and safety profile
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Tumor boost volumes delineated with and without gold seeds
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Dose-volume histogram analysis of PTV2 and PTV3 coverage
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Change in diffusion coefficient between pre- and post-radiotherapy dwMRI scans
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공동 작업자 및 조사자
수사관
수사관
- 수석 연구원: Robert A. Huddart, MD, Royal Marsden NHS Foundation Trust
연구 기록 날짜
연구 주요 날짜
연구 시작
연구 시작
기본 완료 (예상)
기본 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
기타 연구 ID 번호
- CDR0000671670
- ICR-IDEAL
- EU-21035
- CCR-3217
- MREC-09/H0801/40
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