- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT07667192
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
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Mateusz Bilski, MD, PhD
- Telefoonnummer: 048 84 535 99 10
- E-mail: mateusz.bilski@affidea.com
Studie Contact Back-up
- Naam: Paulina Kleban, MGR
- Telefoonnummer: 048 84 535 99 10
- E-mail: paulina.kleban@affidea.com
Studie Locaties
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Lublin Voivodeship
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Zamość, Lublin Voivodeship, Polen, 22-400
- Werving
- Affidea Nu-med Center of Oncological DIagnostics and Therapy
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Contact:
- Mateusz Bilski, MD, PhD
- Telefoonnummer: 048 84 535 99 10
- E-mail: mateusz.bilski@affidea.com
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Contact:
- Paulina Kleban, MGR
- Telefoonnummer: 048 84 535 99 10
- E-mail: paulina.kleban@affidea.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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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.
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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.
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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
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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.
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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.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Radiographic Progression-Free Survival
Tijdsspanne: From treatment start to progression or death, up to 5 years
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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.
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From treatment start to progression or death, up to 5 years
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Severe Treatment-Related Adverse Events
Tijdsspanne: From treatment start through 24 months and longer follow-up, up to 5 years
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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.
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From treatment start through 24 months and longer follow-up, up to 5 years
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Overall Survival
Tijdsspanne: From treatment start to death or last follow-up, up to 5 years
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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.
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From treatment start to death or last follow-up, up to 5 years
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Fistula Events
Tijdsspanne: From treatment start through 24 months and long-term follow-up, up to 5 years
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Incidence of new or worsening fistula events, including anatomical type, timing, suspected relationship to treatment, management, surgical intervention, and resolution or persistence.
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From treatment start through 24 months and long-term follow-up, up to 5 years
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Complete Response
Tijdsspanne: From treatment completion through 5 years, with response assessed at approximately 3 and 6 months after treatment completion and during scheduled follow-up.
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Proportion of participants with disappearance of all treated measurable active disease sites and no new disease, assessed by routine imaging and/or clinical assessment.
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From treatment completion through 5 years, with response assessed at approximately 3 and 6 months after treatment completion and during scheduled follow-up.
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Local Recurrence-Free Survival
Tijdsspanne: From treatment completion to local progression or death, up to 5 years
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Time from completion of reirradiation and/or total ablative strategy to local recurrence or progression in the treated region, or death.
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From treatment completion to local progression or death, up to 5 years
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From treatment completion to local progression or death, up to 5 years
Tijdsspanne: From treatment completion to regional progression or death, up to 5 years
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Time from treatment completion to regional nodal recurrence or progression, or death.
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From treatment completion to regional progression or death, up to 5 years
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Distant Metastasis-Free Survival
Tijdsspanne: From treatment completion to event or last follow-up, up to 5 years
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Time from completion of reirradiation and/or total ablative strategy to distant metastatic progression or death from any cause.
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From treatment completion to event or last follow-up, up to 5 years
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Freedom From Oligometastatic Reccurence/Progression
Tijdsspanne: From treatment completion to event or last follow-up, up to 5 years
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Time to new oligometastatic recurrence or oligometastatic progression after reirradiation and/or total ablative strategy, assessed according to investigator review and local imaging practice.
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From treatment completion to event or last follow-up, up to 5 years
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Freedom From Polymetastatic Recurrence/Progression
Tijdsspanne: From treatment completion to polymetastatic progression, up to 5 years
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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.
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From treatment completion to polymetastatic progression, up to 5 years
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Pattern of First Failure
Tijdsspanne: From treatment completion to first progression, up to 5 years
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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.
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From treatment completion to first progression, up to 5 years
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Pelvic Exenteration-Free Survival
Tijdsspanne: From treatment completion to pelvic exenteration or death, up to 5 years.
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Time from completion of reirradiation and/or total ablative strategy to pelvic exenteration or death, assessed in selected pelvic recurrence cohorts where applicable.
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From treatment completion to pelvic exenteration or death, up to 5 years.
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Systemic Therapy-Free Survival
Tijdsspanne: From treatment completion to initiation or escalation of systemic therapy, up to 5 years.
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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.
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From treatment completion to initiation or escalation of systemic therapy, up to 5 years.
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Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
- Radiotherapie
- Brachytherapie
- Fistel
- Proton therapie
- Herbestraling
- Intraoperatieve radiotherapie
- Algemeen overleven
- Stereotactische lichaamsradiotherapie
- Patiëntenregistratie
- Externe Beam Radiotherapie
- Metastasis-Directed Therapy
- Total Ablative Strategy
- Oligometastatic Recurrence
- Radiographic Progression-Free Survival
- Treatment-Related Adverse Events
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Genitale ziekten
- Endocriene systeemziekten
- Urogenitale neoplasmata
- Neoplasmata per site
- Neoplasmata
- Pathologische aandoeningen, anatomisch
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Baarmoeder Ziekten
- Genitale ziekten, vrouw
- Endocriene klierneoplasmata
- Ovariële ziekten
- Adnexale ziekten
- Genitale neoplasmata, vrouwelijk
- Gonadale aandoeningen
- Baarmoederhalsaandoeningen
- Vulvaire ziekten
- Ziekten van de eileiders
- Vaginale ziekten
- Pathologische aandoeningen, tekenen en symptomen
- Ovariumneoplasmata
- Baarmoeder Cervicale Neoplasmata
- Vulvaire neoplasmata
- Eileiderneoplasmata
- Baarmoeder Neoplasmata
- Fistel
- Vaginale neoplasmata
- Therapeutica
- Radiotherapie
- Herbehandeling
- Herziening
Andere studie-ID-nummers
- REGYNE(RA)DIATION
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