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CArdiac STereotactic Radiation Treatment for Ablation of ventRicular Tachycardia (CASTAR)

5 november 2026 uppdaterad av: Cancer Research Antwerp

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 .

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

20

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Belgien
    • Belgium
      • Antwerp, Belgium, Belgien, 2610
        • Rekrytering
        • ZAS Augustinus
        • Kontakt:
        • Huvudutredare:
          • Ines Joye, PhD
      • Edegem, Belgium, Belgien, 2600
        • Rekrytering
        • UZA
        • Kontakt:
        • Huvudutredare:
          • Johan Saenen, PhD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: SBRT

A single radiation dose of 25 Gy is delivered to the VT target.
Strålning: Stereotactic body radiation therapy (SBRT)

Stereotactic body radiation therapy (SBRT): a single radiation dose of 25 Gy is delivered to the VT target.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Feasibility of SBRT for the treatment of ventricular tachycardia
Tidsram: 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.
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in ventricular tachycardia burden following SBRT
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Cancer Research Antwerp

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

25 februari 2026

Primärt slutförande (Beräknad)

25 februari 2032

Avslutad studie (Beräknad)

25 februari 2035

Studieregistreringsdatum

Först inskickad

20 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

5 november 2026

Första postat (Faktisk)

12 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

12 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

5 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CTO22012GZA

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