FLT PET Imaging for Cervical Cancer
'F-18 Fluorothymidine ([18F]FLT) PET Imaging for Early Evaluation of Response to Chemoradiation Therapy in Patients With Cervical Cancer
Our primary hypothesis is that [18F]FLT PET can identify active bone marrow in addition to metabolically active tumor.
This trial will use FLT-PET imaging to define areas of active bone marrow in the pelvis. The radiation plan is then designed to spare that area, in hopes of keeping the bone marrow active during therapy. Bone marrow and tumor activity will be monitored using a sequence of FLT PET scans during the course of chemotherapy and radiation therapy.
研究概览
详细说明
Subjects will undergo a total of up to 5 FLT PET scans.
Subjects are randomized between two groups to reduce radiation exposure from the FLT PET scans. If bone marrow activity is not identified in one scan, further scans are cancelled until the 1-month follow up scan. This is not a randomization to compare therapeutic efficacy between two study arms. Data will be pooled for analysis as pre-specified in the study's statistical plan.
Group 1 has FLT PET scans pretreatment, after 5 radiation treatments, after 10 radiation treatments, after 15 radiation treatments, and then 1 month after completing radiation therapy.
Group 2 has FLT PET scans pretreatment, after 5 radiation treatments, after 10 radiation treatments, after 20 radiation treatments, and then 1 month after completing radiation therapy.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Iowa
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Iowa City、Iowa、美国、52242
- Holden Comprehensive Cancer Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Ability to understand and willingness to sign a written informed consent document.
- Histologically confirmed stage IB2, IIA, IIB, IIIB, and IVA squamous cell carcinoma of the cervix.
- Scheduled to receive chemo-radiation for oncologic treatment.
- Karnofsky of at least 60 at time of screening
- Life expectancy of at least 6 months.
- Leukocytes at least 3,000/microL
- absolute neutrophil count at least 1,500/microL
- platelets at least 100,000/microL
- total bilirubin at maximum 1.0 mg/dL (UIHC limit of normal)
- either ALT or AST less than 2.5 times the upper limit of normal
- creatinine less than 1.5 times the upper limit of normal
- non-pregnant, non-nursing, willing to use contraception
Exclusion Criteria:
- oncology research protocol requiring full pelvic radiation (i.e., 4-field box technique) or experimental chemotherapy
- uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with the study requirements.
- subjects taking nucleoside analog medications such as those used as antiretroviral agents.
- patients who have undergone hysterectomy or will have a hysterectomy as part of their cancer therapy.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Group 2
Receives fourth [F18]Fluorothymidine (FLT) PET scan after 20 fractions of radiation therapy.
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FLT PET scan 5 mCi (+/- 10%)
其他名称:
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实验性的:Group 1
Receives fourth [F18]Fluorothymidine (FLT) PET scan after 15 fractions of radiation therapy.
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FLT PET scan 5 mCi (+/- 10%)
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Percent Difference From Baseline IMRT Plan (%)
大体时间:Baseline (pre-treatment)
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The difference in volume of bone marrow receiving radiation using a bone-marrow-sparing radiation plan compared to a standard radiation plan (IMRT), expressed as a percentage.
Both plans are patient-specific.
Bone-marrow is identified using the baseline FLT PET/CT obtained pre-imaging.
Active bone marrow is considered to have an uptake value (SUV) of 2, 3, or 4. The standard IMRT plan was created using the criteria of the National Cancer Institute's Radiation Therapy Oncology Group study RTOG-0418.
Radiation dose bins evaluated are 5 Gray, 10 Gray, 20 Gray, and 30 Gray.
The change in dose to tumor is also provided.
A negative value indicates that more bone marrow or tissue was spared using the bone-marrow sparing plan.
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Baseline (pre-treatment)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Chemotherapy Compliance
大体时间:post-treatment
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The number of participants who missed at least one prescribed chemotherapy administration due to low blood counts.
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post-treatment
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Number of Participants With Standardized Toxicity Severity Grades for White Blood Cell Counts
大体时间:baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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White blood cell counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured weekly during combined chemotherapy and radiation therapy treatment and then once at 30 day follow-up and at 1 year follow-up
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baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Number of Participants With Standardized Toxicity Severity Grades for Decreased Platelet Counts.
大体时间:baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Platelet cell counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up
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baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Number of Participants With Standardized Toxicity Severity Grades for Decreased Absolute Neutrophil Counts (ANCs)
大体时间:baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Absolute neutrophil counts (ANCs) measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up.
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baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Number of Participants With Standardized Toxicity Severity Grades for Decreased Lymphocyte Counts.
大体时间:baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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Lymphocyte counts measurements expressed in standardized toxicity severity grades (Common Terminology Criteria for Adverse Events, v4.03) measured once weekly during combined chemotherapy and radiation therapy, then once at 30 day follow-up, and once at 1 year follow-up
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baseline, weekly during radiation treatment for up to 5 weeks, and 30 days post treatment
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合作者和调查者
调查人员
- 研究主任:Michael M Graham, Ph.D., M.D.、University of Iowa
- 首席研究员:Sarah McGuire, Ph.D.、University of Iowa
出版物和有用的链接
一般刊物
- McGuire SM, Menda Y, Ponto LL, Gross B, Juweid M, Bayouth JE. A methodology for incorporating functional bone marrow sparing in IMRT planning for pelvic radiation therapy. Radiother Oncol. 2011 Apr;99(1):49-54. doi: 10.1016/j.radonc.2011.01.025. Epub 2011 Mar 22.
- McGuire SM, Menda Y, Boles Ponto LL, Gross B, Buatti J, Bayouth JE. 3'-deoxy-3'-[(1)(8)F]fluorothymidine PET quantification of bone marrow response to radiation dose. Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):888-93. doi: 10.1016/j.ijrobp.2010.12.009. Epub 2011 Feb 6. Erratum In: Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):7.
- Menda Y, Ponto LL, Dornfeld KJ, Tewson TJ, Watkins GL, Gupta AK, Anderson C, McGuire S, Schultz MK, Sunderland JJ, Graham MM, Buatti JM. Investigation of the pharmacokinetics of 3'-deoxy-3'-[18F]fluorothymidine uptake in the bone marrow before and early after initiation of chemoradiation therapy in head and neck cancer. Nucl Med Biol. 2010 May;37(4):433-8. doi: 10.1016/j.nucmedbio.2010.02.005.
- McGuire SM, Bhatia SK, Sun W, Jacobson GM, Menda Y, Ponto LL, Smith BJ, Gross BA, Bayouth JE, Sunderland JJ, Graham MM, Buatti JM. Using [(18)F]Fluorothymidine Imaged With Positron Emission Tomography to Quantify and Reduce Hematologic Toxicity Due to Chemoradiation Therapy for Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys. 2016 Sep 1;96(1):228-39. doi: 10.1016/j.ijrobp.2016.04.009. Epub 2016 Apr 19.
- McGuire SM, Menda Y, Ponto LLB, Gross B, TenNapel M, Smith BJ, Bayouth JE. Spatial mapping of functional pelvic bone marrow using FLT PET. J Appl Clin Med Phys. 2014 Jul 8;15(4):129-136. doi: 10.1120/jacmp.v15i4.4780.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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