Monitoring of Patients Treated With Particle Therapy Using Positron-Emission-Tomography (PET): The MIRANDA Study

This study is currently recruiting participants. (see Contacts and Locations)
Verified February 2013 by University Hospital Heidelberg
Sponsor:
Information provided by (Responsible Party):
Stephanie Combs, University Hospital Heidelberg
ClinicalTrials.gov Identifier:
NCT01528670
First received: December 30, 2011
Last updated: February 18, 2013
Last verified: February 2013
  Purpose

The purpose of this clinical study is to investigate the clinical feasibility and effectiveness of off-line Positron-Emission-Tomography (PET) quality assurance for promoting the accuracy of proton and carbon ion beam therapy. One main clinical advantage of ion therapy over conventional radiation therapy is the excellent conformation of the delivered dose to the tumour volume while well sparing the surrounding healthy tissue. However, clinical exploitation of this potential to the maximum extent requires in-vivo validation of the actual treatment delivery and, in particular, of the ion beam range within the patient. Since the primary ions are completely stopped in the target volume as opposed to photon radiation, no conventional quality assurance techniques like transmission electronic portal imaging can be applied to monitor ion beam therapy. Hence, ion treatment planning currently relies on models and experimental data accurately validated in tissue-equivalent targets, but no direct verification of the actual treatment delivery and of the ion beam range within the patient is possible in standard clinical practice.

At present, PET offers the unique possibility to monitor the precision of ion irradiation in-vivo and non-invasively. The method is based on the detection of the b+-activity which is formed as a by-product of the irradiation, i.e. without administration of radio-tracers to the patient. A positive clinical impact of in-beam (i.e. during the irradiation) PET monitoring has been demonstrated for carbon ion therapy in the pilot project at GSI Darmstadt, Germany, and promising clinical data of post-radiation PET/CT imaging have been recently reported for passive proton beam delivery in USA and Japan. Therefore, a pilot clinical study is hereby proposed at the Heidelberg Ion Therapy Center in order to 1) assess the applicability of post-radiation PET imaging to scanned ion beam delivery, 2) identify the patient population which may benefit from it and 3) extract population-based information on the reliability of the beam range in different tumour locations for all the ion species clinically available at HIT.

The investigated patients are expected to benefit from this study, since in case of detected deviations between planned and actual treatment delivery a proper correction could be applied in the next irradiation fraction, assuring an overall better treatment than without any monitoring. Moreover, site-specific patient-population information on the ion range precision at HIT might enable improvement of the CT-range calibration curve as well as safe reduction of the treatment margins to promote enhanced treatment plan conformality for full clinical exploitation of the promises of ion beam therapy.


Condition
Particle Therapy

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Monitoring of Patients Treated With Particle Therapy Using Positron-Emission-Tomography (PET): The MIRANDA Study.

Further study details as provided by University Hospital Heidelberg:

Estimated Enrollment: 240
Study Start Date: December 2011
Estimated Primary Completion Date: February 2014 (Final data collection date for primary outcome measure)
Groups/Cohorts
Skull Base
Lower GI
Prostate
Pelvic Region
Head-and-Neck
Upper GI
Brain
Other

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Patients treated with Particle Therapy at the Heidelberg Ion Therapy (HIT) Center will be included and grouped into 8 anatomical regions: Brain, Skull base, Head-and-neck, Upper GI, Lower GI, Prostate, Pelvic region and other.

Criteria

Inclusion Criteria

  • The patient is treated at the Heidelberger Ionenstrahl Therapiezentrum (HIT) with protons or carbon ions.
  • During the radiotherapeutic treatment patient positioning is verified using validated radiological imaging such as cone beam CT, X-ray or conventional CT (Reference-Imaging as described above).
  • The patient is at least 18 years of age and is able to give informed consent.
  • The patient has been informed about the aims and the content of the study.

Exclusion Criteria

  • No informed consent to take part in the study.
  • Medical reasons that impair the patients from being in the supine position for the data acquisition time, e.g. pain.
  • Non-compliance of the patient.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01528670

Contacts
Contact: Jürgen Debus, MD PhD +49-6221-56-8202 juergen.debus@med.uni-heidelberg.de
Contact: Stephanie E Combs, MD +49-6221-56-8202 stephanie.combs@med.uni-heidelberg.de

Locations
Germany
Department of Radiation Oncology Recruiting
Heidelberg, Germany, 69120
Contact: Stephanie E Combs, MD    +49-6221-56-8202    stephanie.combs@med.uni-heidelberg.de   
Contact: Katia Parodi, PhD    +49-6221-56-38239    katia.parodi@med.uni-heidelberg.de   
Sponsors and Collaborators
University Hospital Heidelberg
Investigators
Principal Investigator: Stephanie E Combs, MD University Hospital of Heidelberg
  More Information

No publications provided by University Hospital Heidelberg

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Stephanie Combs, Leitende Oberärztin, University Hospital Heidelberg
ClinicalTrials.gov Identifier: NCT01528670     History of Changes
Other Study ID Numbers: MIRANDA
Study First Received: December 30, 2011
Last Updated: February 18, 2013
Health Authority: Germany: Ethics Commission

ClinicalTrials.gov processed this record on July 28, 2014