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Carbon Ion Radiotherapy for Hepatocellular Carcinoma (PROMETHEUS-01)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified July 2010 by University Hospital Heidelberg.
Recruitment status was:  Recruiting
Information provided by:
University Hospital Heidelberg Identifier:
First received: July 20, 2010
Last updated: August 3, 2011
Last verified: July 2010

Treatment options for patients with advanced hepatocellular carcinoma (HCC) are often limited. In most cases, they are not amenable to local therapies including surgery or radiofrequency ablation. The multi-kinase inhibitor sorafenib has shown to increase overall survival in this patient group for about 3 months.

Radiation therapy is a treatment alternative, however, high local doses are required for long-term local control. However, due to the relatively low radiation tolerance of liver normal tissue, even using stereotactic techniques, delivery of sufficient doses for successful local tumor control has not be achieved to date.

Carbon ions offer physical and biological characteristics. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increased relative biological effectiveness (RBE), which can be calculated between 2 and 3 depending on the HCC cell line as well as the endpoint analyzed.

Japanese Data on the evaluation of carbon ion radiation therapy showed promising results for patients with HCC.

In the current Phase I-PROMETHEUS-01-Study, carbon ion radiotherapy will be evaluated for patients with advanced HCC. The study will be performed as a dose-escalation study evaluating the optimal carbon ion dose with respect to toxicity and tumor control.

Primary endpoint is toxicity, secondary endpoint is progression-free survival and response.

Condition Intervention Phase
Hepatocellular Carcinoma Radiation: Carbon Ion Radiotherapy Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I Study Evaluating the Treatment of Patients With Hepatocellular Carcinoma (HCC) With Carbon Ion Radiotherapy

Further study details as provided by University Hospital Heidelberg:

Primary Outcome Measures:
  • Maximum Tolerated Dose (MTD) [ Time Frame: 3 months ]
    Determination the maximum tolerated dose (MTD) and dose limiting toxicities (DLTs) of carbon ion radiotherapy

Secondary Outcome Measures:
  • Progression-free Survival [ Time Frame: Follow-up unti progression ]

Estimated Enrollment: 33
Study Start Date: August 2011
Estimated Study Completion Date: January 2013
Estimated Primary Completion Date: January 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Carbon Ion Radiotherapy
Increasing Dose of Carbon Ion Radiotherapy 4 x 10 Gy E to 4 x 14 Gy E
Radiation: Carbon Ion Radiotherapy
Increasing Dose of Carbon Ion Radiotherapy 4 x 10 Gy E to 4 x 14 Gy E


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • histologically confirmed HCC or diagnosis of HCC according to AASLD-guidelines
  • macroscopic tumor
  • liver-confined disease without extrahepatic disease as diagnosed by CT, MRT, ultrasound and bone scan
  • minimal distance of tumor edge to the intestines of 1cm
  • age ≥ 18 years of age
  • Karnofsky Performance Score ³60
  • For women with childbearing potential, (and men) adequate contraception.
  • Ability of subject to understand character and individual consequences of the clinical trial
  • Written informed consent (must be available before enrolment in the trial)

Exclusion Criteria:

  • refusal of the patients to take part in the study
  • previous radiotherapy of the hepatobiliary system
  • margin of < 1cm between tumor edge and intestines
  • Patients who have not yet recovered from acute toxicities of prior therapies
  • Known carcinoma < 2 years ago (excluding Carcinoma in situ of the cervix, basal cell carcinoma, squamous cell carcinoma of the skin) requiring immediate treatment interfering with study therapy
  • Pregnant or lactating women
  • Participation in another clinical study or observation period of competing trials, respectively
  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 identifier: NCT01167374

Contact: Jürgen Debus, MD PhD +6221-56- ext 8201
Contact: Stephanie E Combs, MD +621-56- ext 8202

University Hospital of Heidelberg, Radiation Oncology Recruiting
Heidelberg, Germany, 69120
Principal Investigator: Jürrgen Debus, MD PHD         
Sponsors and Collaborators
University Hospital Heidelberg
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Prof. Dr. Dr. Jürgen Debus, University Hospital of Heidelberg, Radiation Oncology Identifier: NCT01167374     History of Changes
Other Study ID Numbers: PROMETHEUS-01
Study First Received: July 20, 2010
Last Updated: August 3, 2011

Keywords provided by University Hospital Heidelberg:

Additional relevant MeSH terms:
Carcinoma, Hepatocellular
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Liver Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases processed this record on August 16, 2017