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Adaptive Radiotherapy Using Plan Selection for Bladder Cancer (plan selection)

This study is ongoing, but not recruiting participants.
Copenhagen University Hospital at Herlev
Odense University Hospital
Information provided by (Responsible Party):
University of Aarhus Identifier:
First received: January 3, 2013
Last updated: May 20, 2016
Last verified: December 2015
This protocol describes a Phase 2 clinical trial of online adaptive Radiotherapy, using a library of 3 dose plans corresponding to Small, Medium and Large size bladder. The procedure includes 'Common Toxicity Criteria for Adverse Effects'(CTCAE) for registration of adverse effects (baseline, every 2'nd week during RT, 2 weeks, 3, 6, 12 and 24 month after RT) as well as cineMR for intra-fractional motion (baseline and every week during RT). Patients receive standard non-adaptive RT in the first week. Delineations of the bladder on the Cone-Beam scans (CBCT) from first week of treatment are used for planning the Small and Medium size bladder plans. Large size plan are the standard non-adaptive treatment plan used for the first week of treatment. A margin of 5 mm for intra fractional movement is used.

Condition Intervention Phase
Adverse Effects for Adaptive RT of Bladder Cancer
Radiation: Adaptive Radiotherapy
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Adaptive Radiotherapy Using Plan Selection for Bladder Cancer: A Phase II Trial

Resource links provided by NLM:

Further study details as provided by University of Aarhus:

Primary Outcome Measures:
  • Gastro- Intestinal toxicity [ Time Frame: Up to 2 years after ART ]
    Grade 2 or more GI toxicity using CTCAE 4.0 baseline, every 2'nd week during RT, 2 weeks, 3, 12 and 24 month after RT

Secondary Outcome Measures:
  • Intra-fractional changes of bladder shape and size [ Time Frame: spring 2013 ]
    CineMR (time resolved MR) is performed pre-treatment and weekly during RT for the first 10 patients

  • Difference in accumulated dose to normal tissue [ Time Frame: autum 2014 ]
    The gain of normal tissue sparring will be calculated using dose accumulation

  • 1 or 2 years disease free survival [ Time Frame: 2015 ]
    1 or 2 years disease free survival will be calculated

Estimated Enrollment: 65
Study Start Date: October 2012
Estimated Study Completion Date: March 2018
Estimated Primary Completion Date: October 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: ART
Online adaptive radiotherapy
Radiation: Adaptive Radiotherapy
CTCAE scoring baseline, every 2'nd week during RT, 2 weeks, 3, 12 and 24 month after RT cineMR (time resolved MR) baseline and weekly during RT for intra fractional motion
Other Name: Online Adaptive RT using plan selection

Detailed Description:
After inclusion patients are asked about their adverse effects by an oncologist using CTCAE (version 4.0) questionnaire. A planning CT-scan is acquired and for the first 10 patients also a MR-scan for intra fractional motion is acquired. The MR sequence is repeated every week during radiotherapy. The first week of treatment a standard non-adaptive IMRT-plan is used and CBCT-scans are acquired before and after treatment. The CBCT-scans are used for delineation of the bladder on the CBCT-scans from the first 4 fractions. The adaptive plans are generated from the union of the first 4 CBCT-bladders and the planning CT bladder (medium size) and the volume contained in at least 2 out of the 5 bladder volumes (small size). Details can be found in the reference list. From the 6'Th fraction the treatment is performed using the most appropriate size of treatment plan. CTCAE is repeated every other week during radiotherapy and 2 weeks, 3, 6, 12 and 24 month after radiotherapy.

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

Inclusion Criteria:

  • Histologically proven bladder cancer
  • Age over 18 years
  • Urothelial or planocellular carcinoma
  • Stage T2 T4A
  • Stage N0M0
  • Suitable for radiotherapy
  • ECOG/WHO performance status 0-2

Exclusion Criteria:

  • Suspected or confirmed distant metastases
  • Previous surgery in the small pelvis
  • Inflammatory bowel disease
  Contacts and Locations
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Please refer to this study by its identifier: NCT01762527

Department of Oncology, Aarhus University Hospital
Aarhus, Denmark, 8000 C
Herlev Hospital
Herlev, Denmark, 2730
Odense University Hospital
Odense, Denmark, 5000
Sponsors and Collaborators
University of Aarhus
Copenhagen University Hospital at Herlev
Odense University Hospital
Principal Investigator: Morten Høyer, MD, Professor Aarhus University Hospital
  More Information

Additional Information:
Responsible Party: University of Aarhus Identifier: NCT01762527     History of Changes
Other Study ID Numbers: AUH-KFE-1217 1-16-02-283-12 ( Other Grant/Funding Number: The Danish National Committee on Health Research Ethics )
Study First Received: January 3, 2013
Last Updated: May 20, 2016

Keywords provided by University of Aarhus:
Adaptive radiotherapy
Bladder cancer

Additional relevant MeSH terms:
Urinary Bladder Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Urinary Bladder Diseases
Urologic Diseases processed this record on April 28, 2017