Head and Neck Cancer, Liver Cancer, Prostate Cancer, Recurrent Adenocarcinoma
Conditions
Keywords
Prostate Cancer, Recurrent Adenocarcinoma, Liver Cancer, Head and Neck Cancer
Brief summary
This is a master protocol for a prospective Phase I-II study evaluating feasibility and efficacy of incorporating magnetic resonance imaging (MRI) simulation into the planning of radiation treatments.
Detailed description
This is a Phase I/II clinical trial. A Phase I clinical trial tests the feasibility and safety of an investigational intervention. "Investigational" means that the process targeting high doses of radiation to the tumor based on MRI is still being studied. This research study is a Feasibility Study, which means it is the first-time investigators at this institution are examining this type of MR-guided dose planning. The U.S. Food and Drug Administration (FDA) has cleared MRI planning for use. * In Phase I of this study, will prospectively determine the feasibility of using an MRI simulator to plan radiation therapy. * In Phase II, the efficacy of adjusting RT based on MRI simulation will be explored, either by utilizing an MRI-simulation and synthetic CT to plan treatment or by dose-painting based on functional MRI data
Interventions
DEVICEMRI Simulator
Radiation mapping to define the target for radiation.acquiring MR data at the specified timepoint in a patient's care plan and ability to identify the radiation target and develop a radiation therapy plan on the MR data.
RADIATIONRadiation Therapy
In Phase I, radiation will be institutional standard per disease site. In Phase II, either radiation according to MR-based dose painting or adjusted RT. These adjusted doses and/or RT will vary per disease site and will be pre-specified in the subprotocols.
Sponsors
Brigham and Women's Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participants must have a confirmed malignancy requiring radiation therapy. * Age: 18 years or older * ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A) * Ability to understand and the willingness to sign a written informed consent document. * Disease-specific eligibility criteria will be specified in the appropriate subprotocol.
Exclusion criteria
* For MRI involving contrast, history of allergic reactions attributed to gadolinium based IV contrast. Note: If patient will not receive contrast, this is not applicable * Participants who cannot undergo an MRI * Disease-specific
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of acquiring MRI simulation prior to radiation therapy planning | 1 Year | Feasibility is defined as successfully enrolling patients, successfully acquiring MR data at the specified timepoint in a patient's care plan and ability to identify the radiation target and develop a radiation therapy plan on the MR data |
| Proportion of patients with QOL decline exceeding 2 x MID | baseline up to 24 months | 12 points; MID of the EPIC-26 urinary irritative/obstructive domain is 6 points) measured by EPIC-26 urinary irritation/obstruction domain from baseline to 2 years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE v4.0 | 24 Months | — |
| MRI evidence of disease at 2 years from treatment initiation. | 24 Months | — |
| PSA progression (nadir + 2) at 2 years from treatment initiation | 24 months | — |
| Progression free survival | 24 months | — |
| Change in target volumes between CT simulation and MRI simulation | 24 Months | To ascertain the effects of MRI simulation on size of target volumes and OAR, the volume (cc) will be compared between CT vs MR simulation by t-test for normal data or Wilcoxon signed-rank test if data does not follow a normal distribution. The extent of overlap calculated with the Sorensen-Dice coefficient and Hausdorff distance. |
| Change in coverage of target volumes between CT simulation and MRI simulation | 24 Months | The dose to OARS using the CT-simulation and MR-simulation derived plans will be compared using the t-test for normal data or Wilcoxon signed-rank test if data does not follow a normal distribution. |
| Change in dose to organs at risk (OARs) between CT simulation and MRI simulation | 24 Months | The dose to OARS using the CT-simulation and MR-simulation derived plans will be compared using the t-test for normal data or Wilcoxon signed-rank test if data does not follow a normal distribution. |
| Performance of the synthetic CT in RT planning | 24 Months | To assess performance of the synthetic CT in RT planning, fluence patterns from the synthetic CT plan will be copied onto the CT simulation electron density grids and dose recalculated. Accuracy of synthetic CT dose calculations to target volumes and OARs will be assessed with a goal of \<1% difference in target and OAR dose between synthetic CT plans and CT simulation plans |
Countries
United States
Contacts
CONTACTRaymond Mak, MD
PRINCIPAL_INVESTIGATORRaymond Mak, MD
Brigham and Women's Hospital
Outcome results
None listed