Advanced Radiotherapy (ART) in Gynecological Cancer Patients (GYN-ART)

Gynecologic Cancer Clinical Trial

— GYN-ART  

Official title:

Efficacy of Advanced Radiotherapy (ART) in Gynecological Cancer Patients (GYN-ART)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06306170
• Other study ID #: GYN-ART
• Status: Recruiting
• Start date: February 15, 2024
• Est. completion date: February 15, 2029

Study information

• Verified date: March 2024
• Source: IRCCS San Raffaele
• Contact: Andrei Fodor, MD
• Phone: +390226437634
• Email: fodor.andrei[@]hsr.it
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This is an observational mono-institutional study. Patients with gynecologic tumors treated with advanced radiotherapy- Image Guided Radiotherapy (IGRT), Intensity Modulated Radiotherapy (IMRT), Stereotactic Body Radiotherapy (SBRT)- will be included and toxicity and outcomes analyzed.

Description:

The patients with gynecological cancer treated with Advanced Radiotherapy (ART)- Image Guided Radiotherapy (IGRT), Intensity Modulated Radiotherapy (IMRT), Stereotactic Body Radiotherapy (SBRT)- at the Department of Radiotherapy of "IRCCS San Raffaele Scientific Institute" (IRCCSSRaffaele) from January 2005 to January 2024 will be identified and their clinical and dosimetric data retrieved and analyzed. The study objectives are the analysis of acute and late toxicity, and clinical outcomes, such as local, regional and distant control,disease free survival, cancer-specific survival, and overall survival. Secondary objective is the identification of prognostic factors for toxicity, disease progression, survival, including radiomic characteristics.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 1000
• Est. completion date: February 15, 2029
• Est. primary completion date: February 15, 2027
• Gender: Female
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

• gynecologic cancer patients
• >18 years old
• treated with advanced radiotherapy techniques (IGRT, IMRT, SBRT)

Exclusion Criteria:

• other tumors
• > 90 years old

Related Conditions & MeSH terms

• Disease Progression
• Gynecologic Cancer
• Progression, Disease
• Radiotherapy Side Effect
• Radiotherapy; Complications
• Survivorship

Intervention

Radiation:
• Image Guided Radiotherapy
Patients treated with IGRT, IMRT, SBRT for Gynecological cancer will be evaluated

Locations

Country	Name	City	State
Italy	San Raffaele Scientific Institute	Milan	MI

Sponsors (1)

Lead Sponsor	Collaborator
IRCCS San Raffaele

Country where clinical trial is conducted

Italy, 

References & Publications (24)

Berek JS, Matias-Guiu X, Creutzberg C, Fotopoulou C, Gaffney D, Kehoe S, Lindemann K, Mutch D, Concin N; Endometrial Cancer Staging Subcommittee, FIGO Women's Cancer Committee. FIGO staging of endometrial cancer: 2023. Int J Gynaecol Obstet. 2023 Aug;162( — View Citation

Chen CC, Lin JC, Jan JS, Ho SC, Wang L. Definitive intensity-modulated radiation therapy with concurrent chemotherapy for patients with locally advanced cervical cancer. Gynecol Oncol. 2011 Jul;122(1):9-13. doi: 10.1016/j.ygyno.2011.03.034. Epub 2011 Apr — View Citation

Colombo N, Creutzberg C, Amant F, Bosse T, Gonzalez-Martin A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C; ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis — View Citation

Fournier M, Stoeckle E, Guyon F, Brouste V, Thomas L, MacGrogan G, Floquet A. Lymph node involvement in epithelial ovarian cancer: sites and risk factors in a series of 355 patients. Int J Gynecol Cancer. 2009 Nov;19(8):1307-13. doi: 10.1111/IGC.0b013e318 — View Citation

Gavinski K, DiNardo D. Cervical Cancer Screening. Med Clin North Am. 2023 Mar;107(2):259-269. doi: 10.1016/j.mcna.2022.10.006. Epub 2022 Dec 26. — View Citation

Grigsby PW, Singh AK, Siegel BA, Dehdashti F, Rader J, Zoberi I. Lymph node control in cervical cancer. Int J Radiat Oncol Biol Phys. 2004 Jul 1;59(3):706-12. doi: 10.1016/j.ijrobp.2003.12.038. — View Citation

Guckenberger M, Lievens Y, Bouma AB, Collette L, Dekker A, deSouza NM, Dingemans AC, Fournier B, Hurkmans C, Lecouvet FE, Meattini I, Mendez Romero A, Ricardi U, Russell NS, Schanne DH, Scorsetti M, Tombal B, Verellen D, Verfaillie C, Ost P. Characterisat — View Citation

Jereczek-Fossa BA, Ronchi S, Orecchia R. Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective? Rep Pract Oncol Radiother. 2015 Nov-Dec;20(6):472-83. doi: 10.1016/j.rpor.2014.10.004. Epub 2014 Nov 7. — View Citation

Jhingran A, Winter K, Portelance L, Miller B, Salehpour M, Gaur R, Souhami L, Small W Jr, Berk L, Gaffney D. A phase II study of intensity modulated radiation therapy to the pelvis for postoperative patients with endometrial carcinoma: radiation therapy o — View Citation

Kidd EA, Siegel BA, Dehdashti F, Rader JS, Mutic S, Mutch DG, Powell MA, Grigsby PW. Clinical outcomes of definitive intensity-modulated radiation therapy with fluorodeoxyglucose-positron emission tomography simulation in patients with locally advanced ce — View Citation

Ling DC, Vargo JA, Burton SA, Heron DE, Beriwal S. Salvage Curative-Intent Reirradiation Stereotactic Body Radiation Therapy for Isolated Pelvic and/or Paraortic Recurrences of Gynecologic Malignancies. Pract Radiat Oncol. 2019 Nov;9(6):418-425. doi: 10.1 — View Citation

Macchia G, Lazzari R, Colombo N, Laliscia C, Capelli G, D'Agostino GR, Deodato F, Maranzano E, Ippolito E, Ronchi S, Paiar F, Scorsetti M, Cilla S, Ingargiola R, Huscher A, Cerrotta AM, Fodor A, Vicenzi L, Russo D, Borghesi S, Perrucci E, Pignata S, Arist — View Citation

Macchia G, Nardangeli A, Laliscia C, Fodor A, Draghini L, Gentile PC, D'Agostino GR, Balcet V, Bonome P, Ferioli M, Autorino R, Vicenzi L, Raguso A, Borghesi S, Ippolito E, Di Cataldo V, Cilla S, Perrucci E, Campitelli M, Gambacorta MA, Deodato F, Scambia — View Citation

Macchia G, Pezzulla D, Campitelli M, Laliscia C, Fodor A, Bonome P, Draghini L, Ippolito E, De Sanctis V, Ferioli M, Titone F, Balcet V, Di Cataldo V, Russo D, Vicenzi L, Cossa S, Lucci S, Cilla S, Deodato F, Gambacorta MA, Scambia G, Morganti AG, Ferrand — View Citation

Makker V, MacKay H, Ray-Coquard I, Levine DA, Westin SN, Aoki D, Oaknin A. Endometrial cancer. Nat Rev Dis Primers. 2021 Dec 9;7(1):88. doi: 10.1038/s41572-021-00324-8. — View Citation

Milam MR, Java J, Walker JL, Metzinger DS, Parker LP, Coleman RL; Gynecologic Oncology Group. Nodal metastasis risk in endometrioid endometrial cancer. Obstet Gynecol. 2012 Feb;119(2 Pt 1):286-92. doi: 10.1097/AOG.0b013e318240de51. — View Citation

Ramanathan S, Tirumani SH, Ojili V. Nodal metastasis in gynecologic malignancies: Update on imaging and management. Clin Imaging. 2020 Feb;59(2):157-166. doi: 10.1016/j.clinimag.2019.11.006. Epub 2019 Nov 28. — View Citation

Reshko LB, Baliga S, Crandley EF, Harry Lomas IV, Richardson MK, Spencer K, Bennion N, Mikdachi HE, Irvin W, Kersh CR. Stereotactic body radiation therapy (SBRT) in recurrent, persistent or oligometastatic gynecological cancers. Gynecol Oncol. 2020 Dec;15 — View Citation

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708. Epub 2022 Jan 12. — View Citation

Stewart C, Ralyea C, Lockwood S. Ovarian Cancer: An Integrated Review. Semin Oncol Nurs. 2019 Apr;35(2):151-156. doi: 10.1016/j.soncn.2019.02.001. Epub 2019 Mar 11. — View Citation

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caa — View Citation

Tortorella L, Restaino S, Zannoni GF, Vizzielli G, Chiantera V, Cappuccio S, Gioe A, La Fera E, Dinoi G, Angelico G, Scambia G, Fanfani F. Substantial lymph-vascular space invasion (LVSI) as predictor of distant relapse and poor prognosis in low-risk earl — View Citation

Woelber L, Eulenburg C, Choschzick M, Kruell A, Petersen C, Gieseking F, Jaenicke F, Mahner S. Prognostic role of lymph node metastases in vulvar cancer and implications for adjuvant treatment. Int J Gynecol Cancer. 2012 Mar;22(3):503-8. doi: 10.1097/IGC. — View Citation

Yang B, Zhu L, Cheng H, Li Q, Zhang Y, Zhao Y. Dosimetric comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy in patients with gynecologic malignancies: a systematic review and meta-analysis. Radiat Oncol. 2012 Nov — View Citation

* Note: There are 24 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Predictive factors for disease progression and death	Factors predicting survival. Survival trees, univariate/multivariate Cox regression models will be estimated to identify potential risk factors associated with survival outcomes	From radiotherapy end to date of local, regional progression, distant failure, or death, assessed up to 120 months
Other	Radiomic predictive factors for disease progression and death	CT and PET/CT radiomic features predicting relapse or death will be extracted, acording to IBSI (Image Biomarker Standardisation Initiative), owning to the different families of features: Morphology, Statistical, Intensity Histogram, Grey Level Cooccurrence Matrix 3D-average, Grey Level Co-occurrence Matrix 3D-combined, Grey Level Run Lenght 3D-average. Grey Level Run Lenght 3D_combined, Grey Level Size Zone Matrix 3D, Neighbors Grey Tone Difference Matrix 3D, Grey Level Distance Zone Matrix 3D, standard convolutional filters within radiomic workflow (wavelets, Laplacian of Gaussian)	From radiotherapy end to the first registered event (disease progression or death), assessed up to 120 months
Primary	Local Relapse Free Survival	local control (on the treated site) of the disease	From date of radiotherapy end until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 120 months
Primary	Regional Relapse Free Survival	regional control (regional lymph nodal chain) of the disease	From date of radiotherapy end until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 120 months
Primary	Distant Metastases Free Survival	distant metastases developed after the treatment	From date of radiotherapy end until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 120 months
Primary	Disease Free Survival	absence of disease progression during the follow-up	From date of radiotherapy end until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 120 months
Primary	Overall Survival	survival from all causes	From date of radiotherapy end until the date of death from any cause, assessed up to 120 months
Primary	Cancer Specific Survival	cancer survival	From date of radiotherapy end until the date of death from disease progression, assessed up to 120 months
Secondary	Acute toxicity	Toxicity developed in the first three months after the treatment, assessed with Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale, which displayes grades from 1 to 5, with grade 1 meaning mild toxicity and grade 5 death related to toxicity	Up to three months from the start of radiotherapy
Secondary	Late toxicity	Toxicity developed after three months until the end of follow-up or death, assessed with Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale, assessed with Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale, which displayes grades from 1 to 5, with grade 1 meaning mild toxicity and grade 5 death related to toxicity	From three months after the start of radiotherapy until the end of follow-up or death, assessed up to 120 months