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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05942742
Other study ID # 69HCL23_0133
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date June 1, 2022
Est. completion date November 1, 2024

Study information

Verified date July 2023
Source Hospices Civils de Lyon
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The management of locally advanced cervical cancer (Figo >IB) is based on radiochemotherapy (RCT) followed by brachytherapy. At present there is no personalized treatment, all patients undergoing radiochemotherapy will follow a conventional treatment by external radiotherapy (46 Gy in 23 sessions associated with cisplatin (CDDP) weekly) and brachytherapy to achieve a total equivalent biological dose around 80-90 Gy).The efficacy of this treatment has been proven for most patients, almost 80% being in complete response after RCT. Nevertheless, on an individual scale, there remains a significant variation in the tumor response, with patients who respond from the first week of treatment, "early responders" or, on the contrary, others who present significant tumor residues after external beam radiotherapy.Various macroscopic tumor volume (GTV) response patterns have been identified based on magnetic resonance imaging (MRI) at diagnosis and MRI before brachytherapy, implying very different clinical target volumes for brachytherapy technique. The difference in tumor volume response has been identified as having a major impact on treatment response. This is the first study attempting to evaluate tumor response in real time during radiochemotherapy treatment. Knowing the tumor response during treatment will make it possible to modify the management of locally advanced cervical cancer, several therapeutic options might then be discussed depending on the early response to treatment: dose de-escalation for early responders, reduction of time total treatment, personalization of brachytherapy management (technique and dose). This observational study will allow rapid identification of responder and non-responder patients and might be used as a basis for personalized treatment strategies


Recruitment information / eligibility

Status Recruiting
Enrollment 55
Est. completion date November 1, 2024
Est. primary completion date September 1, 2024
Accepts healthy volunteers No
Gender Female
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - Women aged = 18 and = 70 years old. - Histologically confirmed cervical cancer: stage IB2-IVA squamous cell carcinoma or adenocarcinoma (FIGO 2018 criteria), regardless of pelvic lymph node status, no positive lomboaortic lymph nodes. Patients should have no metastatic localization of disease. - Performance index = 1 (WHO). - Hematological function: polymorphonuclear neutrophils > 1.5 x 109/L, platelets > 100 x 109/L, hemoglobin > 8,5 g/dL. - Liver function: total bilirubin < 20 µmol/L or < 12mg/L - Renal function: creatinine clearance MDRD (Modification of diet in renal disease) >40 ml/min creatinine - Serum pregnancy test within 7 days before the start of study treatment if risk of pregnancy mentioned by the patient - Patient able to sign an informed consent form Exclusion Criteria: - Previous treatment with radiotherapy, chemotherapy, targeted therapy or immunotherapy treatment for cancer of the cervix or for any other cancer within the previous 5 years. - Live vaccine, such as yellow fever vaccine. - History of pelvic irradiation or prior surgical treatment for cancer of the cervix (excluding diagnostic conization). - Contraindication to MRI imaging (pace maker, metal prosthesis, phobia, etc.) - Contraindication to the use of cisplatin. - Inability to perform the follow-up required by the study for geographical, social or psychological reasons. - History of HIV, HBV or HCV infection with positive serology. - Pregnant or breastfeeding woman

Study Design


Related Conditions & MeSH terms


Intervention

Device:
MRI Linac
External radiotherapy will be performed at Linac MRI, 25 fractions of radiation will be delivered for each patient.The MR-linac offers the ability to individualise and adapt daily treatment plans based on the position or anatomy of the day, following either a simple 'virtual couch shift' adapt-to-position (ATP) approach, or a more complex full reoptimisation adapt-to-shape (ATS) method based on the recontouring of relevant structures. During each radiation therapy, T2-weighted images and diffusion images will be purchased.Treatment plans can be produced and checked by appropriately trained Radiation Oncologists. Each radiation oncologist will decide based on the anatomy of the day the type of workflow to be used (ADP or ATS) for treatment.Patients will undergo accurate image acquisition, registration and interpretation to make sound clinical judgements and proceed to safe and accurate treatment delivery.

Locations

Country Name City State
France Centre Hospitalier Lyon-Sud - Radiotherapie/Oncologie Pierre-Benite

Sponsors (1)

Lead Sponsor Collaborator
Hospices Civils de Lyon

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary Recist criteria The local response will be defined by the Recist 1.1 criteria on MRI. The response will be binary, i.e. complete response versus the 3 other categories of the Recist 1.1 classification that is to say partial response, stabilization or progression.
Nevertheless will identified 3 favorable situation:
complete response on MRI and PET scan
partial response but surgery no performed
partial response, surgery performed and no disease identified on the anatomopathology results
8-10 weeks after the end of the treatment
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