Rectal Cancer Clinical Trial
Official title:
TraceIT® Hydrogel Spacer Injections for Vagina and Erectile Bundles Sparing in Rectal Cancer Patients Treated With Neoadjuvant Radiotherapy: a Feasibility Study
For advanced rectal tumors, the standard of care is neoadjuvant radiotherapy (RT) +/-
chemotherapy followed by surgery 8-10 weeks later. Despite its proven efficacy in reducing
local relapse, the neo-adjuvant treatment has been associated to non-negligible side effects,
especially in terms of impaired sexual function. For females, pelvic RT is frequently
associated to long-term complications such as vaginal stenosis (VS), vaginal dryness, and
dyspareunia, while in men RT doses delivered to the neurovascular peri-prostatic bundles and
penile bulb have been associated to the risk to develop erectile dysfunction.
In prostate cancer, hydrogel spacers have been evaluated to create space between the target
(prostate) and the organ (rectum) to be spared during radiotherapy treatments. Clinical
studies have shown the ease of spacer application; patient tolerance and, good clinical
outcomes (decrease in rectal toxicities).
This pilot study wishes to investigate feasibility and efficacy of the injected hydrogel
spacers TraceIT® in sparing vagina/prostate in the treatment of rectal cancer patients.
This is a feasibility prospective pilot study. Ten patients (5 males and 5 females) with a histologically proven locally advanced rectal cancer with the indication of neoadjuvant radiotherapy or radio-chemotherapy will be recruited for this study. Prior to enrollment, potential candidates will undergo a thorough physical and clinical examination and documentation on medical and surgical history. If eligible, a baseline planning computed tomography (CT) simulation will be performed at the Radiation Oncology Department before the TraceIT® implant. Participants will undergo a transperineal injection of TraceIT® spacer gel between rectum and vagina or prostate performed by a trained radiologist under transrectal ultrasound guidance. A CT simulation will be repeated within 3 to 5 days post injection using the same imaging modality and treatment position used the pre- TraceIT® injection. Radiation treatment plans will be generated using scans realized pre- and post- TraceIT® injection and compared using dose volume histograms (DVH) analyses. Tolerance, side effects, and adverse events related to the procedure will be recorded prospectively from the injection until week-4 after EBRT (External Beam Radiation Therapy) completion. Radiological status of the spacer will be evaluated on the preoperative magnetic resonance Imaging (MRI). Histopathological results and any serious and/or unanticipated adverse events following surgery procedure will be recorded retrospectively. ;
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