Magnetic Resonance Imaging (MRI) Guided Stereotactic Adaptive Radiotherapy for Targeting Abdominal Cancer

Launched by AUSTRALASIAN GASTRO-INTESTINAL TRIALS GROUP · Sep 17, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new way to treat abdominal cancer using a technique called MRI-guided adaptive stereotactic radiotherapy (SABR). This method helps doctors target cancer spots in the abdomen more precisely, which may improve control of the cancer, increase survival rates, and reduce side effects. The trial is looking for patients who have a specific type of cancer called oligometastatic disease, where there are only a few cancer spots (up to five) in the abdomen. Eligible patients should be at least 18 years old and have had their original cancer treated with the aim to cure it.

If you or someone you know is interested and meets the criteria, participating in this trial could involve imaging tests to ensure the cancer is visible and treatable with SABR. Participants will need to provide consent and may undergo regular check-ups during the study. It's important to note that certain conditions, like previous high-dose radiation treatment or specific types of cancers, may exclude someone from joining. This trial is currently not recruiting participants, but it aims to provide valuable insights into a promising treatment option for abdominal cancer.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Aged 18 years or older
• * Patients with diagnosis of oligometastatic disease from primary colorectal, upper gastrointestinal (e.g. gastric, oesophagus, pancreatic), breast, non-small cell lung, renal cell, or gynaecological malignancy. Oligometastatic disease with controlled primary disease\* and maximum total of 5 metastatic lesions in a maximum of 2 different organ systems in any of the following sites:
• • 1. Liver
• • 2. Adrenal
• • 3. Abdomino-pelvic lymph node
• • 4. Other abdominal site e.g. pancreatic, renal.
• • 5. Other pelvic site
• • 6. Bony or lung is allowed only if in conjunction with an abdominal site above
• • De novo or metachronous oligometastatic disease where the original tumour site has been treated with curative intent.
• • Controlled primary disease in metachronous oligometastastic disease defined as at least 3 months since original tumour treated with curative intent and no progression at primary site
• • Controlled primary disease in de novo oligometastatic disease defined as primary tumour site treated with curative intent and no progression at primary site
• • Oligometastatic disease: Histological confirmation of primary malignancy (histological confirmation of metastasis is not mandatory but should be performed in any situation where there is any diagnostic uncertainty).
• • All oligometastatic sites treatable with SABR.
• • OR
• • Patients with oligo-progressive / oligo-persistent disease in maximum total of 2 oligo-progressive abdominal metastases and in a maximum 2 different organ systems
• • Visible imaging defined targets and suitable for treatment with SABR
• • Childs Pugh A to B7 (in case of liver treatment)
• • ECOG 0 -2
• • Patient consented
• Exclusion Criteria:
• • Contra-indication to MRI
• • Previous high dose radiotherapy to a site requiring stereotactic treatment (including SIRTEX). Further SABR treatment of lesions previously treated with SABR or high dose radiotherapy is not permitted in this trial.
• • Substantial overlap with a previously treated high dose (definitive or stereotactic dose) radiation volume.
• • Primary prostate cancer, carcinoid tumours, germ cell tumours, lymphoma, small cell tumours
• • Pregnant women
• • Complete response of metastatic disease to systemic therapy (i.e. no target for SABR)
• • Competing medical co-morbidity with a more limited prognosis than the cancer diagnosis