Toward High Fidelity Adaptive Radiotherapy in the Thorax
Study Details
Study Description
Brief Summary
Daily adaptive radiotherapy with individualized planning margins for thoracic and pelvic cancer patients will increase the potential of reducing dose to OARs, thereby reducing treatment-related toxicities and ultimately providing these patients with a better quality of life. Thus, the overarching objective of this work is to develop a CBCT-guided adaptive workflow and to measure the benefits to patients of the adaptive treatment paradigm utilizing patient reported outcomes in a first-of-kind study.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
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To individualize the planning margins used for treatment, we will assess the impact of the different uncertainties on patient-specific planning margins. We determine the dosimetric uncertainties for patients during planning and delivery through the daily adaptive process. In so doing, we will determine the relationship between the dose distributions and the associated treatment outcomes.
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To perform retrospective clinical studies using patient data, we determine the relationship between dosimetry from plans developed using the optimized patient-specific margins (plans from (1) that are robust to uncertainties) and retrospective, clinical outcomes. This data will be used to inform daily adaptation and plan quality criteria for a prospective clinical protocol.
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To develop (with our clinical collaborators) a first-of-kind study to measure the efficacy of daily adaptive treatment with individualized planning margins, using clinical and quality of life (patient reported) outcomes, and to compare these against the conventional treatment approach, where a single treatment plan with population-based treatment margins is utilized for all treatment fractions.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Adaptive Radiotherapy Patients treated using adaptive radiotherapy on the Varian Ethos linear accelerator |
Radiation: CBCT-guided Adaptive Radiotherapy
The aim is to deliver adaptive radiotherapy using a CBCT-based radiotherapy delivery system.
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| Conventional Radiotherapy Patients treated using conventional, non-adaptive radiotherapy on the Varian Truebeam linear accelerator |
Outcome Measures
Primary Outcome Measures
- Determine the incidence of dose limiting toxicity (grade >= 3) for NSCLC patients using CBCT-guided adaptive radiotherapy and the CTCAE/QUANTEC protocols [2 years]
The study aims to determine whether CBCT-guided adaptive radiotherapy can have a positive benefit in reducing the incidence of normal tissue toxicity (e.g. radiation pneumonitis)
Secondary Outcome Measures
- Quality of Life measures using the FACT-TOI Lung [2 years]
Dose and volume data will be collected and correlated with treatment-related side effects and quality of life data.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Histologically confirmed non-small cell lung cancer patients
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Locally advanced
Exclusion Criteria:
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Henry Ford Health System
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Dial C, Weiss E, Siebers JV, Hugo GD. Benefits of adaptive radiation therapy in lung cancer as a function of replanning frequency. Med Phys. 2016 Apr;43(4):1787. doi: 10.1118/1.4943564.
- Herschtal A, Te Marvelde L, Mengersen K, Foroudi F, Eade T, Pham D, Caine H, Kron T. Sparing healthy tissue and increasing tumor dose using bayesian modeling of geometric uncertainties for planning target volume personalization. Int J Radiat Oncol Biol Phys. 2015 Jun 1;92(2):446-52. doi: 10.1016/j.ijrobp.2015.01.034. Epub 2015 Apr 3.
- Yan D, Georg D. Adaptive radiation therapy. Z Med Phys. 2018 Aug;28(3):173-174. doi: 10.1016/j.zemedi.2018.03.001. Epub 2018 Mar 27.
- Zhong H, Siddiqui SM, Movsas B, Chetty IJ. Evaluation of adaptive treatment planning for patients with non-small cell lung cancer. Phys Med Biol. 2017 Jun 7;62(11):4346-4360. doi: 10.1088/1361-6560/aa586f. Epub 2017 Jan 10.
- HighFidelityART