To quantify rectal tumour motion using (cine-)MRI and to correlate this motion with rectal wall movement in order to check the feasibility for CBCT controlled dose escalation for rectal cancer.
ID
Source
Brief title
Condition
- Malignant and unspecified neoplasms gastrointestinal NEC
- Gastrointestinal neoplasms malignant and unspecified
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Quantification of rectal tumour motion and correlation with rectal wall
movements using one (cine-)MRI in order to develop a CBCT controlled dose
escalation strategy for rectal cancer.
Secondary outcome
Not applicable
Background summary
For rectal cancer patients a clear association is known between the radiation
dose delivered at the tumour, the response and the prognosis. However delivery
of a high radiation dose is accompanied with high risk of adverse effects if
healthy tissues can not be spared. Therefore optimal tumour localisation during
radiotherapy (target verification) is an important issue. With standard x-ray
portal image target verification there is insufficient soft tissue contrast to
visualize pelvic soft tissue anatomy. Cone-beam computed tomography (CBCT)
improves this with appropriate rectal wall visualisation, but still it is not
possible to visualise the tumour and track tumour motion during therapy. Large
irradiation fields are therefore needed to assure complete tumour irradiation.
Consequentially healthy tissues are also irradiated which prevents delivery of
very high dose because of the large adverse effects expected. Magnetic
resonance imaging (MRI) provides excellent soft tissue contrast to visualise
the tumour and rectal wall. Cinematic-MRI (cine-MRI) besides, offers the
possibility to track real-time tumour motion to quantify tumour movement during
a therapy fraction. From these (cine-)MRI data the relation between the rectal
tumour motion and the rectal wall motion can be determined. When verifying the
rectal wall position using CBCT, this relation will estimate the tumour
position. This is the first prerequisite for dose escalation using CBCT
guidance.
Study objective
To quantify rectal tumour motion using (cine-)MRI and to correlate this motion
with rectal wall movement in order to check the feasibility for CBCT controlled
dose escalation for rectal cancer.
Study design
Observational study during short course pre-operative radiotherapy for rectal
cancer with daily (cine-)MRI. One the first day of irradiation treatment a
(cine-)MRI will be performed for quantification of tumour and rectal wall
movement. On the second till the fifth day (cine-)MRI scans will be performed
to validate the motion characteristics and correlations found in the first
scan.
Study burden and risks
Patients will undergo daily (cine-)MRI scans. All scans will be scheduled in
combination with radiation treatment, before or after the treatment fraction.
The use of MRI is after proper screening free of any risks. For the patients
included in the study there is no individual benefit.
Heidelberglaan 100
3584 CX Utrecht
Nederland
Heidelberglaan 100
3584 CX Utrecht
Nederland
Listed location countries
Age
Inclusion criteria
Rectal tumour < 15cm from the anal verge
Receiving 5x5 Gy short course pre-operative radiotherapy
Written informed consent
Exclusion criteria
Patients who meet exclusion criteria for MRI following the protocol of the department of radiology UMC Utrecht
Patients with history of pelvic surgery
Patients with other pelvic malignancies
Patients with inflammable bowel diseases or diverticulitis
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL29622.041.09 |