The measurement of pancreatic tumour motion during end expiratory and end inspiratory breath hold during the preparatory CTscan and three radiation fractions and comparing this with the tumour motion during free breathing. The assessment of the…
ID
Source
Brief title
Condition
- Gastrointestinal neoplasms malignant and unspecified
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
tumour motion during the preparatory CT scan and during three radiation
fractions under breathhold conditions compared to the tumour motion under free
breathing conditions.
Practical feasibility of applying a breathhold technique in patients with
pancreatic cancer.
Secondary outcome
Calculation of the impact of the above indicated measurementson the safety
margin for irradiation of pancreatic cancer
Background summary
During irradiation for pancreatic cancer a safety margin has to be taken into
account for tumour motion due to breathing. Endosonographically implanted gold
fiducials. have recently been introduced to visualize the tumour on CT scans
and during radiotherapy on cone beam CT scans, to enhance the accuracy of
radiation. Thanks to these fiducials we have been able to measure that intra
fractional tumour motion may be in the order of 1 cm, particularly in
craniocaudal direction.
We hope to diminish this intrafractional tumour motion by applying breathhold
techniques, giving radiation while the patient holds his or her breath during
inspiration or expiration. Whether tis is useful in pancreatic cancer is not
known, since it is possible that the intra fraction tumour motion is partly
dependent upon other factors than breathing.
Study objective
The measurement of pancreatic tumour motion during end expiratory and end
inspiratory breath hold during the preparatory CTscan and three radiation
fractions and comparing this with the tumour motion during free breathing.
The assessment of the feasibility of a breath hold technique for irradiation of
pancreatic cancer.
Study design
In 10 patients being irradiated for their (borderline) resectable pancreatic
cancer who give informed consent for participation in this study, The tumour
motion will be measured in breath hold conditions during the preparatory CT
scan and during three radiotherapy fractions and will be compared to the tumour
motion in free breathing conditions. During the preparatory phase this will be
done taking extra CT-scans during breath hold in insiration and expiration.
During the three radiotherapy fractions extra cone beam CT scans in breath hold
conditions and fluoroscopy in breath hold conditions will be performed.
Based on these measurements, the potential impact of a breath hold technique on
the safety margins for irradiation of pancreatic cancer will be calculated.
Study burden and risks
Participation to this study will mean an extra time investment for the patient
of about an hour in the preparatory phase and three times a quarter of an hour
during the radiation course. There is an extra radiation burden of 390-675
milliSievert, comprising less than 2% of the total therapeutic radiation dose
that is prescribed.
If, indeed, the safety margins can be diminished by applying a breath hold
technique for radiation of pancreatic cancer, this may lead to less toxicity
and hence improvement of the therapeutic window for radiochemotherapy.
Meibergdreef 9
Amsterdam 1105 AZ
NL
Meibergdreef 9
Amsterdam 1105 AZ
NL
Listed location countries
Age
Inclusion criteria
* Patients with pancreatic cancer, with locally advanced or (borderline) resectable status, who are treated with radio(chemo)therapy;
* WHO performance status of 0-2;
* Written informed consent.
Exclusion criteria
* Inability to undergo the additional treatment planning CT scan and fluoroscopy;
* Serious lung condition precluding breath-hold.
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 | NL47655.018.14 |