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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02588846
Registration number
NCT02588846
Ethics application status
Date submitted
14/07/2015
Date registered
28/10/2015
Titles & IDs
Public title
Multi-target Tracking in Prostate Radiotherapy Using MLC and KIM
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Scientific title
Phase I Feasibility Study of Accounting for Relative Motion of Multiple Targets in Prostate Cancer Radiotherapy Using Realtime Multi-leaf Collimator Adaptation and Kilovoltage (kV) Intrafraction Monitoring
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Secondary ID [1]
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Multi-target tracking
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Universal Trial Number (UTN)
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Trial acronym
KOALA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prostate Cancer
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Condition category
Condition code
Cancer
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring'
Experimental: Stage 1: Optimise nodal treatment margin - During Stage 1: Optimise nodal treatment margin, Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring' will be used to reshape the radiation beam in real-time. The nodal target position stability will be evaluated by the cone beam computed tomography (CBCT) imaging before and after each treatment session for the first 10 patients.
Experimental: Stage 2: Use treatment margin - During Stage 2: Use treatment margin, Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring' will be used to reshape the radiation beam in real-time. At the same time, multi-leaf collimator (MLC) tracking will be used to reshape the radiation beam in real-time using the margin size determined in Stage 1.
Treatment: Devices: Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring'
This intervention uses the simultaneous combined use of two technologies: 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring'. kV Intrafraction Monitoring (KIM) measures the motion of tissues targeted for radiotherapy in real time using kV imaging.The multi-leaf collimator (MLC) reshapes the radiation beam to maximise dose to the target tissue and minimise dose to the surrounding healthy tissue. Combining KIM and MLC allows the shaped radiation beam to follow the moving target (the prostate) while remaining fixed on a stationary target (lymph nodes) that are also being treated at the same time.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Software or mechanical failure
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Assessment method [1]
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The percentage of fractions delivered without software or mechanical failure
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Timepoint [1]
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The treatment period (2-9 weeks)
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Secondary outcome [1]
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Geometric accuracy
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Assessment method [1]
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The geometric accuracy of the beam shape, determined by comparing the ideal beam shape with the actual beam shape.
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Timepoint [1]
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The treatment period (2-9 weeks)
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Secondary outcome [2]
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Prostate motion trajectory
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Assessment method [2]
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Prostate motion trajectory measured by KIM.
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Timepoint [2]
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Treatment period (2-9 weeks)
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Secondary outcome [3]
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Dosimetric accuracy
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Assessment method [3]
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The estimated dose distributions will be compared to the original plan using the dose reconstruction method18 based on the prostate motion trajectory and the logged MLC positions (beam shapes).
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Timepoint [3]
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Treatment period (2-9 weeks)
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Secondary outcome [4]
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Acute toxicity
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Assessment method [4]
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Toxicity during treatment
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Timepoint [4]
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Treatment period (2-9 weeks) plus 3 months
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Eligibility
Key inclusion criteria
* Patients undergoing definitive external beam radiotherapy at Northern Sydney Cancer Centre
* Patients histologically proven prostate adenocarcinoma
* PSA obtained within 3 months prior to enrolment
* Pelvic lymph nodes are included for treatment for patients at stage T1c-T3b with Gleason 8-10 or prostate-specific antigen (PSA) > 20 ng/ml or pelvic lymph node positivity on conventional imaging or prostate-specific membrane antigen (PSMA) scans.
* Patient must be able to have gold fiducial markers placed in the prostate
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Ability to understand and the willingness to sign a written informed consent document.
* Prostate dimension that allows leaf span with tracking margin of ±8mm
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients with artificial Hip(s), lumbar spinal surgical rods or other large metallic pelvic implants
* Patient's dimensions >40cm as measured at the level of the prostate
* Patients with overlapping implanted gold fiducials in x-ray imaging
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Withdrawn
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
1/07/2020
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2023
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Actual
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Sample size
Target
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
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2065 - St Leonards
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Funding & Sponsors
Primary sponsor type
Other
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Name
Royal North Shore Hospital
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Assessing the feasibility of implementing real-time multi-leaf collimator (MLC) tracking to account for the relative motion of the moving prostate tumour target and the static pelvic nodal target for high-risk prostate cancer patients. The capability of tracking for the relative motion of multiple targets will ensure that all the treatment targets receive correct dose as prescribed by the doctor and minimise side effects to the critical organs.
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Trial website
https://clinicaltrials.gov/study/NCT02588846
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Thomas Eade, MBBS, RANZCR
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Address
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Director of Research, Senior Staff Specialist
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Share for research purposes with interested parties.
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02588846