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CompletedNCT03459898Updated May 5, 2022

Assessment of Left-sided Cardiac Sparing Through the Use of 3-dimensional Surface Matching-based Deep Inspiration Breath Hold and Active Breathing Control

An interventional study of AlignRT system (VisionRT Ltd., London, UK) in Left-Sided Breast Cancer, sponsored by Sunnybrook Health Sciences Centre. Completed at 1 site in Canada. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-05-05.

Sponsored by Sunnybrook Health Sciences Centre · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Non-randomized
Ages
18 Years and older
Sex
Female
01

Study summary

The standard treatment for breast cancer is surgery followed by adjuvant breast radiation therapy in most cases. For left sided breast cancers, the heart dose delivered by the radiation treatment is often of particular concern. In order to spare the heart, different strategies are currently available, including active breathing control (ABC) and voluntary deep in inspiration breath hold (DIBH) (both strategies are currently being used at our centre). To perform accurate heart-sparing treatments, it is important to ensure that patients are positioned consistently. One available approach is through surface imaging which tracks the position of a portion of the skin surface, known as the AlignRT system (VisionRT Ltd, London, UK).

02

Conditions studied

  • Left-Sided Breast Cancer
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Women with diagnosis of left-sided breast malignancy
  • Women who require left chest wall or breast irradiation status post mastectomy or lumpectomy
  • Treatment with modified wide tangents to include IMCs
  • Treatment with four-field technique
  • Age >18 years
  • Performance status ECOG \<3
  • Patient must be able to maintain a 30 second breath hold
  • Conventional chest wall or breast radiation delivery dose of 50Gy/25 or hypofractionated chest wall/breast radiation delivery dose of 42.56Gy/16 with or without a boost

Exclusion criteria

Exclusion Criteria:

  • Right sided breast cancer patients
  • Treatment with partial breast irradiation
  • Previous left breast/chest wall irradiation
  • Locally advanced breast cancer
  • Pregnant patients
  • Unable to follow commands
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Other
    Active Breathing Control

    To review our institutional clinical experience of applying the AlignRT system to monitor patient setup and reproducibility when using ABC and DIBH techniques in the treatment of left-sided breast cancer patients.

    Device: AlignRT system (VisionRT Ltd., London, UK)

  • Other
    Deep Inspiration Breath Hold

    To review our institutional clinical experience of applying the AlignRT system to monitor patient setup and reproducibility when using ABC and DIBH techniques in the treatment of left-sided breast cancer patients.

    Device: AlignRT system (VisionRT Ltd., London, UK)

Interventions

  • DeviceAlignRT system (VisionRT Ltd., London, UK)

    To review our institutional clinical experience of applying the AlignRT system to monitor patient setup and reproducibility when using ABC and DIBH techniques in the treatment of left-sided breast cancer patients.

05

What researchers measure

Primary outcomes

  1. Reproducibility of ABC or vDIBH set-up as measured by Align RT.

    Reproducibility of set-up will be evaluated by determining discrepancies in patient's surface between treatment and CT simulation which will be acquired with the Align RT system using multiple measures along with daily portal images during treatment and weekly CBCTs.

    Time frame: 2 years

  2. Mean heart dose as determined using Align RT.

    Estimate the change in mean heart dose for each breath-hold/heart sparing strategy by: i. Converting differences in heart position on 2D portal images acquired during treatment to 3D volumes on Pinnacle plans. ii. Using the CBCT images (acquired weekly), to recalculate dose to heart based on the patient's position and anatomy that day.

    Time frame: 2 years

Secondary outcomes

  1. The impact of Align RT with vDIBH as compared to vDIBH without AlignRT on quality of life as assessed by the EORTC core QoL questionnaire.

    QoL will be assessed using the EORTC core QoL questionnaire (QLQ-C30) which is a well-validated and widely used QoL questionnaire available in multiple languages (12,13). QLQ-C30 is composed of 30 questions that represent 5 functional scales (physical, role, cognitive, emotional and social), 3 symptom scales (fatigue, nausea and vomiting, and pain), and a global health / QoL scale. The questionnaire will be completed by patients at time of radiation simulation as baseline, at completion of RT (during routine review) and at the 6-8 week follow-up.

    Time frame: 2 years

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Study locations

1 site
  • Sunnybrook Health Sciences Centre
    Toronto, Ontario M4N 3M5, Canada
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT03459898
Lead sponsor
Sunnybrook Health Sciences Centre
Responsible party
Dr. Irene Karam (Radiation Oncologist, Sunnybrook Health Sciences Centre) — Principal investigator
First posted
Mar 9, 2018
Start date
May 19, 2018
Primary completion
Dec 31, 2021
Completion
Jan 30, 2022
Last update
May 5, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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