Stereotactic Body Radiotherapy for Lung Lesions With Markerless Tracking (MLT) on the VERO® SBRT System (SBRT_LOV)

Universitair Ziekenhuis Brussel

Status: Withdrawn

Conditions: Lung Cancer Metastatic; Lung Cancer, Nonsmall Cell; Lung Cancer Stage IV; Lung Diseases; Lung Cancer; Stereotactic Body Radiotherapy

Treatments: Radiation: Standard radiotherapy treatment

Study type: Observational

Funder types: Other

Identifiers

NCT06722885

SBRT_LOV

Details and patient eligibility

About

Stereotactic Body Radiotherapy (SBRT) delivers an ablative dose of radiation to tumours, with high precision. This technique offers an alternative to surgery for lung lesions. The UZ Brussel of the VUB developed with the support of the Hercules foundation (grant for heavy research infrastructure) in collaboration with Brainlab AG a breathing-synchronized radiation technique on the VERO SBRT system, where the radiation beam follows the moving target (dynamic tumour tracking). The implantation of a marker in the tumour is thereby mandatory for its visualization but excluding patients with poor pulmonary function. Therefore Brainlab® recently released an update of the VERO SBRT system that allows "Markerless Tracking". This markerless technique is currently being implemented at the Radiotherapy Department of UZ Brussel for lung lesions. Hence we plan an observational study that will document the outcome of and feasibility for patients with lung lesions treated with markerless tracking on the VERO SBRT system at the Radiotherapy Department in UZ Brussel.

Full description

Stereotactic Body Radiotherapy (SBRT) delivers an ablative dose of radiation to tumours, with high precision. This technique offers an alternative to surgery for lung lesions. The movement of these tumours represents a clinical problem and a technological challenge. The UZ Brussel of the VUB developed with the support of the Hercules foundation (grant for heavy research infrastructure) in collaboration with Brainlab AG a breathing-synchronized radiation technique on the VERO SBRT system, where the radiation beam follows the moving target (dynamic tumour tracking). The implantation of a marker in the tumour is thereby mandatory for its visualization but excluding patients with poor pulmonary function. Moreover, the placement of such an implanted fiducial marker is contraindicated for about 30% of the patients and may be associated with complications such as pneumothorax and bleeding.

Therefore Brainlab® recently released an update of the VERO SBRT system that allows "Markerless Tracking" (MLT). This markerless technique is currently being implemented at the Radiotherapy Department of UZ Brussel for lung lesions. Within the Spearhead Strategic Research Program "Societal Benefit of Markerless Stereotactic Body Radiotherapy: a Statistical Support based on Quantitative Imaging", the investigators aim at evaluating the implementation of this technique focusing on patient outcomes and clinical feasibility. In order to do so they plan an observational study that will document the feasibility and outcome of patients with lung lesions treated with markerless tracking on the VERO SBRT system at the Radiotherapy Department in UZ Brussel.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

1. Primary NSCLC patients, stage T1-2bN0M0 (TNM 8th edition)

2. Oligometastatic patients with ≤ 3 lung metastases; SBRT as a primary treatment or as a consolidative treatment after induction chemotherapy;

3. >= 18 years

4. Patients will be recruited via the treating radiotherapist

   Exclusion Criteria:

Trial design

0 participants in 3 patient groups

Markerless tracking

Description:

* Gross tumor volume for MLT (GTV_MLT): lesion delineated on stable exhale phase of the 4DCT. * Planning target volume for MLT (PTV_MLT): GTV + 8 mm isotropic expansion

Treatment:

Radiation: Standard radiotherapy treatment

ITV approach

Description:

* Gross tumor volume (GTV): lesion delineated on the ten phases of the 4DCT. * Internal target volume (ITV): propagate all GTV on stable exhale phase of the 4DCT. * Planning target volume for ITV (PTV_ITV): ITV + 5 mm isotropic expansion

Treatment:

Radiation: Standard radiotherapy treatment

Markerbased tracking

Description:

* Gross tumor volume for tracking (GTV_Track): lesion delineated on stable exhale phase of the 4DCT. * Planning target volume for tracking (PTV_Track): GTV + 5 mm isotropic expansion

Treatment:

Radiation: Standard radiotherapy treatment