Study of Pelvic Hypofractionated Radiotherapy in Endometrial Cancer

The University of Chicago

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: Endometrial Cancer

Treatments: Other: Clinical Follow-Up and Assessments; Radiation: Hypofractionated Radiation

Study type: Interventional

Funder types: Other

Identifiers

NCT04683653

IRB20-1390

Details and patient eligibility

About

This study will investigate if a shorter treatment course (known as "hypofractionation") for pelvic radiation is safe for women with endometrial cancer. Doctors leading the study will also determine the safest and most tolerable dose of shortened radiation (hypofractionation) used to treat women in this study. Because this study will shorten the radiation course typically used to treat endometrial cancer, each daily treatment given to women in this study will be slightly higher than normal to ensure that the total radiation dose they receive is still effective and similar to the radiation dose they would receive if they were not participating in this study (standard treatment).

Enrollment: 100 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of primary cervical cancer or uterine cancer of any histology
• Age ≥ 18 years.
• Non-metastatic disease according to the International Federation of Gynecology and Obstetrics (FIGO).
• Must have been treated with definitive intent, including standard-of-care hysterectomy, without any gross residual disease post-operatively. Nodal dissection is not required, but if it is not performed, then diagnostic imaging to confirm absence of gross pelvic or para-aortic disease should be obtained pre- or post-operatively.
• Recommended to undergo whole pelvic radiotherapy without concurrent chemotherapy or para-aortic radiation. Chemotherapy before or after radiotherapy is acceptable.
• Eastern Cooperative Oncology Group (ECOG) PS≤ 2
• Able to provide informed consent and willingness to sign an approved consent form

Exclusion criteria

• Distant metastases as determined clinically or radiographically based upon standard-of-care work-up for endometrial cancer.
• Concurrent (or other) chemotherapy occurring at the time of study.
• Gross residual disease (cancer cells that remain after attempts to remove the cancer have been made) post-operatively and/or at the time of radiation based upon pre-op or post-op imaging, intra-operative findings, and gynecologic oncologists' judgment.
• History of small bowel obstruction, inflammatory bowel disease, irritable bowel syndrome, connective tissue disorder requiring ongoing active medical management, or prior radiation therapy directed to the pelvis.
• Unresolved grade 2 or higher chemotherapy-associated diarrhea or abdominopelvic pain requiring medication prior to the initiation of radiation.
• Recommendation to undergo para-aortic nodal irradiation.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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100 participants in 2 patient groups

Hypofractionated Radiation Treatment (Dose-Finding Arm)

Experimental group

Description:

All study participants in this arm will receive hypofractionated whole pelvic radiation treatment for a shortened time period of 3-5 weeks. The goal of this arm is to establish a safe and tolerable dose of shortened (hypofractionated) pelvic radiation treatment for study participants. Once a safe and tolerable dose is established for this shortened form of radiation treatment, participants who meet criteria for the second phase of this study will participate in an expansion cohort that will explore the efficacy (how effective shortened/hypofractionated radiation treatment is for treating endometrial cancer).

Treatment:

Radiation: Hypofractionated Radiation

Expansion Cohort (Efficacy Arm)

Experimental group

Description:

Participants in this arm will test how effective hypofractionated/shortened whole radiation treatment is ("efficacy") at the dose established in the first phase of this study by following up with their doctors to report their current health status and symptoms during clinical visits. Participants will return for routine clinical follow-up approximately 1 month following radiation, then at 3 months following radiation, then every 3 months for the next 2 years following treatment.

Treatment:

Other: Clinical Follow-Up and Assessments