Clinical trial · Interventional
Efficiency of Contemporary Off-line Adaptive Radiotherapy for Lung Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 17, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260917-000001
Summary
Brief summary (as posted)
Locally advanced non-small cell lung cancer (LA-NSCLC) patients could benefit in overall and progression-free survival from regular dosimetric treatment plan adaptations during radiotherapy. This is known as adaptive radiotherapy (ART). However, implementing an adaptive radiotherapy workflow presents a highly cumbersome process. First, repeated planning-CT imaging during treatment is required, which results in additional radiation dose for patients. Second, an ART workflow includes the repetition of various manual and semi-automated tasks such as target and organ-at-risk contouring on the images and dosimetric treatment planning. These obstacles hinder widespread ART implementation. To avoid repeated planning-CT imaging, position-verification imaging can be utilized. Modern cone-beam CT (CBCT) imaging, integrated into the treatment unit, assists radiation therapists (RTTs) in administering the dose. Recent improvements in CBCT imaging sources and detectors have enhanced image quality. Moreover, it may be possible to calculate radiation dose directly on these CBCTs. Utilizing CBCT imaging for plan adaptation could also eliminate the need for an additional CT procedure, thereby increasing patient comfort. To address the labor-intensive contouring and treatment planning steps, CE-marked and validated commercial AI applications are already being used to support organ contouring and accelerate the treatment-planning process. These tools are currently applied to pre-treatment planning CTs. The time efficiency of these contemporary tools in a prospective ART workflow has yet to be studied, as has the feasibility of applying these applications within a CBCT-based ART workflow.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Adaptive Radiotherapy | — | UNRESOLVED | — |
| NSCLC (Advanced Non-small Cell Lung Cancer) | Lung Non-Small Cell Carcinoma | ALIAS | 0.85 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| CBCT-based adaptive radiotherapy | Device | — | UNRESOLVED |
Design
Arms and outcomes
Arms (1)
- type
- EXPERIMENTAL
- label
- CT-based Adaptive Radiotherapy applied midtreatment. Retrospective CBCT-based Adaptive comparison
- interventionNames
- Device: CBCT-based adaptive radiotherapy
Primary outcomes (4)
- measure
- Time required for each step of the prospective adaptive radiotherapy workflow
- timeFrame
- From initiation of the mid-treatment 4DCT scan until final approval of the adapted treatment plan, assessed for each participant, up to 7 weeks of radiotherapy
- description
- The total time required to complete each component of the prospective adaptive radiotherapy workflow will be quantified. Time measurements will be recorded using standardized digital workflow time-logging templates in the department's hospital document management system. The following steps will be assessed: * Acquisition of the repeated 4D planning CT * Automated organ-at-risk contouring (Syngo.via®) * Physician approval of organ-at-risk contouring * Manual tumor delineation * Knowledge-based treatment planning (RapidPlan®) * Medical physics plan review and approval * Physician plan review and approval The primary variable will be the total cumulative duration (minutes) and step-specific durations (minutes).
Eligibility
Eligibility (as posted)
- Sex
- All
Show eligibility criteria text
Inclusion Criteria: 1. Voluntary written informed consent of the participant or their legally authorized representative has been obtained prior to any screening procedures 2. Patients diagnosed with non-small-cell lung cancer 3. Locally advanced disease (≥Stage III) 4. Treated with sequential or concurrent chemoradiotherapy Exclusion Criteria: 1. Small-cell lung cancer 2. Non-small-cell lung cancer of early stage 3. Mesothelioma
References
Publications (3)
- BACKGROUNDBertholet J, Anastasi G, Noble D, Bel A, van Leeuwen R, Roggen T, Duchateau M, Pilskog S, Garibaldi C, Tilly N, Garcia-Molla R, Bonaque J, Oelfke U, Aznar MC, Heijmen B. Patterns of practice for adaptive and real-time radiation therapy (POP-ART RT) part II: Offline and online plan adaption for interfractional changes. Radiother Oncol. 2020 Dec;153:88-96. doi: 10.1016/j.radonc.2020.06.017. Epub 2020 Jun 21. PMID 32579998
- BACKGROUNDMoller DS, Lutz CM, Khalil AA, Alber M, Holt MI, Kandi M, Schmidt HH, Tvilum M, Appelt A, Knap MM, Hoffmann L. Survival benefits for non-small cell lung cancer patients treated with adaptive radiotherapy. Radiother Oncol. 2022 Mar;168:234-240. doi: 10.1016/j.radonc.2022.01.039. Epub 2022 Feb 2. PMID 35121030
- BACKGROUNDBerkovic P, Paelinck L, Gulyban A, van Eijkeren M, Surmont V, Lievens Y, Vandecasteele K. Adaptive radiotherapy for locally advanced non-small cell lung cancer: dosimetric gain and treatment outcome prediction. Acta Oncol. 2017 Nov;56(11):1656-1659. doi: 10.1080/0284186X.2017.1352103. Epub 2017 Aug 23. No abstract available. PMID 28835160