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Image-guided Brachytherapy for Vaginal Cancer (EMBRAVE)

Recruiting
Conditions
Vaginal Neoplasms
Interventions
Other: Observational study (Non-interventional study)
Registration Number
NCT06514235
Lead Sponsor
Erasmus Medical Center
Brief Summary

The goal of this clinical study is to improve clinical outcomes of patients with vaginal cancer who are treated with curative intent by primary radio(chemo)therapy and image-guided adaptive brachytherapy (IGABT).

Being an observational, prospective registration study, wherein neither an experimental treatment is compared to the standard treatment, nor groups of patients are compared.

The specific aims are:

* to develop evidence-based recommendations for curative intent treatment with primary radio(chemo)therapy and IGABT.

* to identify prognostic parameters for oncological outcomes, morbidity and quality of life.

The study aims to enroll at least 300 patients. Oncological events will be evaluated at 2 and 5 years of follow-up. Acute and late morbidity events will be evaluated at end of treatment, 2 and 5 years of follow-up.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
300
Inclusion Criteria
  • Histologically proven primary vaginal cancer or carcinoma in situ, per WHO classification
  • Histological types: main cohort: squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma of the vagina; parallel cohort: other epithelial carcinomas and carcinoma in situ/vaginal intraepithelial neoplasia, as per WHO classification
  • Primary vaginal cancer are treated following the protocol target concept.
  • Primary vaginal cancer: Stage I-IVA; para-aortic lymph node metastasis below L1-L2 interspace are allowed
  • Planned IGABT treatment with MRI-guided adaptive brachytherapy (at least the 1st fraction contouring and planning on MRI; CT for later fractions is allowed); main cohort: External beam radio(chemo)therapy followed by IGABT; parallel cohort IGABT alone
  • IGABT alone for stage I <2 cm or carcinoma in situ will be registered in a parallel cohort in this study
  • Treatment with curative intent
  • Written informed consent
Exclusion Criteria
  • Vaginal cancers with involvement of the ostium of the cervix or vulva (these should be classified as cervical cancer or vulvar cancer, respectively)
  • Metastatic disease beyond para-aortic region L1-L2 interspace
  • Sarcomas and melanomas.
  • Treatment only by external beam radiotherapy
  • Treatment by primary surgery or debulking surgery
  • Treatment with neo-adjuvant radiotherapy and/or neo-adjuvant chemotherapy followed by surgery
  • Treatment including neo-adjuvant or adjuvant chemotherapy
  • Previous pelvic or abdominal radiotherapy
  • Pregnancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Primary vaginal cancerObservational study (Non-interventional study)Adult patients with vaginal cancer treated with curative intent by primary radio(chemo)therapy and MRI based image-guided adaptive brachytherapy according to the protocol target concept.
Primary Outcome Measures
NameTimeMethod
Local failure2 and 5 years of follow-up

A new, recurrent or progressive residual tumor within the external beam low-risk clinical target volume (CTV-TLR).

Acute physician-assessed morbidity and patient reported outcomesEnd of Treatment

Physician-assessed (CTCAE v.5) and Patient Reported Outcome (EORTC C30, selected items of CX24, EN24 and VU34).

Late physician-assessed morbidity and patient reported outcomes2 and 5 years of follow-up

Physician-assessed (CTCAE v.5) and Patient Reported Outcome (EORTC C30, selected items of CX24, EN24 and VU34).

Secondary Outcome Measures
NameTimeMethod
Other oncological outcomes2 and 5 years of follow-up

Regional failure, distant metastasis, disease free survival, disease-specific survival, overall survival.

Trial Locations

Locations (1)

Erasmus MC

🇳🇱

Rotterdam, Zuid-Holland, Netherlands

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