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Efficiency of Contemporary Off-line Adaptive Radiotherapy for Lung Cancer

NCT07259447 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 30

Last updated 2025-12-02

No results posted yet for this study

Summary

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

  • NSCLC (Advanced Non-small Cell Lung Cancer)
  • Adaptive Radiotherapy

Interventions

DEVICE

CBCT-based adaptive radiotherapy

The objective is to temporarily implement and study the efficiency of a prospective ART workflow for LA-NSCLC using repeated planning-CT imaging. This initiative aims to contour and plan in accordance with the contemporary clinical AI-tools already being standard-of-care in the pre-treatment workflow, with a specific focus on evaluating and reporting the time efficiency of the process. Following the prospective part, we want to retrospectively study a CBCT-based ART workflow for LA-NSCLC using CBCT imaging in comparison with the CT-based ART workflow. The contours and treatment plans generated utilizing 4DCT imaging serve as ground truth. These retrospective tests are fully outside the clinical flow. We will evaluate whether it is possible to implement an adaptive workflow without repeated planning-CT imaging. For this objective, we will utilize the same commercial AI tools, with a focus on reporting both the time efficiency and the quality of contours and plans in comparison.

Sponsors & Collaborators

  • Universitaire Ziekenhuizen KU Leuven

    lead OTHER

Study Design

Allocation
NA
Purpose
TREATMENT
Masking
NONE
Model
SINGLE_GROUP

Eligibility

Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2024-06-21
Primary Completion
2026-08-01
Completion
2026-12-31

Countries

  • Belgium

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07259447 on ClinicalTrials.gov