Brachytherapy

Researchers are evaluating the safety and effectiveness of combining radioactive particles with the drug fluzoparib to treat advanced, inoperable soft tissue sarcoma. This phase II clinical trial focuses on patients with measurable tumors that cannot be surgically removed, aiming to understand how well this combination works in controlling the disease. Participants receive implantation of radioactive iodine-125 seeds followed by oral doses of fluzoparib at 150 mg twice daily after meals, starting 48 hours after the implantation. Fluzoparib is given continuously for 2 months per cycle, with tumor assessments monthly during the first cycle. Depending on tumor response, additional particle implantations (up to three) may be given, with medication pauses before surgeries and continuation after surgery until 6 months after the last implantation. The maximum treatment duration with fluzoparib is one year. Throughout the study, patients undergo regular tumor evaluations using CT or MRI scans and monitoring for side effects. Key outcomes include the objective response rate after 12 months, progression-free survival at multiple time points, overall survival rates, and safety events. Patients who experience intolerable side effects, disease progression, or choose to stop treatment enter a survival follow-up phase. The total participation may extend until study completion in December 2028.

Researchers are studying the long-term effects of high dose rate (HDR) brachytherapy in men who have isolated local relapses of prostate cancer after undergoing radical prostatectomy. The study aims to find out if HDR brachytherapy improves control rates and reduces complications compared to conventional external irradiation. This observational study focuses on men with prostate cancer recurrence visible on imaging and suitable for HDR brachytherapy. The treatment involves HDR brachytherapy combined with external beam radiation and six months of androgen deprivation therapy. HDR brachytherapy targets small, well-defined tumor areas using imaging techniques like PET/MRI and transrectal ultrasound guidance to deliver higher radiation doses while sparing sensitive surrounding tissues. This approach aims to reduce radiation exposure to critical structures such as the external urinary sphincter and penile bulb. Participants will receive HDR brachytherapy as part of their usual medical care and will be monitored for biochemical relapse-free survival over five years. The study includes regular imaging assessments, PSA monitoring, and evaluation of treatment effects and complications. The total participation period covers long-term follow-up to observe outcomes and safety in men treated for isolated prostate bed relapses after prostatectomy.

Researchers are investigating whether a higher radiation dose to the tumor can increase the rate of preserving the rectum in patients with non-locally advanced rectal cancer. This prospective study focuses on patients who want to avoid surgery and aims to improve quality of life by reducing long-term side effects. The trial explores a new radiation approach using cone-beam computed tomography (CBCT) for more accessible and adaptive treatment compared to MRI-guided methods. The study involves adding a simultaneous integrated boost (SIB) to the standard chemoradiotherapy regimen. Patients receive 25 radiation sessions where the mesorectum gets 2.0 Gy per fraction and the tumor plus affected lymph nodes receive 2.4 Gy per fraction. This single-arm trial includes 25 patients and uses CBCT imaging daily to guide treatment and monitor tumor and organ movement. Participants will have five MRI scans during treatment weeks, complete questionnaires at five time points, and provide blood samples to assess treatment effects and safety. Researchers will track organ preservation rates over two years, clinical and pathological responses, survival outcomes, bowel function, quality of life, and any treatment-related toxicities. The total follow-up lasts up to three years for some outcomes, with regular assessments to understand the effectiveness and impact of this adapted radiation therapy.

This research aims to collect data during High Dose Rate (HDR) brachytherapy treatments to track the brachytherapy source inside patients. The goal is to verify that the treatment plan is being delivered accurately and to detect errors or motion that are not currently monitored. The study involves patients receiving HDR brachytherapy for gynecologic (endometrium/cervix) or prostate cancer, treated on a CT couch. An external imaging panel (the investigational product) will be positioned beside the treatment table to continuously acquire data throughout the treatment. This device will not touch the patient or change the clinical workflow, as it is placed at a safe distance and powered by two cables integrated neatly with the treatment table setup. The data collected will be compared against the planned treatment information to identify discrepancies and improve treatment verification. Participants will undergo their usual HDR brachytherapy treatment while the external panel collects data automatically during radiation exposure. Clinical staff will not need to perform additional actions. The data analysis will be done offline after treatment sessions to avoid interruptions. The primary outcomes measured are dwell times and dwell positions during treatment within one year. The total participation duration depends on the patient's treatment schedule.

Researchers are evaluating Micro-Ultrasound Guided Focal Laser Ablation (MicroUSgFLA) as a treatment for men with intermediate-risk prostate cancer. This study aims to determine if this minimally invasive procedure can safely delay or avoid the need for more invasive treatments like surgery or radiation. The research focuses on men diagnosed with intermediate-risk prostate cancer to explore a simpler alternative to current options. Participants will receive MicroUSgFLA treatment using the TRANBERG|CLS Thermal Therapy device, which targets cancerous areas in the prostate guided by micro-ultrasound imaging. This single-arm study involves treating patients and then assessing them through MRI scans, biopsies, and PSA blood tests at six months after treatment. The procedure is designed to be less complex than MRI-guided treatments and may be accessible in community settings. During the study, participants will complete questionnaires about urinary and erectile function before treatment. Follow-up assessments include monitoring PSA levels, imaging, and biopsies to evaluate the treatment's technical success and impact on prostate cancer. The study's main outcomes are measured over six months, with safety and effectiveness closely monitored by the research team.

This research aims to evaluate the use of MRI guided Focal Laser Ablation (MRgFLA) in men with early stage, low to intermediate risk prostate cancer. The study focuses on determining how well MRgFLA can control prostate cancer while reducing the need for more invasive treatments like surgery or radiation. Previous studies suggest that MRgFLA may be a safe option with minimal side effects and help many patients avoid radical therapies over several years. Participants will receive focal laser ablation treatment guided by MRI, targeting the visible tumor with a margin around it to ensure thorough treatment. This is a single arm study where all patients will undergo the MRgFLA procedure using The TRANBERGCLS|Thermal Therapy device. After treatment, patients will have follow-up MRI scans and prostate biopsies at 6 months and 2 years, along with regular PSA blood tests to monitor cancer status. During the study, researchers will assess the presence of clinically significant prostate cancer using MRI and biopsy results. Patients will also complete validated questionnaires measuring urinary and sexual function before and at several points after treatment to track quality of life changes. The total monitoring period includes evaluations at 6 months, 12 months, and 24 months after treatment, allowing detailed assessment of treatment effects and safety over time.

The trial investigates the effects of adding postoperative radiotherapy (PORT) to surgery for patients with Stage II or III thoracic esophageal squamous cell carcinoma who have already received neoadjuvant chemoradiotherapy (nCRT). This study aims to compare overall survival time between patients treated with surgery plus PORT and those treated with surgery alone. Recurrence is a major challenge in treating this cancer, and the study evaluates whether PORT can reduce recurrence and improve survival. Patients are randomly assigned to two groups to assess these outcomes with a follow-up of at least 60 months. Participants in Group A receive a combination of neoadjuvant radiotherapy and chemotherapy, followed by esophagectomy surgery and then postoperative radiotherapy using intensity modulated radiotherapy (IMRT) to deliver a total dose of 18 Gy in 10 fractions. Group B receives the same neoadjuvant radiotherapy and chemotherapy plus esophagectomy but without the postoperative radiotherapy. The neoadjuvant radiotherapy involves 45 Gy in 25 fractions delivered 5 days per week, with chemotherapy given as two cycles of Docetaxel and Cisplatin every 21 days. Surgery is performed 4-6 weeks after chemotherapy. During the study, participants undergo assessments for overall survival as the primary outcome, with secondary outcomes including disease-free survival, local recurrence rate, and side effects monitored up to 12 weeks after treatment. The trial includes detailed evaluations of treatment effects over a minimum of five years post-treatment. Participants provide informed consent and are monitored for safety and treatment response throughout the study period.

This trial studies men with prostate cancer that has spread to pelvic lymph nodes but not to distant sites, identified using PSMA PET imaging. The goal is to compare two radiation dose escalation strategies—focusing on the prostate alone versus both prostate and lymph nodes—to find the best way to control the disease long-term. This phase II/III trial addresses gaps in current treatments by using modern imaging and ultrahypofractionated radiotherapy techniques alongside hormone therapies. Participants receive a standardized ultrahypofractionated whole-pelvis radiotherapy over five sessions combined with long-term androgen deprivation therapy. The study randomly assigns patients to receive either a prostate radiotherapy dose without additional boost or an ablative prostate boost via one of three methods. They also compare two levels of radiation dose to the PSMA PET-positive pelvic lymph nodes. Dose adjustments to protect organs at risk are allowed. Use of androgen receptor pathway inhibitors is permitted according to clinical practice. Throughout the study, participants undergo baseline PSMA PET/CT scans to confirm eligibility and exclude distant metastases. They are monitored regularly for metastasis-free survival up to 10 years, with additional assessments including overall survival, progression-free survival measured by imaging, local and nodal control, time to resistant cancer, treatment toxicity, and quality of life measures. Patient-reported outcomes on urinary, bowel, sexual function, and global health are collected, ensuring comprehensive evaluation of treatment impact and safety over long-term follow-up.

This research investigates the use of brachytherapy for treating gynecological cancers by looking back at past treatments and outcomes. It aims to evaluate aspects such as the applicator, dose, schedule, technology, imaging methods, 3D printing, effectiveness, and side effects of brachytherapy in this patient group. The study is observational and focuses on female patients with various gynecologic cancers. Participants include females aged 18 to 80 who have previously undergone brachytherapy for gynecological cancers such as cervical, uterine, vulvar, vaginal, or ovarian cancers. The study collects data retrospectively on different types of brachytherapy treatments, including radical, adjuvant, palliative, and others related to gynecologic oncology. The interventions studied involve radiation treatment details and technology used. During the study, researchers review past patient data to measure outcomes like the 5-year overall survival rate, progression-free survival rate, and side effects experienced over five years. There is no active treatment or new intervention; instead, the study analyzes historical records to better understand brachytherapy's long-term results and safety. The study is sponsored by Zhejiang Cancer Hospital and will continue collecting data until the end of 2027.

Researchers are evaluating a new approach for treating locally advanced rectal cancer by testing different doses of short-course radiotherapy (SCRT) followed by chemotherapy. The study aims to find the safest and most effective dose escalation of SCRT (5x6Gy, 7Gy, or 8Gy per fraction) combined with four cycles of modified FOLFOX6 chemotherapy to improve treatment outcomes. This approach is based on previous findings that SCRT shortens treatment time and reduces costs but has lower pathological complete response (pCR) rates compared to long-course radiotherapy. Participants receive preoperative short-course radiotherapy with escalating doses of radiation in groups, followed by four cycles of mFOLFOX6 chemotherapy before surgery. The radiation doses will increase stepwise from 6Gyx5 fractions to 8Gyx5 fractions using a traditional dose escalation design. This study includes three groups corresponding to each radiation dose level, and the safety and effectiveness of this combined treatment will be assessed. During the study, participants will undergo assessments to measure the pathological complete response rate, tumor removal success (R0 resection), sphincter preservation, surgical complications, and acute toxicities from radiation and chemotherapy. These evaluations occur four weeks after surgery and up to three months post-treatment. The study follows patients from preoperative treatment through surgery and recovery to monitor treatment effects and safety over this period.