Phase 2 Randomized Trial of MRI-Guided Adaptive Stereotactic Radiotherapy for Treating Abdominal Oligometastatic Cancer

What this Trial Is About

Researchers are evaluating the effects of MRI-guided adaptive stereotactic radiotherapy on local control, survival, and side effects in patients with oligometastatic cancer in the abdomen. This Australian-led Phase 2 randomized trial aims to provide high-level evidence on whether this new technology improves patient outcomes and helps select suitable patients for MRI-Linac treatment. The study focuses on abdominal oligometastatic or primary liver cancer and investigates treatment accuracy and potential MRI biomarkers predicting response. Participants will be assigned to either the experimental group receiving MRI-Linac stereotactic ablative body radiotherapy SABR or the control group receiving standard SABR. Treatment follows UK SABR Consortium Guidelines, prescribing the highest dose possible without exceeding normal organ limits. The MRI-Linac allows adaptive dose escalation during each session to optimize targeting. Both groups receive treatment tailored to meet organ tolerance limits for liver, kidney, spinal cord, stomach, bowel, heart, lungs, and chest wall. During the study, patients will undergo clinical imaging every three months after radiotherapy for up to three years to monitor local control of lesions. Researchers will assess survival, treatment safety, delivered radiation dose, and treatment targeting accuracy. Functional MRI scans will be explored to identify biomarkers that may predict how tumors respond to radiotherapy. Total participation length varies, with ongoing follow-up imaging and clinical evaluation to measure outcomes.

Magnetic Resonance Imaging (MRI) Guided Stereotactic Adaptive Radiotherapy for Targeting Abdominal Cancer