Dose-escalated Adaptive Radiotherapy for Bladder Cancer: Results of the Phase 2 RAIDER Randomised Controlled Trial

被引:1
|
作者
Huddart, Robert [1 ,2 ]
Hafeez, Shaista [1 ,2 ]
Griffin, Clare [1 ]
Choudhury, Ananya [3 ]
Foroudi, Farshad [4 ]
Syndikus, Isabel [5 ]
Hindson, Benjamin [6 ]
Webster, Amanda [7 ,8 ]
Mcnair, Helen [1 ,2 ]
Birtle, Alison [9 ,10 ,11 ]
Varughese, Mohini [12 ]
Henry, Ann [13 ,14 ]
Mclaren, Duncan [15 ]
Parikh, Omi [9 ]
Nikapota, Ashok [16 ]
Tang, Colin [17 ]
Patel, Emma [18 ]
Miles, Elizabeth [18 ]
Warren-Oseni, Karole [1 ,2 ]
Kron, Tomas [19 ]
Hill, Courtney [20 ]
Philipps, Lara [1 ]
Vassallo-Bonner, Catalina [1 ]
Cheung, Ka Ching [1 ]
Gribble, Hannah [1 ]
Lewis, Rebecca [1 ]
Hall, Emma [1 ]
机构
[1] Inst Canc Res, Sutton, England
[2] Royal Marsden NHS Fdn Trust, Sutton, England
[3] Christie NHS Fdn Trust, Manchester, England
[4] Austin Hlth, Heidelberg, Vic, Australia
[5] Clatterbridge Canc Ctr, Bebington, England
[6] Christchurch Hosp, Canterbury Reg Canc & Haematol Serv, Christchurch, New Zealand
[7] Univ Coll Hosp, London, England
[8] Univ Coll Hosp, Univ Coll Hosp NHS Fdn Trust, London, England
[9] Lancashire Teaching Hosp NHS Fdn Trust, Royal Preston Hosp, Rosemere Canc Ctr, Preston PR2 9HT, Lancs, England
[10] Univ Manchester, Manchester, England
[11] Univ Cent Lancashire, Preston, England
[12] Royal Devon & Exeter NHS Fdn Trust, Royal Devon & Exeter Hosp, Exeter, England
[13] Univ Leeds, Leeds, England
[14] St James Univ Hosp, Leeds Teaching Hosp NHS Trust, Leeds, England
[15] Western Gen Hosp, NHS Lothian, Edinburgh, Scotland
[16] Royal Sussex Cty Hosp, Brighton & Sussex Univ Hosp NHS Trust, Brighton, England
[17] Sir Charles Gairdner Hosp, Nedlands, WA, Australia
[18] Mt Vernon Hosp, Natl Radiotherapy Trials Qual Assurance Grp RTTQA, Northwood, England
[19] Peter Maallum Canc Ctr, Melbourne, Vic, Australia
[20] TROG Canc Res, Waratah, NSW, Australia
关键词
Adaptive radiotherapy; Image-guided radiotherapy; Radiotherapy; Randomised controlled trial; LONG-TERM OUTCOMES; GASTROINTESTINAL SYMPTOMS; RADIATION-THERAPY; QUESTIONNAIRE; VOLUME;
D O I
10.1016/j.eururo.2024.09.006
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background and objective: Delivering radiotherapy to the bladder is challenging as it is a mobile, deformable structure. Dose-escalated adaptive image-guided radiotherapy could improve outcomes. RAIDER aimed to demonstrate the safety of such a schedule. Methods: RAIDER is an international phase 2 noncomparative randomised controlled trial (ISRCTN26779187). Patients with unifocal T2-T4a urothelial bladder cancer were randomised (1:1:2) to standard whole bladder radiotherapy (WBRT), standard-dose adaptive radiotherapy (SART), or dose-escalated adaptive radiotherapy (DART). Two fractionation (f) schedules recruited independently. WBRT and SART dose was 55 Gy/20f or 64 Gy/32f, and DART dose was 60 Gy/20f or 70 Gy/32f. For SART and DART, a radiotherapy plan (small, medium, or large) was chosen daily. The primary endpoint was the proportion of patients with radiotherapy-related late Common Terminology Criteria for Adverse Events grade >= 3 toxicity; the trial was designed to rule Key findings and limitations: A total of 345 patients were randomised between October 2015 and April 2020: 41/46 WBRT, 41/46 SART, and 81/90 DART patients in the 20f/32f
引用
收藏
页码:60 / 70
页数:11
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