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Trial registered on ANZCTR
Registration number
ACTRN12624000522516p
Ethics application status
Not yet submitted
Date submitted
21/02/2024
Date registered
26/04/2024
Date last updated
26/04/2024
Date data sharing statement initially provided
26/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Partially Ablative Body Radiotherapy (PABR) for the Palliation of Bulky Tumours
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Scientific title
A Prospective Single-Arm Pilot Study of the Safety, Tolerability and Preliminary Efficacy of Partially Ablative Body Radiotherapy (PABR) for the Palliation of Bulky Tumours
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Secondary ID [1]
311581
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
locally advanced tumours
332962
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bulky tumours
333156
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unresectable tumours
333157
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Condition category
Condition code
Cancer
329675
329675
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0
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Any cancer
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The treatment for this study is partially ablative body radiotherapy (PABR). This technique delivers an ablative dose to the central core of the tumour and a palliative dose to the periphery using simultaneous integrated boost (SIB). Prescribed dose for all patients is 20Gray in 5 fractions with SIB to 50Gy, delivered on non-consecutive days over 2 weeks, at 2-3 visits per week. Each treatment visit may take up to 30 minutes. Treatment will be prescribed by a Radiation Oncologist and delivered at a radiotherapy centre approved as a study site.
Prior to treatment commencing, all participants will be required to attend for a planning CT scan. Participants will be positioned using stabilisation and/or immobilisation equipment to ensure that set-up can be reproduced on each day of treatment. This planning appointment may take 1 hour.
To ensure treatment is delivered as planned, a daily online image guidance procedure will be performed. Additionally, the direct observation of PABR administration by the Investigator and site staff will ensure compliance with the protocol requirements. The date and time of each dose and fraction of PABR administered in the clinic will be recorded in the participant’s medical record and study electronic case report form.
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Intervention code [1]
328034
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Treatment: Other
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Comparator / control treatment
no control group - this is a single-arm study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
337458
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Incidence of acute and late toxicities including at least grade 3 treatment related adverse events
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Assessment method [1]
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Adverse events will be recorded and graded according to CTCAE v5.0.
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Timepoint [1]
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Adverse events will be assessed at every treatment visit, then at weeks 4, 8 and 12 from the start of PABR, then months 6, 9, and 12 from the start of PABR
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Primary outcome [2]
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Changes in laboratory parameters from baseline.
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Assessment method [2]
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Whole blood sample will be collected from participants to facilitate assessment of laboratory parameters.
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Timepoint [2]
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Laboratory parameters will be assessed at baseline, at the first and last treatment visits, then at weeks 8 and 12 from the start of PABR and then at month 6, 9 and 12 from the start of PABR.
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Primary outcome [3]
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Changes in Eastern Cooperative Oncology Group (ECOG) performance status from baseline.
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Assessment method [3]
338020
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Clinician assessed via questioning patient on their activities of daily living
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Timepoint [3]
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ECOG will be assessed at baseline, at the first and last treatment visits, then at weeks 8 and 12 from the start of PABR and then at month 6, 9 and 12 from the start of PABR.
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Secondary outcome [1]
431950
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Tumour absolute volume difference
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Assessment method [1]
431950
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Tumour assessment by CT or PET-CT scan
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Timepoint [1]
431950
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Tumour assessment imaging conducted at baseline, at 12 weeks after the start of PABR, then 3-monthly until 12 months from the start of PABR treatment.
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Secondary outcome [2]
431951
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Objective response rate, defined as the proportion of patients with either complete or partial response
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Assessment method [2]
431951
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Tumour assessment by CT or PET-CT scan based on RECIST v1.1
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Timepoint [2]
431951
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Tumour assessment imaging conducted at baseline, at 12 weeks after the start of PABR, then 3-monthly until 12 months from the start of PABR treatment.
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Secondary outcome [3]
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Local tumour control, defined as the proportion of patients with either complete/partial response or stable disease
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Assessment method [3]
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Tumour assessment by CT or PET-CT scan based on RECIST v1.1
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Timepoint [3]
433812
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Tumour assessment imaging conducted at baseline, at 12 weeks after the start of PABR, then 3-monthly until 12 months from the start of PABR treatment.
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Secondary outcome [4]
433813
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One-year progression free survival, defined as the time from the start of treatment to the onset of tumour progression or death from any cause and one-year overall survival defined as the time from the start of treatment to the date of death from any cause
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Assessment method [4]
433813
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Tumour assessment by CT or PET-CT scan
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Timepoint [4]
433813
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Tumour assessment imaging conducted at baseline, at 12 weeks after the start of PABR, then 3-monthly until 12 months from the start of PABR treatment.
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Secondary outcome [5]
433814
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Abscopal tumour response, defined as a reduction of at least 30% in diameter of the best responding non-irradiated lesion before initiation of the next line of systemic therapy
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Assessment method [5]
433814
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Tumour assessment by CT or PET-CT scan
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Timepoint [5]
433814
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Tumour assessment imaging conducted at baseline, at 12 weeks after the start of PABR, then 3-monthly until 12 months from the start of PABR treatment
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Secondary outcome [6]
433815
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Patient-reported change in pain symptoms
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Assessment method [6]
433815
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Assessed by the mean difference in symptom scores from baseline to each subsequent time point, using the following assessment tool: BPI-SF (brief pain inventory-short form)
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Timepoint [6]
433815
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Patient reported outcomes assessed at days 1, 3 and 5 of PABR, at weeks 4, 8 and 12 from start of treatment, then months 6, 9 and 12 from the start of PABR
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Secondary outcome [7]
433816
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Difference in opioid dose
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Assessment method [7]
433816
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Assessed by the mean difference in opioid dose (slow-release opioid and immediate-release opioid dose converted into oral Morphine Equivalent Daily Dose [oMEDD]), and number of breakthrough opioids taken in the past 24 hours at each assessment time point.
Information will be self-reported and collected via clinician discussion with patient
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Timepoint [7]
433816
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Assessed at days 1, 3 and 5 of PABR, at weeks 4, 8 and 12 from start of treatment, then months 6, 9 and 12 from the start of PABR
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Secondary outcome [8]
433817
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Change in quality of life
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Assessment method [8]
433817
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Assessed by the mean change from baseline (total scores and subscale scores) in using the EORTC QLQ-C30 assessment tool (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire 30 item core module)
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Timepoint [8]
433817
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Assessed at days 1, 3 and 5 of PABR, at weeks 4, 8 and 12 from start of treatment, then months 6, 9 and 12 from the start of PABR.
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Secondary outcome [9]
434160
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Patient-reported change in neuropathic symptoms and signs
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Assessment method [9]
434160
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Assessed by the mean difference in symptom scores from baseline to each subsequent time point, using the following assessment tool: S-LANSS (self report version of Leeds assessment for neuropathic symptoms and signs)
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Timepoint [9]
434160
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Patient reported outcomes assessed at days 1 and 3 of PABR, and 4 weeks from the start of PABR
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Secondary outcome [10]
434161
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Patient reported change in cancer-related symptom burden (for example: pain, fatigue, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, wellbeing, etc)
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Assessment method [10]
434161
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Assessed by the mean difference in symptom scores from baseline to each subsequent time point, using the following assessment tool: ESAS-r (Edmonton Symptom Assessment System-revised)
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Timepoint [10]
434161
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Patient reported outcomes assessed at days 1, 3 and 5 of PABR, at weeks 4, 8 and 12 from start of treatment, then months 6, 9 and 12 from the start of PABR
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Eligibility
Key inclusion criteria
Histologically or cytologically confirmed non-haematologic malignancy not amenable to curative intent treatment.
Must be a candidate for palliative radiotherapy for a tumour size of at least 5cm as measured by clinical examination or radiologic imaging
At least one measurable disease tumour lesion as assessed by investigator per RECIST v1.1
Not suitable for SABR (stereotactic ablative body radiotherapy) or surgery, or has declined surgery
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Tumours at or within 2cm from spinal cord
Prior radiotherapy that overlaps with planned site of intervention within 2 years prior to screening
Received concurrent cytotoxic or targeted therapy within 3-4 weeks prior to the fraction of PABR, or concurrent use of these therapies during intervention period
Evidence of central necrosis on imaging
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2024
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Actual
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Date of last participant enrolment
Anticipated
1/07/2025
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Actual
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Date of last data collection
Anticipated
1/06/2026
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
26195
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
42071
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3000 - Melbourne
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Funding & Sponsors
Funding source category [1]
315883
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Charities/Societies/Foundations
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Name [1]
315883
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Peter MacCallum Cancer Foundation
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Address [1]
315883
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Country [1]
315883
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Australia
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Funding source category [2]
315885
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Government body
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Name [2]
315885
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Victorian Cancer Agency
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Address [2]
315885
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Country [2]
315885
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Australia
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Primary sponsor type
Hospital
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Name
Peter MacCallum Cancer Centre
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Address
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Country
Australia
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Secondary sponsor category [1]
318026
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None
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Name [1]
318026
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Address [1]
318026
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Country [1]
318026
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
314729
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Peter MacCallum Cancer Centre Human Research Ethics Committee
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Ethics committee address [1]
314729
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https://www.petermac.org/research/doing-research-us/ethics-governance
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Ethics committee country [1]
314729
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Australia
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Date submitted for ethics approval [1]
314729
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27/05/2024
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Approval date [1]
314729
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Ethics approval number [1]
314729
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Summary
Brief summary
This study is assessing the safety and efficacy of a new way of delivering radiotherapy, called Partially Ablative Body Radiotherapy (PABR), to tumours that are considered too bulky to treat with curative intent. Who is it for? You may be eligible for this study if you have a confirmed diagnosis of a non-haematologic malignancy not amenable to curative intent treatment, however are a candidate for palliative radiotherapy for a tumour size of at least 5cm. Study details Patients will undergo 5 sessions of radiotherapy on non-consecutive days over 2 weeks. The radiotherapy will be planned to deliver a higher dose to the core of the tumour and a lower, palliative dose to the periphery. Participants will have data collected on treatment related adverse events and tumour response to the radiotherapy, and will be asked to complete questionnaires on outcomes such as pain and quality of life. It is hoped that findings from this study will help develop PABR as a treatment modality for the palliation of bulky tumours.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Sarat Chander
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Address
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Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne VIC 3000
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Country
132546
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Australia
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Phone
132546
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+61 3 85597742
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Fax
132546
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Email
132546
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[email protected]
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Contact person for public queries
Name
132547
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Catherine Anderson
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Address
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Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne VIC 3000
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Country
132547
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Australia
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Phone
132547
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+61 3 85595000
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Fax
132547
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Email
132547
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[email protected]
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Contact person for scientific queries
Name
132548
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Sarat Chander
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Address
132548
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Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne VIC 3000
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Country
132548
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Australia
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Phone
132548
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+61 3 85595000
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Fax
132548
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Email
132548
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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