Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)

Background Though stereotactic body radiation therapy (SBRT) has been widely used in advanced tumors, ablative doses may not be appropriate in the case of large tumors or those abutting to the gastrointestinal tracts, resulting in unfavorable outcomes. Therefore, partial irradiation with high doses...

Full description

Saved in:
Bibliographic Details
Main Authors: Lingong Jiang MD, Yangsen Cao MD, Xiaolan Yin MD, Chunshan Yu MD, Yusheng Ye MD, Xiaofei Zhu MD, Huojun Zhang MD
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338251350833
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849337507397763072
author Lingong Jiang MD
Yangsen Cao MD
Xiaolan Yin MD
Chunshan Yu MD
Yusheng Ye MD
Xiaofei Zhu MD
Huojun Zhang MD
author_facet Lingong Jiang MD
Yangsen Cao MD
Xiaolan Yin MD
Chunshan Yu MD
Yusheng Ye MD
Xiaofei Zhu MD
Huojun Zhang MD
author_sort Lingong Jiang MD
collection DOAJ
description Background Though stereotactic body radiation therapy (SBRT) has been widely used in advanced tumors, ablative doses may not be appropriate in the case of large tumors or those abutting to the gastrointestinal tracts, resulting in unfavorable outcomes. Therefore, partial irradiation with high doses to tumors have been investigated. In order to achieve a larger high dose area within the tumor center, we developed a novel radiation modality, which was central-boost ablative radiation therapy (CBART). It was delivered by SBRT, with a central ablative dose in the tumor and a relatively low margin dose. And we tried to assess the efficacy of CBART for patients with large tumors or tumors adjacent to the gastrointestinal tracts. Methods It is a prospective, single-arm, phase II trial. Eligible patients would receive CBART. Gross tumor volume (GTV) was defined as a radiographically evident gross disease. The margin of GTV was shrinked to form central core GTV (cGTV). The volume of cGTV should be 50% of GTV volume. A 2-5 mm margin expansion on GTV formed planning target volume (PTV). While no margin expansion was performed on cGTV. The prescription dose of tumor margin was 30-45Gy/5f, determined by the tumor location and pathological features. While the prescription dose of cGTV was 120%-150% of that of tumor margin. Ninety percent of PTV and cGTV should be covered by the prescription dose. After CBART, sequential systemic therapy, including chemotherapy, targeted therapy or immunotherapy would be given according to pathological types and tumor stages. The primary outcome is one-year local control rate. Discussion An ablative dose to the hypoxic tumor center while a relatively low dose to the tumor margin may improve local control in the case of large tumors or those abutting the gastrointestinal tracts. Further investigations are required to assess the clinical benefits of CBART.
format Article
id doaj-art-d3c0e7b05e564d808538f780c1bac59b
institution Kabale University
issn 1533-0338
language English
publishDate 2025-06-01
publisher SAGE Publishing
record_format Article
series Technology in Cancer Research & Treatment
spelling doaj-art-d3c0e7b05e564d808538f780c1bac59b2025-08-20T03:44:39ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-06-012410.1177/15330338251350833Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)Lingong Jiang MD0Yangsen Cao MD1Xiaolan Yin MD2Chunshan Yu MD3Yusheng Ye MD4Xiaofei Zhu MD5Huojun Zhang MD6 Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, China Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, China Cancer Center, Shanghai 411 Hospital, China RongTong Medical Healthcare Group Co. Ltd./411 Hospital, Shanghai University, Shanghai, China Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, China Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, China Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, China Department of Radiation Oncology, Changhai Hospital affiliated to Naval Medical University, Shanghai, ChinaBackground Though stereotactic body radiation therapy (SBRT) has been widely used in advanced tumors, ablative doses may not be appropriate in the case of large tumors or those abutting to the gastrointestinal tracts, resulting in unfavorable outcomes. Therefore, partial irradiation with high doses to tumors have been investigated. In order to achieve a larger high dose area within the tumor center, we developed a novel radiation modality, which was central-boost ablative radiation therapy (CBART). It was delivered by SBRT, with a central ablative dose in the tumor and a relatively low margin dose. And we tried to assess the efficacy of CBART for patients with large tumors or tumors adjacent to the gastrointestinal tracts. Methods It is a prospective, single-arm, phase II trial. Eligible patients would receive CBART. Gross tumor volume (GTV) was defined as a radiographically evident gross disease. The margin of GTV was shrinked to form central core GTV (cGTV). The volume of cGTV should be 50% of GTV volume. A 2-5 mm margin expansion on GTV formed planning target volume (PTV). While no margin expansion was performed on cGTV. The prescription dose of tumor margin was 30-45Gy/5f, determined by the tumor location and pathological features. While the prescription dose of cGTV was 120%-150% of that of tumor margin. Ninety percent of PTV and cGTV should be covered by the prescription dose. After CBART, sequential systemic therapy, including chemotherapy, targeted therapy or immunotherapy would be given according to pathological types and tumor stages. The primary outcome is one-year local control rate. Discussion An ablative dose to the hypoxic tumor center while a relatively low dose to the tumor margin may improve local control in the case of large tumors or those abutting the gastrointestinal tracts. Further investigations are required to assess the clinical benefits of CBART.https://doi.org/10.1177/15330338251350833
spellingShingle Lingong Jiang MD
Yangsen Cao MD
Xiaolan Yin MD
Chunshan Yu MD
Yusheng Ye MD
Xiaofei Zhu MD
Huojun Zhang MD
Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
Technology in Cancer Research & Treatment
title Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
title_full Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
title_fullStr Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
title_full_unstemmed Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
title_short Central-boost Ablative Radiation Therapy for Solid Tumors: Study Protocol of a Single-arm, Phase II Trial (CBART)
title_sort central boost ablative radiation therapy for solid tumors study protocol of a single arm phase ii trial cbart
url https://doi.org/10.1177/15330338251350833
work_keys_str_mv AT lingongjiangmd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT yangsencaomd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT xiaolanyinmd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT chunshanyumd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT yushengyemd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT xiaofeizhumd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart
AT huojunzhangmd centralboostablativeradiationtherapyforsolidtumorsstudyprotocolofasinglearmphaseiitrialcbart