Cihoric Nikola, Tsikkinis Alexandros, Miguelez Cristina Gutierrez, Strnad Vratislav, Soldatovic Ivan, Ghadjar Pirus, Jeremic Branislav, Dal Pra Alan, Aebersold Daniel M, Lössl Kristina
Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
Department of BT, ICO Hospitalet, Hospital Duran iReynals, l'Hospitalet de Llobregat, Barcelona, Spain.
Radiat Oncol. 2016 Mar 22;11:48. doi: 10.1186/s13014-016-0624-8.
To evaluate the current status of prospective interventional clinical trials that includes brachytherapy (BT) procedures.
The records of 175,538 (100 %) clinical trials registered at ClinicalTrials.gov were downloaded on September 2014 and a database was established. Trials using BT as an intervention were identified for further analyses. The selected trials were manually categorized according to indication(s), BT source, applied dose rate, primary sponsor type, location, protocol initiator and funding source. We analyzed trials across 8 available trial protocol elements registered within the database.
In total 245 clinical trials were identified, 147 with BT as primary investigated treatment modality and 98 that included BT as an optional treatment component or as part of the standard treatment. Academic centers were the most frequent protocol initiators in trials where BT was the primary investigational treatment modality (p < 0.01). High dose rate (HDR) BT was the most frequently investigated type of BT dose rate (46.3 %) followed by low dose rate (LDR) (42.0 %). Prostate was the most frequently investigated tumor entity in trials with BT as the primary treatment modality (40.1 %) followed by breast cancer (17.0 %). BT was rarely the primary investigated treatment modality for cervical cancer (6.8 %).
Most clinical trials using BT are predominantly in early phases, investigator-initiated and with low accrual numbers. Current investigational activities that include BT mainly focus on prostate and breast cancers. Important questions concerning the optimal usage of BT will not be answered in the near future.
评估包括近距离放射治疗(BT)程序在内的前瞻性介入性临床试验的现状。
2014年9月下载了在ClinicalTrials.gov注册的175538项(100%)临床试验记录,并建立了一个数据库。确定使用BT作为干预措施的试验进行进一步分析。根据适应症、BT源、应用剂量率、主要申办者类型、地点、方案发起者和资金来源对选定的试验进行人工分类。我们分析了数据库中注册的8个可用试验方案要素的试验。
共确定了245项临床试验,其中147项以BT作为主要研究治疗方式,98项将BT作为可选治疗组成部分或作为标准治疗的一部分。在以BT作为主要研究治疗方式的试验中,学术中心是最常见的方案发起者(p<0.01)。高剂量率(HDR)BT是最常研究的BT剂量率类型(46.3%),其次是低剂量率(LDR)(42.0%)。在以BT作为主要治疗方式的试验中,前列腺是最常研究的肿瘤实体(40.1%),其次是乳腺癌(17.0%)。BT很少是宫颈癌的主要研究治疗方式(6.8%)。
大多数使用BT的临床试验主要处于早期阶段,由研究者发起,入组人数较少。目前包括BT的研究活动主要集中在前列腺癌和乳腺癌。关于BT最佳使用的重要问题在不久的将来无法得到解答。