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研究方案 STEREOLAB:立体定向肝脏消融术联合动脉内 CT 肝动脉造影和消融确认软件评估。

Study Protocol STEREOLAB: Stereotactic Liver Ablation Assisted with Intra-Arterial CT Hepatic Arteriography and Ablation Confirmation Software Assessment.

机构信息

Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1471, Houston, TX, USA.

Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Cardiovasc Intervent Radiol. 2023 Dec;46(12):1748-1754. doi: 10.1007/s00270-023-03524-9. Epub 2023 Aug 10.

DOI:10.1007/s00270-023-03524-9
PMID:37563313
Abstract

PURPOSE

This study aims to evaluate the technical efficacy and local tumor progression-free survival (LTPFS) of a standardized workflow for thermal ablation of colorectal liver metastases (CRLM) consisting of CT during hepatic arteriography (CTHA)-based imaging analysis, stereotactic thermal ablation, and computer-based software assessment of ablation margins.

MATERIALS AND METHODS

This investigator initiated, single-center, single-arm prospective trial will enroll up to 50 patients (≤ 5 CRLM, Measuring ≤ 5 cm). Procedures will be performed in an angio-CT suite under general anesthesia. The primary objective is to estimate LTPFS with a follow-up of up to 2 years and secondary objectives are analysis of the impact of minimal ablative margins on LTPFS, adverse events, contrast media utilization and radiation exposure, overall oncological outcomes, and anesthesia/procedural time. Adverse events (AE) will be recorded by CTCAE (Common Toxicity Criteria for Adverse Events), and Bayesian optimal phase-2 design will be applied for major intraprocedural AE stop boundaries. The institutional CRLM ablation registry will be used as benchmark for comparative analysis with the historical cohort.

DISCUSSION

The STEREOLAB trial will introduce a high-precision and standardized thermal ablation workflow for CRLM consisting of CT during hepatic arteriography imaging, stereotactic guidance, and ablation confirmation. Trial Registration ClinicalTrials.gov identifier: (NCT05361551).

摘要

目的

本研究旨在评估由 CT 肝动脉造影(CTHA)成像分析、立体定向热消融和基于计算机的消融边界评估软件组成的标准化结直肠癌肝转移(CRLM)热消融技术疗效和局部肿瘤无进展生存期(LTPFS)。

材料和方法

本研究者发起的、单中心、单臂前瞻性试验将招募多达 50 名患者(≤5 个 CRLM,最大直径≤5cm)。手术将在全身麻醉下在血管造影 CT 室进行。主要目标是在最长 2 年的随访中估计 LTPFS,次要目标是分析最小消融边界对 LTPFS、不良事件、对比剂利用和辐射暴露、整体肿瘤学结果以及麻醉/手术时间的影响。不良事件(AE)将根据 CTCAE(不良事件通用毒性标准)进行记录,并将应用贝叶斯最优 2 期设计来确定主要术中 AE 停止边界。将使用机构 CRLM 消融登记处作为与历史队列进行比较分析的基准。

讨论

STEREOLAB 试验将为 CRLM 引入一种高精度和标准化的热消融工作流程,包括 CTHA 成像、立体定向引导和消融确认。试验注册ClinicalTrials.gov 标识符:(NCT05361551)。

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