[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Homi Bhabha Cancer Hospital & Research Centre\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":52},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,1,0,[8],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":23,"conditions":24,"keywords":29,"overallStatus":40,"whyStopped":4,"lastUpdateSubmitDate":41,"lastUpdatePostDateStruct":42,"startDateStruct":45,"completionDateStruct":47,"leadSponsor":49,"locationsCount":5},"100612087","this-is-a-multicentre-international-study-evaluating-ct-based-igabt-with--without-either-trus-during-btpre-bt-mr-as-per-ibs-gecestro-abs-recommendations-for-target-contouring-as-an-alternative-to-mrigabt-for-cervical-cancer-from-implementation-perspectives-under-embrace-iiitriplet-impact-study-100612087",false,"NCT07249021","This is a Multicentre International Study Evaluating CT-based IGABT With \u002F Without Either TRUS During BT\u002FPre BT MR as Per IBS-GECESTRO-ABS Recommendations for Target contouring-as an Alternative to MRIGABT for Cervical Cancer From Implementation Perspectives Under EMBRACE-III:TRIPLET IMPACT Study.","Integration of Multi-modality Imaging Protocols With emphAsis on CT in Image Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer - EMBRACE III-IMPACT STUDY","IMPACT","Inclusion Criteria:\n\n1. Cancer of the uterine cervix considered suitable for curative treatment with definitive chemo radiotherapy including brachytherapy.\n2. Biopsy showing invasive squamous-cell carcinoma or adenocarcinoma or adeno - squamous cell carcinoma of the uterine cervix.\n3. FIGO (2018) stage IB2 to IVA\n4. Willingness to participate by signing informed consent form.\n\nExclusion Criteria:\n\n* Other previous or current primary malignancies except carcinoma in situ of the cervix.\n\n  * Metastatic Inguinal Nodes not amenable to radical radiation therapy\n  * Metastatic disease in para-aortic region beyond renal vessels\n  * Not eligible for concurrent cisplatin chemotherapy (creatinine clearance \\\u003C 50mg\u002Fml\u002Fmin)\n  * Previous pelvic or abdominal radiotherapy.\n  * Previous total or partial hysterectomy.\n  * Patients receiving BT alone.\n  * Patients receiving EBRT alone.\n  * Patients receiving any form of neoadjuvant anti-neoplastic therapy prior to definitive treatment or adjuvant therapy\n  * Active infection or severe medical condition which precludes radical chemoradiotherapy.\n  * Pregnant or lactating or childbearing potential without adequate contraception.","FEMALE","18 Years",{"count":20,"type":21},1200,"ESTIMATED","OBSERVATIONAL","Title: Integration of Multi-modality Imaging Protocols with Emphasis on CT in Image-Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer - EMBRACE III-TRIPLET : IMPACT Study Locally advanced cervical cancer (LACC) remains a major health challenge, particularly in low- and middle-income countries (LMICs), which account for the majority of global cases. The standard curative treatment involves a combination of external beam radiotherapy (EBRT) with concurrent chemotherapy, followed by brachytherapy (BT). Brachytherapy plays a crucial role in achieving high local control by delivering radiation directly to the tumour through internally placed radioactive sources.\n\nHistorically, BT dose prescription was based on two-dimensional (2D) X-ray images and defined anatomical \"points,\" achieving 5-year local control rates of 60-70%. Over the last decade, magnetic resonance imaging (MRI)-based image-guided adaptive brachytherapy (MR-IGABT) has transformed practice by enabling three-dimensional (3D) target-based dose prescription and adaptation to tumour regression. The landmark EMBRACE I study, involving over 1300 patients, demonstrated over 90% 5-year local control rates with MR-IGABT, establishing it as the international gold standard endorsed by NCG, ICRU, NCCN, and ESGO-ESTRO guidelines.\n\nHowever, MRI-based planning for IGABT remains logistically and financially challenging for many centres, especially in LMICs. CT and transrectal ultrasound (TRUS) have emerged as feasible alternatives, offering broader accessibility. Despite encouraging outcomes from smaller institutional studies, the lack of standardized and validated target delineation concepts for CT-IGABT has led to significant variability in clinical implementation. Recognizing this, the Indian Brachytherapy Society (IBS), American Brachytherapy Society (ABS), and GEC-ESTRO jointly published consensus recommendations in 2020 to standardize CT-IGABT practices across diverse clinical environments.\n\nAt Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, our prior work (RetroLACER Study) demonstrated that CT-based IGABT can achieve outcomes comparable to MR-IGABT, highlighting its feasibility and potential for wider adoption. Building on this foundation, the EMBRACE III-IMPACT Study seeks to evaluate whether CT-IGABT can be systematically and uniformly implemented in a multi-centre setting and to benchmark clinical outcomes against the standards set by MR-IGABT.\n\nStudy Design:\n\nThis is a multicentre, prospective, observational study planned to include approximately 1200 participants with locally advanced cervical cancer. All participants will receive standard-of-care treatment, including EBRT, concurrent weekly cisplatin chemotherapy, and brachytherapy with image-guided planning.\n\nObjectives:\n\nTo assess the feasibility of implementing standardized CT-IGABT protocols across diverse clinical environments.\n\nTo evaluate local control, disease-free survival, and treatment-related toxicity outcomes for CT-IGABT.\n\nTo compare and benchmark CT-IGABT outcomes with established MR-IGABT benchmarks from prior international studies.\n\nParticipant Involvement:\n\nParticipants will undergo standard diagnostic imaging, EBRT with weekly cisplatin, and brachytherapy using CT-based planning. Imaging and treatment data will be collected, anonymized, and submitted to a central database for review. Regular follow-up visits will monitor tumour control and treatment-related side effects.\n\nBenefits:\n\nParticipants receive internationally standardized, quality-assured treatment protocols. Centres gain access to expert review and QA support from international collaborators, potentially improving treatment quality and outcomes.\n\nThe study supports global efforts to establish CT-IGABT as a cost-effective, accessible alternative to MRI-based IGABT, expanding equitable cancer care access.\n\nRisks:\n\nThe study is observational and involves standard treatment; therefore, risks and costs are comparable to routine cervical cancer care.\n\nConfidentiality and Ethics:\n\nAll data will be anonymized and handled in compliance with ethical and regulatory standards. Participant confidentiality will be strictly maintained. Written informed consent will be obtained before study participation.\n\nSignificance:\n\nBy validating standardised CT-based protocols and establishing outcome benchmarks, the study aims to facilitate widespread adoption of IGABT in resource-limited settings, ultimately improving treatment accessibility and survival outcomes.",[25,26,27,28],"Locally Advanced Cervical Cancer","Brachytherapy","CT","Transrectal Ultrasound",[30,31,32,33,34,35,36,37,38,39],"Cervical cancer","CT-guided brachytherapy","Image-Guided Adaptive Brachytherapy (IGABT)","Locally advanced cervical cancer","Implementation study","Resource-limited settings","Low- and middle-income countries (LMICs)","EMBRACE III","Trans-rectal ultrasound during BT","Pre BT MR Imaging","NOT_YET_RECRUITING","2025-11-21",{"date":43,"type":44},"2025-11-25","ACTUAL",{"date":46,"type":21},"2025-11",{"date":48,"type":21},"2031-11",{"name":50,"class":51},"Homi Bhabha Cancer Hospital & Research Centre","OTHER",""]