Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Gland and Hormone Related Diseases

Rare Diseases

Breast Neoplasms

Ovarian Neoplasms

Carcinoma, Ovarian Epithelial

Uterine Cervical Neoplasms

Vaginal Neoplasms

Vulvar Neoplasms

Carcinoma

Endometrial Neoplasms

Endocrine Gland Neoplasms

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Genital Neoplasms, Female

Urogenital Neoplasms

Endocrine System Diseases

Gonadal Disorders

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Uterine Neoplasms

Uterine Cervical Diseases

Uterine Diseases

Vulvar Diseases

Vaginal Diseases

Ovarian Cancer

Ovarian Epithelial Cancer

Vaginal Cancer

Vulvar Cancer

Participants randomized to the intervention will receive the Strong Together serious game program on a tablet computer. The goal of this serious game is to teach the participant how to advocate for her needs relate to her cancer and treatment. The research team will send participants weekly notifications for 12 weeks to alert them that a new serious game session is available and encourage them to complete one session per week.

If randomized to the enhanced care as usual arm, the research team will give participants a paper-based self-advocacy patient brochure published by the National Coalition for Cancer Survivorship. This guide is not a part of usual care, but is freely available on the Internet.

The Strong Together serious game program is an interactive, immersive education program in which participants quickly learn the behaviors of self-advocacy and the potential consequences of self-advocating or not. Participants will receive weekly game sessions to play at home for three months.

Strong Together serious game

Teresa H Thomas, PhD, RN

Self-advocacy, defined as the ability of a patient to get her needs and priorities met in the face of a challenge, is an essential skill but not all women with advanced cancer are able to do it. We want to instruct women with advanced cancer who have low self-advocacy to self-advocate for their health and well-being. We will test a new "serious game" or video program that teaches self-advocacy skills through interactive, situation-based activities. The goal of the Strong Together serious game is to engage participants in challenges commonly experienced by women with advanced cancer, offer them choices to self-advocate or not, and directly show them the health and social benefits of self-advocating and the negative consequences of not self-advocating. Through engaging in the Strong Together program, participants vicariously learn the essential skills of self-advocacy, understand the downstream effects of using or not using these skills, and learn distinct behaviors that they can then use to address their own challenges.

Background: When faced with the challenges of advanced cancer, women must advocate (or stand up) for their needs and priorities. However, there are no interventions to promote self-advocacy among female patients with advanced cancer. Preliminary work has developed a theoretically-based, psychometrically-strong measure of self-advocacy (the Female Self-Advocacy in Cancer Survivorship (FSACS) Scale) and demonstrated correlations with symptom burden and healthcare utilization. Serious games offer a novel mechanism by which to deliver interactive, engaging health education that links users' choices to consequences so that users learn a desired skill. The fully-automated Strong Together self-advocacy serious game may allow women with advanced cancer to learn self-advocacy skills and therefore improve their health outcomes.

Objective/Hypothesis: The purpose of this pilot randomized controlled trial (RCT) is to evaluate the feasibility, acceptably, and preliminary efficacy of the Strong Together serious game.

Specific Aims:

Specific Aim 1: To evaluate the feasibility and acceptability of the 3-month Strong Together intervention.

* Benchmark 1: At least 75% of participants will engage in at least 8 out of the 12 serious game sessions.
* Benchmark 2: At least 80% of participants will find the intervention acceptable based on ratings of perceived satisfaction and ease of use, as well as feedback from qualitative exit interviews.

Specific Aim 2: To explore the differences in self-advocacy and symptom burden between groups over time.

• Research Question: Do patients who receive the intervention report improved self-advocacy and lower symptom burden compared to those assigned to enhanced care as usual?

Study Design: This pilot RCT will recruit (N=84) women from cancer clinics at the University of Pittsburgh Medical Center. Eligibility criteria include: female; age ≥ 18 years; diagnosis of Stage III or IV gynecological or Stage IV breast cancer within the past 3 months; 6-month prognosis; Eastern Cooperative Oncology Group score of 0-1; and ability to read and write in English. Measures will be collected at baseline, 3 months, and 6 months. Randomization (2:1) will occur to the 3-month Strong Together intervention group or the enhanced care as usual group. Feasibility will be assessed by calculating percentages of the intervention's dosage, engagement, recruitment, retention, and data completion. Acceptability will be assessed through exit interviews and an acceptability scale. Preliminary efficacy will be measured by exploring differences in self-advocacy and symptom burden scores and calculating point and interval estimates between the groups at 3 and 6 months.

Cancer Relevance: This study represents a unique opportunity to address the lack of self-advocacy interventions, reduce the risks of women with low self-advocacy, and guide an adequately-powered RCT to educate women with advanced cancer to self-advocate.

Inclusion criteria are based on cancer diagnoses which primarily occur in women (gynecological and breast cancer).

Self-Advocacy Serious Game in Advanced Cancer

Piloting a Serious Game to Improve Self-Advocacy Among Women With Advanced Cancer

We will calculate the number of participants in the intervention group who complete two-thirds (66.7%) of the intervention sessions as a measure of intervention feasibility. We will accept that we achieved adequate feasibility if at least 75% of participants engage in at least eight out of the twelve serious game sessions.

We will accept that we achieved adequate acceptability if at least 80% of participants find the intervention acceptable based on the Post Study System Usability Questionnaire scores and if no issues are raised during the qualitative interviews and feedback that cannot be revised prior to the future trial.

We anticipate that self-advocacy scores will increase (improve) among participants in the intervention group compared to the enhanced care as usual group.

We anticipate that symptom burden scores will decrease (improve) among participants in the intervention group compared to the enhanced care as usual group.

We anticipate that the frequency of healthcare utilization will decrease (improve) among participants in the intervention group compared to the enhanced care as usual group.

We anticipate that quality of life will increase (improve) among participants in the intervention group compared to the enhanced care as usual group.

University of Pittsburgh

Assistant Professor

The patient will receive Whole Pelvis Radiation Therapy 40 - 50.4 Gy in 1.8 - 2.0 Gy daily fractions over 4.5 - 5.5 weeks followed by Stereotactic Body Radiotherapy 5.5 - 8.0 Gy per fraction x 5 fractions using arc therapy.

Whole pelvis radiation therapy will be delivered according to institutional standard of care.

SBRT is delivered with 5 fractions of 5.5-8 Gy prescribed to the high-risk CTV, with dose constraints identical to those for high dose rate, volume-directed brachytherapy. The patient will undergo arc therapy with a minimum of two arcs. On-line kV CBCT will be used to verify the isocenter prior to each arc delivery. Patients will be resimulated for SBRT boost planning.

Radiation Therapy

Loren Mell, MD

The purpose of this study is to find out whether patients with cervical cancer treated with about a new radiation technique called "stereotactic body radiotherapy (SBRT) have less stress and anxiety compared to standard brachytherapy radiation. With standard brachytherapy radiation, metal hardware is placed through the vagina and into the uterus, which can cause pain and discomfort. SBRT is a new radiation technique that is non-invasive and does not require the insertion of any metal hardware.

This is a Phase II, single-center, single-arm, study of Stereotactic Body Radiotherapy boost for stage IB-IVB cervical cancer.

The primary objective of the study is to test the hypothesis that stereotactic body radiation therapy (SBRT) leads to an improvement in treatment-related symptoms of post traumatic stress compared to brachytherapy (historical control) according to the Impact of Event Scale-Revision (IES-R).

Study participants will be recruited within the UCSD Health System. For those patients under the clinical management of the recruiting investigator, the investigator will review the patient's medical records and determine if they would be a candidate for the study. The investigator will approach the subject and offer participation in the trial. If the patient chooses to participate, they will undergo pretreatment evaluations to determine if they are a good candidate to participate further in the study. Depending on when the patient last had these tests and procedures performed, some of them may not need to be repeated.

Upon confirmation of all eligibility criteria, the subject will be enrolled. Each enrolled subject will receive radiation therapy consisting of 30 to 35 treatments. The patient will first undergo Whole Pelvis Radiation Therapy 40 - 50.4 Gy in 1.8 - 2.0 Gy daily fractions over 4.5 - 5.5 weeks, followed by Stereotactic Body Radiotherapy 5.5 - 8.0 Gy per fraction x 5 fractions using arc therapy. Concurrent chemotherapy may be given with radiation therapy according to the discretion of the treating oncology team. No chemotherapy will be given during the SBRT phase of treatment. During radiation therapy, the patient will have a weekly physical exam, vital signs collected, evaluation for pain, and review any side effects.

Subjects will undergo a post treatment follow-up period after completion of their radiation therapy. During this follow-up period, subjects will return for a medical and history review with a complete physical examination, review of any side effects, evaluation for outcomes and toxicity, and evaluations for stress, anxiety, and pain.

Non-Invasive Cervical Cancer Radiotherapy for Stage IB-IVB

Non-Invasive Cervical Cancer Radiotherapy: Phase II Clinical Trial of Stereotactic Body Radiotherapy Boost for Stage IB-IVB Cervical Cancer

To quantify treatment-related symptoms of post traumatic stress to determine if stereotactic body radiation therapy (SBRT) leads to an improvement in treatment-related symptoms of post traumatic stress compared to brachytherapy (historical control) according to the Impact of Event Scale-Revision (IES-R).

To quantify rates of acute hematologic, gastrointestinal, and genitourinary toxicity following SBRT.

To measure health-related quality of life based on the cancer-specific EORTC-QLQ-C30 questionnaire (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30).

To measure health-related quality of life based on the cervical cancer module (CX24).

To quantify intrafraction cervical motion using cone beam computed tomography.

University of California, San Diego

Associate Professor

Oculocerebral Syndrome With Hypopigmentation

Cross-sectional Feasibility study on all consecutive patients of locally advanced cancer of the cervix or vault treated entirely at Tata Memorial Centre with curative intent radiation or chemoradiation.

Our institution registers on an average 670 cases of cancer cervix in a year and almost 75% are treated with curative intent, therefore around 500 patients a year would be treated with curative intent. Assuming that 75% of patients registered in a year would be receiving treatment at our institute, 375 patients a year would be completing treatment, of whom the investigator expect 80-85% ,i.e 300 patients to have a complete response. The list of patients who have completed radio(chemotherapy) in 2015 \&2016 can be obtained from the Radiation Oncology Department records. Patients identified for a follow up visit will be telephonically contacted between one and two weeks before the planned clinic visit and verbal telephonic consent taken prior to the nurse-led interview. This study should be able to accrue 300 patients in 6 months.

Patients of locally advanced cervical cancer or vault cancer who have been treated with radiotherapy with or without concurrent chemotherapy and have a clinical complete response at 3 months post treatment and are within the first 2 years post treatment completion will be eligible to participate in this study.

Screening: Patients will be screened from the list of patients treated in the radiotherapy department over the last 2 years (2015-2016), available from the Radiation Oncology Information System (ROIS). All patients with a diagnosis of cervical cancer or vault cancer will be screened using the hospital Electronic Medical Record (EMR) to check stage of disease, schedule of treatment received, response at 3 months post treatment and expected date of next follow up.

If patient fulfils all inclusion criteria, she will be called by the research nurse, approximately 1-2 weeks prior to her expected date of follow up, for a preliminary conversation and invited to participate in the study.

After verbal telephonic consent is obtained, she will be interviewed by the clinical research nurse using the format of the prepared proforma (Form A) regarding symptoms suggestive of disease recurrence as well as treatment induced toxicity. At the end of the interview, the research nurse records her impression of whether the patient has worrisome symptoms of disease or not and has symptoms of treatment toxicity or not for which she should visit the hospital.

When the patient reports to the OPD the next week for scheduled physical follow up, the nurse completes the consenting process by taking a short written informed consent. The examining physician then takes a complete history and in addition, performs a physical examination and any investigations he/she deems necessary. Following this he/she notes down final impression of disease status and toxicity which are taken as the gold standard (Form B). Each patient will be interviewed only once during their follow up schedule.

In addition at the physical visit, information regarding the acceptability of nurse-led telephonic follow-up to the patient and the financial impact of physical follow- up will be collected using a structured format (Form C).

Study participant drop-out/ Lost-to-follow up: Patients may withdraw their consent at any point during the telephonic interview or the subsequent follow up visit.

* A patient who does not attend the scheduled follow up visit within 1-2 weeks of the telephonic interview will be called a second time to remind her of the follow up appointment and enquire about reasons for non-attendance in the clinic, which will be recorded. If patient does not report to the clinic within the next 2 weeks, she will be considered to have dropped out from the study.
* Those patients in whom the interval between telephonic interview and the physician's assessment is more than 4 weeks, will be considered drop outs and follow up telephone call will go out to enquire about reasons for non-attendance in the clinic, which will be recorded.

Feasibility Study Of A Telephonic Questionnaire For Follow-Up Of Locally Advanced Cervical Cancer Patients

A Cross-Sectional Feasibility Study of a Telephonic Questionnaire By Research Nurses For Follow-Up Of Locally Advanced Cervical Cancer Patients With Complete Response To Treatment.

To estimate the accuracy of nurse-led telephonic interview in identifying patients with symptoms suggestive of disease recurrence, in terms of sensitivity and specificity values

To estimate the accuracy of nurse-led telephonic interview in identifying patients with symptoms suggestive of late toxicity of treatment

To assess patients' acceptability of a nurse-led telephonic surveillance program (if found to be concordant with physical clinic visits)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Self-Advocacy Serious Game in Advanced Cancer	NCT03339765	Ovarian Cancer ... Ovarian Cancer ... Breast Cancer S... Cervical Cancer... Cervical Cancer... Cervical Cancer... Endometrial Can... Endometrial Can... Vulvar Cancer, ... Vulvar Cancer, ... Vaginal Cancer ... Vaginal Cancer ... Vaginal Cancer ...	Strong Together...	18 Years -	University of Pittsburgh
Non-Invasive Cervical Cancer Radiotherapy for Stage IB-IVB	NCT03146039	Cervical Cancer Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer...	Radiation Thera...	18 Years -	University of California, San Diego
Non-Invasive Cervical Cancer Radiotherapy for Stage IB-IVB	NCT03146039	Cervical Cancer Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer...	Radiation Thera...	18 Years -	University of California, San Diego
Feasibility Study Of A Telephonic Questionnaire For Follow-Up Of Locally Advanced Cervical Cancer Patients	NCT03477240	Cervical Cancer... Treatment Outco... Follow up QUESTIONNAIRE		-	Tata Memorial Hospital
Non-Invasive Cervical Cancer Radiotherapy for Stage IB-IVB	NCT03146039	Cervical Cancer Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer... Cervical Cancer...	Radiation Thera...	18 Years -	University of California, San Diego
Feasibility Study Of A Telephonic Questionnaire For Follow-Up Of Locally Advanced Cervical Cancer Patients	NCT03477240	Cervical Cancer... Treatment Outco... Follow up QUESTIONNAIRE		-	Tata Memorial Hospital

Spots Global Cancer Trial Database for cervical cancer stage iiib