Magnetic Resonance-guided Adaptive Stereotactic Body Radiotherapy for Liver Metastases

Magnetic Resonance-guided Adaptive Stereotactic Body Radiotherapy for Hepatic Metastases - MAESTRO -

Phase 2 Interventional University Hospital Heidelberg · NCT05027711

This study is testing a new type of radiation therapy for patients with liver cancer that uses real-time imaging to see if it can target tumors better and protect healthy tissue compared to standard methods.

Quick facts

PhasePhase 2
Study typeInterventional
Enrollment90 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity Hospital Heidelberg Academic / other
Drugs / interventionsradiation
Locations1 site (Heidelberg)
Trial IDNCT05027711 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of Magnetic Resonance-guided Stereotactic Body Radiotherapy (MRgSBRT) compared to traditional Internal Target Volume-based Stereotactic Body Radiotherapy (ITV-SBRT) for patients with hepatic metastases. The study aims to improve treatment precision by utilizing real-time imaging and adaptive techniques to minimize radiation exposure to surrounding healthy tissues. It involves a prospective, randomized design with 82 participants who have 1-3 hepatic metastases. The trial will assess safety, efficacy, and potential dose escalation benefits of MRgSBRT.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with 1-3 hepatic metastases from solid tumors, each measuring 5 cm or less.

Not a fit: Patients with primary liver cancer, those who have undergone liver transplantation, or those with significant liver function impairment may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could lead to improved local control of liver metastases with reduced treatment-related toxicity.

How similar studies have performed: While there are limited retrospective analyses on MR-guided SBRT, this prospective study represents a novel approach in this area.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* confirmed underlying solid malignant tumor (no germ cell tumor, leukemia, lymphoma)
* 1-3 hepatic metastases confirmed by pre-therapeutic MRI
* indication for SBRT of 1-3 hepatic metastases
* maximum diameter each hepatic metastasis ≤ 5 cm (in case of 3 metastases: sum of diameters ≤ 12 cm)
* age ≥ 18 years of age
* Karnofsky Performance Score ≥ 60%
* ability to lie still on the radiotherapy treatment couch for at least one hour
* ability to hold one's breath for more than 25 seconds
* for women with childbearing potential, adequate contraception
* ability of subject to understand character and individual consequences of the clinical trial
* written informed consent (must be available before enrolment in the trial)

Exclusion Criteria:

* refusal of the patients to take part in the study
* patients with primary liver cancer (eg. HCC, CCC)
* patients after liver transplantation
* impairment of liver function to an extent contraindicating radiotherapy (to the discretion of the treating radiation oncologist)
* active acute hepatic/biliary infection (e.g. hepatitis, cholangitis, cholecystitis)
* previous radiotherapy of the hepatobiliary system, if previous and current target volumes overlap MAESTRO Study Studienprotokoll Seite 25 von 54 Version 1.0 vom 17.12.2020
* patients who have not yet recovered from acute toxicities of prior therapies
* claustrophobia
* pregnant or lactating women
* contraindications against performing contrast-enhanced MRI scans (pacemakers, other implants making MRI impossible, allergy to gadolinium (GD)-based contrast agent)
* participation in another competing clinical study or observation period of competing trials

Where this trial is running

Heidelberg

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Hepatic MetastasisMagentic Resonance-guided Adaptive Stereotactic Body Radiotherapy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.