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A multicentre, randomised, phase II study of hypofractionated bladder radiotherapy with or without image guided adaptive planning

Disease site: Bladder cancer, urological cancers

Treatment modality: Radiotherapy

Status: In follow-up

Trial details

HYBRID is a multicentre, phase II, randomised controlled trial to assess whether image guided adaptive planning radiotherapy techniques can lead to a reduction in the level of acute non genitourinary side effects experienced by patients with muscle invasive bladder cancer unsuitable for daily radical radiotherapy.

62 patients will be recruited from UK sites over two years. All patients will receive weekly hypofractionated radiotherapy for six weeks and will be randomised between either standard or adaptive planning. Patients in the adaptive planning group will have three radiotherapy plans generated and a CT scan prior to each treatment delivery will be used to select the most appropriate plan of the day, adapting to variations in bladder position. Participants will be followed up at regular intervals for 24 months, and then annually thereafter.


We have prepared a lay summary of the HYBRID results, which can be viewed and downloaded here.

Further information

Chief Investigator: Dr Robert Huddart, The Royal Marsden NHS Foundation Trust

ICR-CTSU Scientific Lead: Dr Emma Hall

Trial management contact: [email protected]

ISRCTN: 18815596

Sponsor: The Institute of Cancer Research

Funding: Cancer Research UK (CRUK/12/055)

View HYBRID on the National Institute for Health Research website: NIHR - Be Part Of Research

Patient friendly information is available from the following link:

CancerHelp UK

Publications and presentations

Huddart R, McDonald F, Lewis R, Hall E. HYBRID – evaluating new radiation technology in patients with unmet needs. Clin Oncol (R Coll Radiol). 2013; 25(9); 546-548.  

Huddart R, Hafeez S, Lewis R, McNair H, Syndikus I, Henry A, Staffurth J, Dewan M, Vassallo-Bonner C, Moinuddin SA, Birtle A, Horan G, Rimmer Y, Venkitaraman R, Khoo V, Mitra A, Hughes S, Gibbs S, Kapur G, Baker A, Hansen VN, Patel E, Hall E  - Clinical Outcomes of a Randomized Trial of Adaptive Plan-of-the-Day Treatment in Patients Receiving Ultra-hypofractionated Weekly Radiation Therapy for Bladder Cancer - International Journal of Radiation Oncology*Biology*Physics, Volume 110, Issue 2, 1 June 2021, Pages 412-424

Hafeez S, Patel E, Webster A, Warren-Oseni K, Hansen V, McNair H, Miles E, Lewis R, Hall E, Huddart R - Protocol for hypofractionated adaptive radiotherapy to the bladder within a multicentre phase II randomised trial: radiotherapy planning and delivery guidance 

Clinical trials

Division of Clinical Studies

The division carries out or coordinates high-quality trials and translational research at both an early phase – typically to test new targeted drugs – and a later stage.