Stereotactic Radiosurgery Compared to Observation in Treating Patients With Brain Metastases
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ClinicalTrials.gov Identifier: NCT00950001 |
Recruitment Status :
Active, not recruiting
First Posted : July 31, 2009
Last Update Posted : February 20, 2024
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Condition or disease | Intervention/treatment | Phase |
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Metastatic Malignant Neoplasm in the Brain | Radiation: Stereotactic Radiosurgery | Phase 3 |
PRIMARY OBJECTIVES:
I. To evaluate benefit of post-surgical stereotactic radiosurgery (SRS) on the resection bed in providing 6 month local control (decreasing the risk of local tumor recurrence) when compared to surgical resection alone.
SECONDARY OBJECTIVES:
I. Overall survival, development of distant brain metastases and complications related to treatment.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients undergo stereotactic radiosurgery to the surgical cavity within 30 days of the craniotomy.
ARM II: Patients undergo clinical observation after craniotomy.
After completion of study treatment, patients are followed up at 5-8 weeks, every 6-9 weeks for 1 year, every 3-4 months for 1 year, and then every 6 months thereafter.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 132 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Efficacy of Post-Surgical Stereotactic Radiosurgery for Metastatic Brain Disease: A Randomized Trial |
Actual Study Start Date : | August 13, 2009 |
Estimated Primary Completion Date : | April 30, 2025 |
Estimated Study Completion Date : | April 30, 2025 |
Arm | Intervention/treatment |
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Experimental: Arm I (SRS)
Patients undergo stereotactic radiosurgery to the surgical cavity within 30 days of the craniotomy.
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Radiation: Stereotactic Radiosurgery
Undergo SRS
Other Names:
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No Intervention: Arm II (observation)
Patients undergo clinical observation after craniotomy.
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- Time to local recurrence [ Time Frame: 6 months ]A univariate test between groups will be conducted using a log rank test of Kaplan-Meier survival estimates and multivariate analyses will be conducted via the Cox proportional hazards model. The hazard ratio comparing each arm will be computed for each endpoint with and without adjustment for other covariates. Confidence intervals (95%) will be computed for the hazard ratio estimates. The proportion of patients experiencing neurological complications will be computed via univariate and multivariate logistic regression analysis.
- Overall survival [ Time Frame: Up to 8 years ]A univariate test between groups will be conducted using a log rank test of Kaplan-Meier survival estimates and multivariate analyses will be conducted via the Cox proportional hazards model. The hazard ratio comparing each arm will be computed for each endpoint with and without adjustment for other covariates. Confidence intervals (95%) will be computed for the hazard ratio estimates.
- Development of distant brain metastases [ Time Frame: Up to 8 years ]A univariate test between groups will be conducted using a log rank test of Kaplan-Meier survival estimates and multivariate analyses will be conducted via the Cox proportional hazards model. The hazard ratio comparing each arm will be computed for each endpoint with and without adjustment for other covariates. Confidence intervals (95%) will be computed for the hazard ratio estimates.
- Incidence of complications related to treatment [ Time Frame: Up to 8 years ]The proportions of patients experiencing neurological complications will be computed via univariate and multivariate logistic regression analysis. The proportion of complications resulting in prolongation of hospital stay will also be computed. The odds ratios comparing both arms will be computed with and without adjustment for other covariates. Confidence intervals (95%) will be computed for the odds ratio estimates.
- Proportion of patients experiencing neurological complications [ Time Frame: Up to 8 years ]Computed via univariate and multivariate logistic regression analysis.
- Proportion of complications resulting in prolongation of hospital stay [ Time Frame: Up to 8 years ]Will be computed.
- Time to first neurological complication [ Time Frame: Up to 8 years ]A univariate test between groups will be conducted using a log rank test of Kaplan-Meier survival estimates and multivariate analyses will be conducted via the Cox proportional hazards model. The hazard ratio comparing each arm will be computed for each endpoint with and without adjustment for other covariates. Confidence intervals (95%) will be computed for the hazard ratio estimates.
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Ages Eligible for Study: | 4 Years and older (Child, Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients must be older than 3 years of age (radiosurgical frames cannot be placed on children younger than age 3).
- Patients must have 3 or fewer newly diagnosed metastatic lesions in the brain with a complete resection of at least one lesion as determined the study neuroradiologist.
- The resection cavity must have a maximum diameter of less than or equal to 4cm. This criteria will be determined by the study radiologist.
- Additional unresected brain metastases (up to 2) must have a maximum diameter of less than or equal to 3 cm.
- Patients must be considered candidates for SRS within 30 days of surgical resection.
- Patients must have a Karnofsky Performance Scores (KPS) of at least 70 at the first post operative visit. Patients under 18 years of age must have a Lansky Performance Score of of at least 70.
- Patients must be able to undergo an MRI scan.
- Patients must agree to randomization as documented by signing the Institutional Review Board (IRB) approved consent form.
Exclusion Criteria:
- Patients who have received prior radiation therapy to the brain for any reason.
- There is radiographic evidence of leptomeningeal disease prior to study entry.
- The primary tumor is small-cell lung cancer, lymphoma, leukemia, or multiple myeloma.
- For females, if they are pregnant or breast-feeding (The exclusion is made because gadolinium may be teratogenic in pregnancy).
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00950001
United States, Texas | |
M D Anderson Cancer Center | |
Houston, Texas, United States, 77030 |
Principal Investigator: | Debra NAna Yeboa | M.D. Anderson Cancer Center |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | M.D. Anderson Cancer Center |
ClinicalTrials.gov Identifier: | NCT00950001 |
Other Study ID Numbers: |
2009-0381 NCI-2011-00542 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) 2009-0381 ( Other Identifier: M D Anderson Cancer Center ) P30CA016672 ( U.S. NIH Grant/Contract ) |
First Posted: | July 31, 2009 Key Record Dates |
Last Update Posted: | February 20, 2024 |
Last Verified: | February 2024 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Neoplasms |