CancerPhase 2NCT01169116
Exclusive Hypofractionated Stereotactic Radiotherapy in Non-resectable Single Brain Metastasis
A Phase 2 study testing hypofractionated stereotactic radiotherapy in people with Cancer and Metastasis, run by Barretos Cancer Hospital at 1 site in Brazil.
Trial summary
Patients with single brain metastasis without other metastatic site have a better prognosis, and they need a better brain metastasis control. For non-resectable and non-radiosurgical brain metastasis, the gold standard treatment is whole-brain irradiation with 30 Gy in 10 fractions, but the local control is not… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Cancer, Metastasis
- What is being tested?
- hypofractionated stereotactic radiotherapy
- Type of treatment
- Surgery or procedure
- How many people
- 0 participants
- Where
- 1 siteBrazil
- Study dates
- Jul 2010to Jul 2010
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histopathology of primary tumors: all but the primary characteristics of melanoma cancer, small cell lung cancer, germ cell tumors, leukemia or lymphoma, or primary central nervous system.
- Primary-site: controlled, meaning operated and / or irradiated tumor activity without detectable local
- Meningeal dissemination: none
- Extra-cranial metastases: none
- Pre-irradiation brain: absent
- Number of brain metastases: one
Show all 9Show fewer
- Location of brain metastasis: brain regions not eligible for surgery (such as the hippocampus, amygdala, motor area, eloquent cortex, thalamus, hypothalamus, basal ganglia, optic tract, midbrain, pons, medulla, corpus callosum and internal capsule) or radiosurgery( metastasis <5 mm from the thalamus, hypothalamus, basal ganglia, optic tract, midbrain, pons, medulla, corpus callosum and internal capsule, and / or ≥ 10 ml or ≥ 3 cm in greatest diameter, or 10 ml tissue receiving ≥ 12 Gy).
- Karnofsky Performance Status ≥ 70%
- Informed consent: authorized
Who cannot join
- patients that don't have the eligibility below
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Exclusive Hypofractionated Stereotactic Radiotherapy in Non-resectable Single Brain Metastasis: Prospective Study
Patients with single brain metastasis without other metastatic site have a better prognosis, and they need a better brain metastasis control. For non-resectable and non-radiosurgical brain metastasis, the gold standard treatment is whole-brain irradiation with 30 Gy in 10 fractions, but the local control is not achieved in most of the cases. This study investigate the possibility to increase radiation dose in this metastasis with exclusive hypofractionated stereotactic radiotherapy.
Read the detailed description
For the planning, patients will undergo magnetic resonance imaging (MRI) 1.5 to 3 Tesla, with contrast and volumetric reconstruction of 1 mm and can be used MRI from the diagnosis of metastasis, if it is compatible with the planning system. Then, there will be individualized mask Mask Set for One Patient 41100 (BrainLAB AG, Heimstetten, Germany) for each patient. Patients will undergo computed tomography (CT) without contrast with 1-mm slices with tracking and stereotactic fixation. The images of MRI and CT are fused in the planning system IPLAN version 4.1 (BrainLAB AG, Heimstetten, Germany), where the plan will be implemented. The clinical target volume (CTV) is the macroscopic disease (GTV) displayed on the sign of T1 contrast. The planning target volume (PTV) is the CTV with 3-mm margin in all directions. Can be used multiple dynamic arcs, static conformal multiple fields, multiple static fields modulated and multiple static arcs. The dose-fractionation scheme will be 4 fractions of 7 Gy at the periphery of the PTV, a once daily on 4 consecutive working days. The dose to the PTV encompassing areas of the brainstem or optic tract will be reduced by 20%. The plans will be standardized at the isocenter. The isodose prescription will be the largest isodose that meets the following criteria: isodose covering at least 95% of the PTV with the prescription dose (V100 ≥ 95%) and 95% of prescription dose covering at least 99% of the PTV (V95 ≥ 99%). The maximum dose should be less than 35 Gy. The dose constraint reported by Ernst-Stecken et al will be respected at the expense of prescription isodose, where the normal brain volume (total brain volume less volume PTV) of 20 cc will not receive a dose of 4 Gy per fraction or larger, there is no maximum size limit of metastasis to be included in the study. Use as an index of compliance reported by the Paddick et al and Radiation Therapy Oncology Group (RTOG). Tests will be done for collision safety tests and quality control to ensure the alignment of isocenters radiation, mechanical and coincidence of lasers (Winston-Lutz test). After all, the patients are treated with 6-MeV photons in the linear accelerator Varian Clinac 600 CD (Varian Medical Systems, Palo Alto, CA, USA) with a system of "micromultileaf" m3 (BrainLAB AG, Heimstetten, Germany).
- Conditions
- Cancer, Metastasis
- Being tested
- hypofractionated stereotactic radiotherapy
- Keywords
- radiotherapy, radiation oncology, brain metastasis, metastases, radiosurgery, neurosurgery, hypofractionation, stereotaxy
- Medical subject headings
- Neoplasms, Neoplasm Metastasis, Brain Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
hypofractionated stereotactic radiotherapyRadiation
hypofractionated stereotactic radiotherapy with 4 fractions of 7 Gy at the periphery of the brain metastasis with 3 mm margin.
What is being measured
The primary outcome is the main question the study is designed to answer.
feasibility
Through this study we prospectively evaluate the alternative of performing exclusive hypofractionated stereotactic radiotherapy for patients with single brain metastasis that is not eligible for surgery or radiosurgery, with a good prognosis for survival and lower risk of metachronous brain metastases, the primary objective being to verify whether the treatment is feasible in clinical practice.
Measured: 1 year
Secondary outcomes (1)
survival
As a secondary objective, we will evaluate local control, tumor reduction, quality of life, overall survival, whole-brain irradiation free survival and acute and late toxicities related to treatment.
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jul 2010 (estimated)
- Study startJul 2010
- Primary completionJul 2010 (estimated)
Why it stopped: No participants enrolled.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Barretos Cancer Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ricardo A Nakamura, MD, Principal investigator, Barretos Cancer Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01169116
- Sponsor's protocol ID
- 3592010
- Status last verified
- Feb 2014
- First submitted
- 22 Jul 2010
- Last updated
- 4 Feb 2014
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 4 Feb 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Exclusive Hypofractionated Stereotactic Radiotherapy in Non-resectable Single Brain Metastasis: Prospective Study
- ClinicalTrials.gov ID
- NCT01169116
- Acronym / sponsor ID
- 3592010
- Conditions
- Cancer, Metastasis
- Keywords
- radiotherapy, radiation oncology, brain metastasis, metastases, radiosurgery, neurosurgery, hypofractionation, stereotaxy
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: No participants enrolled.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Barretos Cancer HospitalUniversity, hospital or other
- Study start
- Jul 2010
- Primary completion
- Jul 2010 (estimated)
- First posted
- 26 Jul 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patients with single brain metastasis without other metastatic site have a better prognosis, and they need a better brain metastasis control. For non-resectable and non-radiosurgical brain metastasis, the gold standard treatment is whole-brain irradiation with 30 Gy in 10 fractions, but the local control is not achieved in most of the cases. This study investigate the possibility to increase radiation dose in this metastasis with exclusive hypofractionated stereotactic radiotherapy.
Detailed description
For the planning, patients will undergo magnetic resonance imaging (MRI) 1.5 to 3 Tesla, with contrast and volumetric reconstruction of 1 mm and can be used MRI from the diagnosis of metastasis, if it is compatible with the planning system. Then, there will be individualized mask Mask Set for One Patient 41100 (BrainLAB AG, Heimstetten, Germany) for each patient. Patients will undergo computed tomography (CT) without contrast with 1-mm slices with tracking and stereotactic fixation. The images of MRI and CT are fused in the planning system IPLAN version 4.1 (BrainLAB AG, Heimstetten, Germany), where the plan will be implemented. The clinical target volume (CTV) is the macroscopic disease (GTV) displayed on the sign of T1 contrast. The planning target volume (PTV) is the CTV with 3-mm margin in all directions. Can be used multiple dynamic arcs, static conformal multiple fields, multiple static fields modulated and multiple static arcs. The dose-fractionation scheme will be 4 fractions of 7 Gy at the periphery of the PTV, a once daily on 4 consecutive working days. The dose to the PTV encompassing areas of the brainstem or optic tract will be reduced by 20%. The plans will be standardized at the isocenter. The isodose prescription will be the largest isodose that meets the following criteria: isodose covering at least 95% of the PTV with the prescription dose (V100 ≥ 95%) and 95% of prescription dose covering at least 99% of the PTV (V95 ≥ 99%). The maximum dose should be less than 35 Gy. The dose constraint reported by Ernst-Stecken et al will be respected at the expense of prescription isodose, where the normal brain volume (total brain volume less volume PTV) of 20 cc will not receive a dose of 4 Gy per fraction or larger, there is no maximum size limit of metastasis to be included in the study. Use as an index of compliance reported by the Paddick et al and Radiation Therapy Oncology Group (RTOG). Tests will be done for collision safety tests and quality control to ensure the alignment of isocenters radiation, mechanical and coincidence of lasers (Winston-Lutz test). After all, the patients are treated with 6-MeV photons in the linear accelerator Varian Clinac 600 CD (Varian Medical Systems, Palo Alto, CA, USA) with a system of "micromultileaf" m3 (BrainLAB AG, Heimstetten, Germany).
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Histopathology of primary tumors: all but the primary characteristics of melanoma cancer, small cell lung cancer, germ cell tumors, leukemia or lymphoma, or primary central nervous system.
- Primary-site: controlled, meaning operated and / or irradiated tumor activity without detectable local
- Meningeal dissemination: none
- Extra-cranial metastases: none
- Pre-irradiation brain: absent
Key exclusion criteria (1 listed)
- patients that don't have the eligibility below
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| hypofractionated stereotactic radiotherapyhypofractionated stereotactic radiotherapy with 4 fractions of 7 Gy at the periphery of the brain metastasis with 3 mm margin. | Radiation | – |
Primary outcome
feasibility
Time frame: 1 year
Through this study we prospectively evaluate the alternative of performing exclusive hypofractionated stereotactic radiotherapy for patients with single brain metastasis that is not eligible for surgery or radiosurgery, with a good prognosis for survival and lower risk of metachronous brain metastases, the primary objective being to verify whether the treatment is feasible in clinical practice.
1 secondary outcome
survival
Time frame: 1 year
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Feb 2014.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ricardo A Nakamura, MD principal investigator
Barretos Cancer Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing hypofractionated stereotactic radiotherapy in people with Cancer and Metastasis, run by Barretos Cancer Hospital at 1 site in Brazil.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 4 Feb 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
feasibility (time frame: 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2014.