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Small-cell Lung CancerNCT01797159

Hippocampal Prophylactic Cranial Irradiation for Small Cell Lung Cancer

A study testing Hippocampal-sparing Prophylactic Cranial Irradiation in people with Small-cell Lung Cancer and SCLC, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The Investigators are looking to compare standard treatment for the management of small cell lung cancer (SCLC) which is prophylactic cranial Irradiation (PCI) (shown to be very good in patient survival) with cranial sparing PCI. Read more about this study

Who is it for?
Ages 18 to 100 years
What is being tested?
Hippocampal-sparing Prophylactic Cranial Irradiation
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
2 sitesUnited States
Study dates
11 Mar 2013to 18 Mar 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient must have newly diagnosed and confirmed small-cell lung cancer (SCLC)
  • Patient must have a performance status of 1 or higher
  • Patients must not have received previous irradiation to the brain
  • Patients must have limited stage disease with complete response to chemotherapy and consolidative chest radiotherapy that was documented at least on standard chest x-rays within one month of study entry
  • Negative MRI or CT scan of the brain at least one month before protocol entry
  • Women of child-bearing potential must have a negative pregnancy test and also agree to use adequate contraceptives while on protocol
  • Patient must be able to understand and sign the informed consent document
  • Patient must be informed of the investigational aspect to this trial prior to singing the informed consent document

Who cannot join

  • Patients receiving prior external beam irradiation to the head or neck, including any form of stereotactic irradiation
  • Radiographic evidence of brain metastases and/or ipsilateral lung metastases/malignant pleural effusion
  • Planned concurrent chemotherapy or antitumoral agent during PCI
  • Concomitant malignancy or malignancy within the past five years other than nonmelanomatous skin cancer or carcinoma in situ of the cervix
  • Patients with minimal pleural effusion evident on chest X-ray; minimal pleural effusion visible on chest CT is allowed.
  • Patients with epilepsy requiring permanent oral medication
  • Patients must not have a serious medical or psychiatric illness that would, in the opinion of the investigator, prevent informed consent or completion of protocol treatment, and/or follow-up visits.
  • Patients may not take Memantine. This is the only eligibility criterion that has been added to those of RTOG 0212, since some physicians might now prescribe Memantine. This medication would not have been given at the time of enrollment on RTOG 0212 and its administration could confound the results of this study.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Bayview Medical Center

    Baltimore, Maryland, 21227

  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, 21287

Other trials in United States

About this study

Official title: "A Phase II Trial of Hippocampal-Sparing Cranial Irradiation (PCI) for Small-Cell Lung Cancer (SCLC)"

The Investigators are looking to compare standard treatment for the management of small cell lung cancer (SCLC) which is prophylactic cranial Irradiation (PCI) (shown to be very good in patient survival) with cranial sparing PCI. Although standard of care PCI is successful in patient survival it also has neurologic side-effects. The Investigators are hoping the cranial sparing PCI has the same positive survival results with the added benefit of lowering neurological side-effects.

Read the detailed description

The standard of care in management of small cell lung cancer consists of chemotherapy plus thoracic radiation followed by prophylactic cranial irradiation (PCI) based on a randomized trial that demonstrated a significant improvement in overall survival (OS) with PCI. Unfortunately radiation therapy to the brain is associated with neurocognitive toxicity, which may be at least in part related to radiation induced injury to neural progenitor cells in the hippocampus. Both human and animal data suggest an inverse relationship between radiation dose to the hippocampus and performance on neuropsychological testing. We hypothesize that hippocampal sparing PCI will allow improved performance on tests of short term memory and executive function compared to a historical control (RTOG 0212) receiving the same dose of conventional PCI. The primary objective of this study is to evaluate performance on the Hopkins Verbal Learning Test-Revised for delayed recall at 6 months following hippocampal-sparing PCI relative to the historical control. Secondary objectives are to estimate: 1) composite cognitive function following hippocampal-sparing PCI relative to the historical control and 2) the rate of metastases in the hippocampus at 2 years following hippocampal-sparing PCI. The long term goal of this research is to reduce the long term sequelae of radiation therapy for both primary and metastatic brain tumors.

Being tested
Hippocampal-sparing Prophylactic Cranial Irradiation
Keywords
Prophylactic Cranial Irradiation, PCI, Hippocampal-sparing irradiation
Medical subject headings
Small Cell Lung Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hippocampal-sparing Prophylactic Cranial IrradiationRadiation

    Hippocampal-sparing Prophylactic Cranial Irradiation

Study groups in NCT01797159
Study groupRoleWhat they receive
Hippocampal-sparing PCIExperimentalHippocampal-sparing PCI 25 Gy in 10 fractions
Receives: Radiation: Hippocampal-sparing Prophylactic Cranial Irradiation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Effect of Hippocampal-sparing Prophylactic Cranial Irradiation (PCI) on Possible Delayed Recall Toxicity as Assessed by the Hopkins Verbal Learning Test-Revised (HVLT-R) for Delayed Recall

    The primary endpoint of this study is cognitive function or memory. Memory is measured by participant performance on the Hopkins Verbal Learning Test-Revised for delayed recall (HVLT-R-Delayed Recall) at 6 months following hippocampal-sparing PCI. The HVLT-Delayed minimum and Maximum scores are 0-12. A higher score means a better outcome.

    Measured: Baseline, 6 months and 12 months post radiation treatment

Secondary outcomes (10)
  1. Compare Cognitive Function Following Sparing PCI to That of Standard PCI

    Composite cognitive function following hippocampal-sparing PCI relative to a historical control receiving standard PCI.

    HVLT-R Hopkins Verbal Learning Test Revised and Brief Visuospatial Memory Test-Revised (BVMT-R)

    • Total Recall (0-36) higher = better
    • Delayed Recall (0-12) higher = better
    • Discrimination (-12 to 12) higher = better Trail Making A \& B (0-300 seconds) higher = poorer Controlled Oral Word Association (COWA) (0-180) higher = better Mini-Mental State Exam (MMSE) (0-30) higher = better Perceptual Comparison Test (PCT) (0-128) higher = better Brief Test of Attention (BTA) (0-20) higher = better Calibrated Ideational Fluency Assessment (CIFA)
    • Letter Word Fluency (0-120) higher = better
    • Category Word Fluency (0-120) higher = better
    • Verbal Fluency (0-240) higher = better Learning and Memory
    • Verbal Composite T score (mean = 100, standard deviation = 15), higher = better
    • Visual Composite T score (mean = 100, standard deviation = 15), higher = better

    Measured: Baseline

  2. Compare Cognitive Function Following Sparing PCI to That of Standard PCI

    Composite cognitive function following hippocampal-sparing PCI relative to a historical control receiving standard PCI.

    HVLT-R Hopkins Verbal Learning Test Revised and Brief Visuospatial Memory Test-Revised (BVMT-R)

    • Total Recall (0-36) higher = better
    • Delayed Recall (0-12) higher = better
    • Discrimination (-12 to 12) higher = better Trail Making A \& B (0-300 seconds) higher = poorer Controlled Oral Word Association (COWA) (0-180) higher = better Mini-Mental State Exam (MMSE) (0-30) higher = better Perceptual Comparison Test (PCT) (0-128) higher = better Brief Test of Attention (BTA) (0-20) higher = better Calibrated Ideational Fluency Assessment (CIFA)
    • Letter Word Fluency (0-120) higher = better
    • Category Word Fluency (0-120) higher = better
    • Verbal Fluency (0-240) higher = better Learning and Memory
    • Verbal Composite T score (mean = 100, standard deviation = 15), higher = better
    • Visual Composite T score (mean = 100, standard deviation = 15), higher = better

    Measured: 6 months post radiation treatment

  3. Compare Cognitive Function Following Sparing PCI to That of Standard PCI

    Composite cognitive function following hippocampal-sparing PCI relative to a historical control receiving standard PCI.

    HVLT-R Hopkins Verbal Learning Test Revised and Brief Visuospatial Memory Test-Revised (BVMT-R)

    • Total Recall (0-36) higher = better
    • Delayed Recall (0-12) higher = better
    • Discrimination (-12 to 12) higher = better Trail Making A \& B (0-300 seconds) higher = poorer Controlled Oral Word Association (COWA) (0-180) higher = better Mini-Mental State Exam (MMSE) (0-30) higher = better Perceptual Comparison Test (PCT) (0-128) higher = better Brief Test of Attention (BTA) (0-20) higher = better Calibrated Ideational Fluency Assessment (CIFA)
    • Letter Word Fluency (0-120) higher = better
    • Category Word Fluency (0-120) higher = better
    • Verbal Fluency (0-240) higher = better Learning and Memory
    • Verbal Composite T score (mean = 100, standard deviation = 15), higher = better
    • Visual Composite T score (mean = 100, standard deviation = 15), higher = better

    Measured: 12 months post radiation treatment

  4. Compare Change in Quality of Life of Hippocampal-sparing PCI Treatment Outcome to Standard PCI Treatment Quality of Life Questionnaire (QLQ)-C30

    Evaluate quality of life following hippocampal-sparing PCI relative to historical control receiving standard PCI. Difference between 6 months and baseline.

    Questions on the Quality of Life Questionnaire (QLQ-C30) assessment are on a four-point scale from "not at all" to "very much". Raw scores are linearly converted to a 0-100 scale with higher scores reflecting higher levels of function and higher levels of symptom burden. Questions on the QLQ-C30 cover the following:

    • Dyspnoea
    • Insomnia
    • Appetite
    • Constipation
    • Diarrhoea
    • Finances
    • Fatigue
    • Nausea/Vomiting
    • Pain
    • Physical Function
    • Role Function
    • Emotional Function
    • Cognitive Function
    • Social Function
    • Global QoL

    Measured: Baseline and 6 months post radiation treatment

  5. Compare Change in Quality of Life of Hippocampal-sparing PCI Treatment Outcome to Standard PCI Treatment QLQ-C30

    Evaluate quality of life following hippocampal-sparing PCI relative to historical control receiving standard PCI. Difference between 12 months and baseline.

    Questions on the Quality of Life Questionnaire (QLQ-C30) assessment are on a four-point scale from "not at all" to "very much". Raw scores are linearly converted to a 0-100 scale with higher scores reflecting higher levels of function and higher levels of symptom burden. Questions on the QLQ-C30 cover the following:

    • Dyspnoea
    • Insomnia
    • Appetite
    • Constipation
    • Diarrhoea
    • Finances
    • Fatigue
    • Nausea/Vomiting
    • Pain
    • Physical Function
    • Role Function
    • Emotional Function
    • Cognitive Function
    • Social Function
    • Global QoL

    Measured: Baseline and 12 months post radiation treatment

  6. Compare Change in Quality of Life of Hippocampal-sparing PCI Treatment Outcome to Standard PCI Treatment Quality of Life Questionnaire-Brain Cancer (QLQ-BN20)

    Evaluate quality of life following hippocampal-sparing PCI relative to historical control receiving standard PCI. Difference between 6 months and baseline.

    Questions on the Quality of Life Questionnaire-Brain Cancer (QLQ-BN20) are rated on a four-point scale ('not at all', 'a little', 'quite a bit' and 'very much'), and are linearly transformed to a 0-100 scale. Higher scores represent more severe symptoms. Questions on the QLQ-BN20 cover the following:

    • Headaches
    • Seizures
    • Drowsy
    • Hair loss
    • Itching
    • Weakness
    • Bladder
    • Future Uncertainty
    • Visual Disorder
    • Motor Dysfunction
    • Communication Deficit

    Measured: Baseline and 6 months post radiation treatment

  7. Compare Change in Quality of Life of Hippocampal-sparing PCI Treatment Outcome to Standard PCI Treatment Using the Quality of Life Questionnaire-Brain Cancer (QLQ-BN20).

    Evaluate quality of life following hippocampal-sparing PCI relative to historical control receiving standard PCI. Difference between 12 months and baseline.

    Questions on the Quality of Life Questionnaire-Brain Cancer (QLQ-BN20) are rated on a four-point scale ('not at all', 'a little', 'quite a bit' and 'very much'), and are linearly transformed to a 0-100 scale. Higher scores represent more severe symptoms. Questions on the QLQ-BN20 cover the following:

    • Headaches
    • Seizures
    • Drowsy
    • Hair loss
    • Itching
    • Weakness
    • Bladder
    • Future Uncertainty
    • Visual Disorder
    • Motor Dysfunction
    • Communication Deficit

    Headaches Seizures Drowsy Hair loss Itching Weakness Bladder Future Uncertainty Scale Visual Disorder Scale Motor Dysfunction Scale Communication Deficit Scale

    Measured: Baseline and 12 months post radiation treatment

  8. Number Participants With Hippocampus Brain Metastases Following Sparing PCI

    The number of participants with brain metastases after sparing PCI treatment was assessed to be compared to two existing studies.

    Measured: 12 months

  9. Assess if Development of Leptomeningeal Carcinomatosis Following Sparing PCI is Higher Than Expected

    Determine whether development of leptomeningeal carcinomatosis following hippocampal-sparing PCI is higher than expected.

    Measured: 6 months, 12 months, 18 months and 24 months post radiation treatment

  10. Percentage of Participants Surviving Following Hippocampal-sparing PCI

    To evaluate the survival rates of study participants following hippocampal-sparing PCI.

    Measured: Up to 24 months post radiation treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Feb 2013 (estimated)
  2. Study start11 Mar 2013
  3. Primary completion18 Mar 2018
  4. Study completion18 Mar 2019

Resources

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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01797159
Sponsor's protocol ID
J12127
Other IDs
NA_00078659
Status last verified
Sep 2021
First submitted
30 Nov 2012
Last updated
18 Oct 2021
Data monitoring committee
Yes
Individual data sharing
No: There is no plan to share data with PIs who are not included on the study team.

Publications

  • Redmond KJ, Hales RK, Anderson-Keightly H, Zhou XC, Kummerlowe M, Sair HI, Duhon M, Kleinberg L, Rosner GL, Vannorsdall T. Prospective Study of Hippocampal-Sparing Prophylactic Cranial Irradiation in Limited-Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2017 Jul 1;98(3):603-611. doi: 10.1016/j.ijrobp.2017.03.009. Epub 2017 Mar 14.

    PubMed 28581401

Questions about this trial

What is this clinical trial studying?

A study testing Hippocampal-sparing Prophylactic Cranial Irradiation in people with Small-cell Lung Cancer and SCLC, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 2 sites in United States.

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 8 inclusion and 8 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: finished, as of the sponsor's last update on 18 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. 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.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Oct 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Effect of Hippocampal-sparing Prophylactic Cranial Irradiation (PCI) on Possible Delayed Recall Toxicity as Assessed by the Hopkins Verbal Learning Test-Revised (HVLT-R) for Delayed Recall (time frame: Baseline, 6 months and 12 months post radiation treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01797159, which also lists 1 linked publication.

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 18 Oct 2021; AzTrials last refreshed its copy on 6 Nov 2026.

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