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Brain MetastasisSBRTNCT02013297

Study of SBRT Efficacy on Intra and Extra -Cranial Tumors or Metastasis in Pediatrics Population (SBRT Pediatrics)

A study testing SBRT treatment in people with Brain Metastasis and Spinal Tumors, run by Centre Leon Berard at 15 sites in France.

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 purpose of this study is to evaluate the efficacy of hypofractionated stereotactic radiation treatments (SBRT) on children, teenagers and young adults malignant tumors. Read more about this study

Who is it for?
Ages 18 months to 20 years
Conditions the study is for
Brain Metastasis, Spinal Tumors, Lung Tumors
What is being tested?
SBRT treatment
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
61 participants
Where
15 sitesFrance
Study dates
3 Dec 2013to 12 Oct 2021
Phase
Interventional
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 months to 20 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • 18 months ≤ age ≤ 20 years
  • Malignant primary tumor, histologically or cytologically proven
  • Systemic disease under control or with slow evolution
  • Written indication of SBRT according to local pediatrics meeting and national Radiotherapy (RT) web conference
  • Performance Status ≤ 2 according to Eastern Cooperative Oncology Group (ECOG)
  • Sites
Show all 33Show fewer
  • Brain metastasis (≤ 3 on MRI) not suitable for surgery, without hemorrhage, less than 3 cm each, not in the brain stem
  • Primary or secondary spinal/para spinal metastasis (≤ 3), not suitable for surgery or with a non operable macroscopic residue, less than 5 cm
  • Lung metastasis (≤ 3), less than 5 cm, not eligible for surgery, or macroscopic residue not suitable for surgery
  • Previously irradiated relapsing isolated primitive/secondary tumor (intra cranial or extra cranial), with no possible surgery, or macroscopic residue.
  • Affiliation to a social security scheme
  • Signed Informed consent by patient or parents and patient
  • IN ADDITION FOR RELAPSING EPENDYMOMA:
  • Histologically proven local ependymoma at diagnosis
  • Previously irradiated ependymoma
  • Exclusive local relapse in previously irradiated site
  • Review of operability at time of relapse by a multidisciplinary staff
  • Relapse must be confirmed by a neuro-oncology multidisciplinary staff, on MRI evolutivity characteristics
  • Time to relapse after previous irradiation ≥ 1 year
  • NON-INCLUSION CRITERIA :
  • Concomitant chemotherapy
  • No evaluable target (except for completely resected ependymomas)
  • Pregnancy
  • Follow-up impossible
  • IN ADDITION FOR RELAPSING EPENDYMOMAS:
  • Metastatic patient at diagnosis and/or at relapse
  • Complete remission never obtained
  • NON-RANDOMIZATION DOSIMETRIC CRITERIA (ONLY FOR EPENDYMOMA)
  • Cumulative doses to brain stem ≥ 115 Gy
  • Tumor volume at relapse ≥ 30 cm3
  • Primary RT dose + Re-irradiation dose more than 112 Gy
  • Cumulative dose to the chiasma > 54 Gy
  • Cumulative dose to any point of the brain > 115 Gy

Who cannot join

None listed.

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

France15 sites
  • CHU Bordeaux - Hôpital Saint André

    Bordeaux, Gironde, 33000

  • Centre François Baclesse

    Caen, Calvados, 14000

  • Centre Oscar Lambret

    Lille, Nord, 59020

  • Centre Léon Bérard

    Lyon, Rhône, 69373

  • Hôpital La Timone

    Marseille, Bouches Du Rhône, 13500

  • Institut de Cancérologie de Montpellier

    Montpellier, Hérault, 34298

  • Centre Antoine Lacassagne

    Nice, Alpes Maritimes, 06050

  • Institut Curie

    Paris, Île-de-France Region, 75231

  • Centre Eugène Marquis

    Rennes, Ille Et Vilaine, 35062

  • Institut de Cancérologie de l'Ouest René Gauducheau

    Saint-Herblain, Loire Atlantique, 44805

  • Centre Paul Strauss

    Strasbourg, Bas-Rhin, 67805

  • Centre Claudius Régaud

    Toulouse, Haute Garonne, 31052

  • CHRU de Tours - Hôpital Bretonneau

    Tours, Indre Et Loire, 37044

  • Institut de Cancérologie de Lorraine

    Vandœuvre-lès-Nancy, Meurthe Et Moselle, 54511

  • Institut Gustave Roussy

    Villejuif, Val De Marne, 94805

Other trials in France

About this study

Official title: Hypofractionated Stereotactic Radiation Treatments (SBRT) on Children, Teenagers and Young Adults Malignant Tumors

The purpose of this study is to evaluate the efficacy of hypofractionated stereotactic radiation treatments (SBRT) on children, teenagers and young adults malignant tumors.

Read the detailed description

SBRT (Stereotactic Body Radiation Therapy) is a radiotherapy treatment which involves the delivery of a single high dose radiation treatment or a few fractionated radiation treatments (usually up to 5). A high potent biological dose of radiation is delivered to the tumor improving the cure rates for the tumor, in a manner previously not achievable by standard conventional radiation therapy.

For adult patients, the "Haute Authorité de Santé" (HAS) validates some indications for this treatment which are the followings :

  • Few primary or secondary brain tumors, which cannot be surgically removed
  • Spinal tumors
  • Primary bronchopulmonary tumors T1 T2 N0 M0 and pulmonary metastasis with slow growth and controled primary tumor.

For pediatrics patients, no indication is now validated by HAS. Indications validated for adults are rare in pediatrics but not exceptional, and in such cases efficient alternative treatments does not exist.

In consequence, and regarding the good results obtained in adult patients, it seems very important to validate the efficacy of this treatment on pediatrics population

Being tested
SBRT treatment
Keywords
Pediatrics, SBRT, Brain metastasis, Pulmonary metastasis, Spinal metastasis, Pulmonary primary tumor, Spinal primary tumor, Relapsed ependymoma, Relapsed irradiated tumors, Local control rate, Safety, Overall survival, Progression Free Survival
Medical subject headings
Brain Neoplasms, Spinal Cord Neoplasms, Lung Neoplasms, Ependymoma

What participants receive

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

  • SBRT treatmentRadiation

    For Brain metastasis the SBRT treatment consists on 3 fractions of 8 Gy or 5 fractions of 7 Gy or 1 fraction of 18 Gy for a single metastasis which is less than 20 mm.

    For primary or secondary pulmonary tumors the SBRT treatment consists on 3 fractions of 15 Gy or 5 fractions of 10 Gy for peripheral lesions and on 5 fractions of 8 Gy for proximal lesions.

    For primary or secondary spinal or para-spinal tumors the SBRT treatment consists on 3 fractions of 9 Gy or 5 fractions of 7 Gy.

    For previously irradiated tumors (same locations) the SBRT treatment consists on 5 to 8 fractions of 5 Gy.

    For relapsed Ependymoma previously irradiated the SBRT treatment will be allocated by surgical stratified randomization and consists on either 3 fractions of 8 Gy or 5 fractions of 5 Gy.

Study groups in NCT02013297
Study groupRoleWhat they receive
SBRT treatmentExperimentalAccording to the site to irradiate and to local constraints, SBRT consist in 1 to 8 fractions of 5 to 18 Gy
Receives: Radiation: SBRT treatment

What is being measured

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

  1. Efficacy of SBRT assessed 6 months after treatment

    The treatment efficacy is assessed by calculation of local control rate of irradiated locations according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria (complete response + partial response + stable disease)

    Measured: 6 months after inclusion

Secondary outcomes (8)
  1. Efficacy of SBRT assessed between 1,5 and 3 months after treatment

    The treatment efficacy is assessed by calculation of local control rate of irradiated locations according to RECIST version 1.1 criteria (complete response + partial response + stable disease) between 1,5 and 3 months after treatment

    Measured: Between 1,5 and 3 months after inclusion

  2. Progressive Free Survival

    Calculated from the date of inclusion to the date defined as the first documented disease progression, or second cancer appearance, or death from any cause (Up to 5 years since the first inclusion)

    Measured: From the date of inclusion to the date of progression

  3. Overall Survival

    Calculated from the date of inclusion to the date of death from any cause (Up to 5 years since the first inclusion)

    Measured: From the date of inclusion to the date of death (Up to 5 years since the first inclusion)

  4. Short time Safety profile of SBRT

    Toxicities appeared during SBRT treatment and up to 3 months after SBRT. Toxicities will be assessed by the evaluation of intensity and incidence of the Adverse Events (AE) displayed by patients. The intensity of each AE will be classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: From inclusion to 3 months after inclusion

  5. Long term Safety profile of SBRT

    Toxicities appeared after 24 months after inclusion. The outcome measure concerns toxicities appeared after the study following period. Toxicities will be assessed by the evaluation of intensity and incidence of the Adverse Events (AE) displayed by patients. The intensity of each AE will be classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: after 24 months after inclusion

  6. Efficacy of SBRT assessed 12 months after treatment

    The treatment efficacy is assessed by calculation of local control rate of irradiated locations according to RECIST version 1.1 criteria (complete response + partial response + stable disease) at 12 months after treatment

    Measured: 12 months after inclusion

  7. Efficacy of SBRT assessed 24 months after treatment

    The treatment efficacy is assessed by calculation of local control rate of irradiated locations according to RECIST version 1.1 criteria (complete response + partial response + stable disease) at 24 months after treatment

    Measured: 24 months after inclusion

  8. Medium time Safety profile of SBRT

    Toxicities appeared between 3 months and 24 months after treatment. Toxicities will be assessed by the evaluation of intensity and incidence of the Adverse Events (AE) displayed by patients. The intensity of each AE will be classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: Between 3 months and 24 months after inclusion

Timeline

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

  1. First posted17 Dec 2013 (estimated)
  2. Study start3 Dec 2013
  3. Primary completion3 Apr 2020
  4. Study completion12 Oct 2021

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
61 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02013297
Sponsor's protocol ID
SBRT
Acronym
SBRT
Status last verified
Mar 2022
First submitted
5 Dec 2013
Last updated
8 Mar 2022
Results posted
No
Data monitoring committee
Yes

Publications

  • Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol. 2008 Oct;18(4):215-22. doi: 10.1016/j.semradonc.2008.04.001. No abstract available.

    PubMed 18725106
  • Rapport ANAES : Evaluation clinique et économique de la radiochirurgie intra cranienne en conditions stéréotaxique - Rapport ANAES/Service évaluation des technologies-évaluation économique: 2000.

  • Rapport HAS : Radiothérapie extra crânienne en conditions stéréotaxiques - Décembre 2006: 2006.

  • Maranzano E, Anselmo P, Casale M, Trippa F, Carletti S, Principi M, Loreti F, Italiani M, Caserta C, Giorgi C. Treatment of recurrent glioblastoma with stereotactic radiotherapy: long-term results of a mono-institutional trial. Tumori. 2011 Jan-Feb;97(1):56-61. doi: 10.1177/030089161109700111.

    PubMed 21528665
  • Minniti G, Armosini V, Salvati M, Lanzetta G, Caporello P, Mei M, Osti MF, Maurizi RE. Fractionated stereotactic reirradiation and concurrent temozolomide in patients with recurrent glioblastoma. J Neurooncol. 2011 Jul;103(3):683-91. doi: 10.1007/s11060-010-0446-8. Epub 2010 Nov 5.

    PubMed 21052773
  • Torok JA, Wegner RE, Mintz AH, Heron DE, Burton SA. Re-irradiation with radiosurgery for recurrent glioblastoma multiforme. Technol Cancer Res Treat. 2011 Jun;10(3):253-8. doi: 10.7785/tcrt.2012.500200.

    PubMed 21517131
  • Zacharoulis S, Ashley S, Moreno L, Gentet JC, Massimino M, Frappaz D. Treatment and outcome of children with relapsed ependymoma: a multi-institutional retrospective analysis. Childs Nerv Syst. 2010 Jul;26(7):905-11. doi: 10.1007/s00381-009-1067-4. Epub 2009 Dec 29.

    PubMed 20039045
  • Kano H, Yang HC, Kondziolka D, Niranjan A, Arai Y, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for pediatric recurrent intracranial ependymomas. J Neurosurg Pediatr. 2010 Nov;6(5):417-23. doi: 10.3171/2010.8.PEDS10252.

    PubMed 21039163
  • Liu AK, Foreman NK, Gaspar LE, Trinidad E, Handler MH. Maximally safe resection followed by hypofractionated re-irradiation for locally recurrent ependymoma in children. Pediatr Blood Cancer. 2009 Jul;52(7):804-7. doi: 10.1002/pbc.21982.

    PubMed 19260098
  • Combs SE, Behnisch W, Kulozik AE, Huber PE, Debus J, Schulz-Ertner D. Intensity Modulated Radiotherapy (IMRT) and Fractionated Stereotactic Radiotherapy (FSRT) for children with head-and-neck-rhabdomyosarcoma. BMC Cancer. 2007 Sep 13;7:177. doi: 10.1186/1471-2407-7-177.

    PubMed 17854490
  • Giller CA, Berger BD, Pistenmaa DA, Sklar F, Weprin B, Shapiro K, Winick N, Mulne AF, Delp JL, Gilio JP, Gall KP, Dicke KA, Swift D, Sacco D, Harris-Henderson K, Bowers D. Robotically guided radiosurgery for children. Pediatr Blood Cancer. 2005 Sep;45(3):304-10. doi: 10.1002/pbc.20267.

    PubMed 15558704
  • Grabb PA, Lunsford LD, Albright AL, Kondziolka D, Flickinger JC. Stereotactic radiosurgery for glial neoplasms of childhood. Neurosurgery. 1996 Apr;38(4):696-701; discussion 701-2.

    PubMed 8692387
  • Hodgson DC, Goumnerova LC, Loeffler JS, Dutton S, Black PM, Alexander E 3rd, Xu R, Kooy H, Silver B, Tarbell NJ. Radiosurgery in the management of pediatric brain tumors. Int J Radiat Oncol Biol Phys. 2001 Jul 15;50(4):929-35. doi: 10.1016/s0360-3016(01)01518-8.

    PubMed 11429220
  • Chawla S, Schell MC, Milano MT. Stereotactic body radiation for the spine: a review. Am J Clin Oncol. 2013 Dec;36(6):630-6. doi: 10.1097/COC.0b013e31822dfd71.

    PubMed 22134513
  • Lo SS, Sahgal A, Wang JZ, Mayr NA, Sloan A, Mendel E, Chang EL. Stereotactic body radiation therapy for spinal metastases. Discov Med. 2010 Apr;9(47):289-96.

    PubMed 20423672

Questions about this trial

What is this clinical trial studying?

A study testing SBRT treatment in people with Brain Metastasis and Spinal Tumors, run by Centre Leon Berard at 15 sites in France.

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 33 inclusion and 0 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 8 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in France. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Efficacy of SBRT assessed 6 months after treatment (time frame: 6 months after inclusion). 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 NCT02013297, which also lists 22 linked publications.

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 8 Mar 2022.

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