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Hypofractionated Brain Radiationcavity

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ClinicalTrials.gov Identifier: NCT03561896
Recruitment Status : Recruiting
First Posted : June 19, 2018
Last Update Posted : February 10, 2022
Information provided by (Responsible Party):
Gianfranco Angelo Pesce, Oncology Institute of Southern Switzerland

Brief Summary:
Stereotactic radiosurgery or hypofractionated radiotherapy of the resection cavity after metastasectomy in cancer patients with brain metastases

Condition or disease Intervention/treatment Phase
Brain Metastases, Adult Cancer Brain Radiation: IGRT Radiation: SRS Not Applicable

Detailed Description:
Patients with limited number of brain metastases from solid tumors are at high risk of local recurrence after surgical removal of the tumor mass. The standard Whole-brain radiotherapy (WBRT) demonstrated to reduce the risk of recurrence without improving survival. At the same time WBRT have substantial acute and late toxicity. Preliminary experiences with Stereotactic radiosurgery or hypofractionated radiotherapy of the resection cavity indicate promising local control and good tolerance. This attitude was only partially explored in prospective trials. In this research patients with limited number of brain metastases and controlled systemic disease will be treated, with such a stereotactic irradiation, at the same time with evaluation of the local control (Primary endpoint) by repeated MRI and of quality of life, neurologic functionning (with a battery of thsts, e.g. MMSE, QLQ-C30, EORTC BN-20) as well as overall survival as secondary endpoints.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Stereotactic Radiosurgery or Hypofractionated Image-Guided Radiotherapy to the Surgical Cavity After Resection of Brain Metastases: a Multicenter, Single Arm, Open-label, Phase II Trial
Actual Study Start Date : January 2015
Estimated Primary Completion Date : June 2023
Estimated Study Completion Date : June 2023

Arm Intervention/treatment
Experimental: IGRT
Image-Guided Hypofractionated Stereotactic Radiation Therapy (IGRT) of the resection cavity
Radiation: IGRT
Image-Guided Radiation Therapy

Experimental: SRS
Stereotactic Radiosurgery of the resection cavity (SRS)
Radiation: SRS
stereotactic radiation therapy

Primary Outcome Measures :
  1. Relapse rate [ Time Frame: 1 year ]
    Evaluate the recurrence probability in the surgical cavity after radiotherapy

Secondary Outcome Measures :
  1. Overall survival [ Time Frame: 1 year ]
    The proportion of surviving patients at 1 year

  2. Time to systemic progression [ Time Frame: 1 year ]
    The proportion of patients with progression of disease in any location other than the brain, according to CTCAE Criteria

  3. Time to neurological progression [ Time Frame: 1 year ]
    Time to neurological deterioration (objective neurological examination and MMSE)

  4. Quality of life assessment [ Time Frame: 1 year ]
    Evaluation of the quality of life through questionnaire

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria:

  • Patient underwent surgery for single brain metastasis arising from solid neoplasia (lung, breast, melanoma, kidney, colorectal), with initial histological diagnosis, or selected cases with a resected lesion and a further non-resected lesion (from 1 to 2 lesions), treatable with SRS / IGRT of the surgical cavity
  • Patient ≥ 18 years
  • Willngness to participate in the study, written informed consent
  • Performance Status according to WHO 0-I
  • Good general conditions and organ function
  • Newly diagnosed chemotherapy-naïve disease or controlled systemic disease
  • Good bone marrow, renal and hepatic function
  • Stable steroid dose or reduced for at least 5 days

Exclusion Criteria:

  • History of previous brain irradiation
  • Pregnancy or breastfeeding
  • Histological diagnosis other than lung, breast, melanoma, kidney and colorectal malignancy

Information from the National Library of Medicine

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): NCT03561896

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Contact: Gianfranco A Pesce, MD +41918119253 GianfrancoAngelo.pesce@eoc.ch
Contact: Che N Azinwi, MD +41918118932 NgwaChe.Azinwi@eoc.ch

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Oncology Institute of Southern Switzerland (IOSI) Recruiting
Bellinzona, Ticino, Switzerland, 6500
Contact: Gianfranco A Pesce, MD    +41 (0)91 8118673    GianfrancoAngelo.pesce@eoc.ch   
Universitätsspital Basel Recruiting
Basel, Switzerland, 4031
Contact: Markus Gross, MD    +41 (0)61 2654945    markus.gross@usb.ch   
Inselspital Recruiting
Bern, Switzerland, 3010
Contact: Ekin Ermis, MD    +41 (0)31 6322632    ekin.ermis@insel.ch   
Kantonsspital Winterthur Recruiting
Winterthur, Switzerland, 8401
Contact: Daniel Zwahlen, MD    +41 (0)52 266 26 45    daniel.zwahlen@ksw.ch   
Klinik Hirslanden Recruiting
Zürich, Switzerland, 8032
Contact: Hansjörg Vees, MD    +41 (0)44 3872550    hansjoerg.vees@hirslanden.ch   
University Hospital Zurich (USZ) Recruiting
Zürich, Switzerland
Contact: Nicolas Andratschke, MD    +41 44 255 37 68    RAO_Akademischesoffice@usz.ch   
Sponsors and Collaborators
Oncology Institute of Southern Switzerland
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Principal Investigator: Gianfranco A Pesce, MD IOSI, Bellinzona, Switzerland
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Responsible Party: Gianfranco Angelo Pesce, MD, Oncology Institute of Southern Switzerland
ClinicalTrials.gov Identifier: NCT03561896    
Other Study ID Numbers: IOSI-RTO-001
First Posted: June 19, 2018    Key Record Dates
Last Update Posted: February 10, 2022
Last Verified: February 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Gianfranco Angelo Pesce, Oncology Institute of Southern Switzerland:
Radation therapy
sterotactic radiosurgery
quality of life
solid cancer
neurologic functionning
Additional relevant MeSH terms:
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Neoplasm Metastasis
Brain Neoplasms
Neoplastic Processes
Pathologic Processes
Central Nervous System Neoplasms
Nervous System Neoplasms
Neoplasms by Site
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases