Radiosurgery With or Without Whole-Brain Radiation Therapy in Treating Patients With Brain Metastases

NCT ID: NCT00030628

Last Updated: 2016-07-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

480 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-12-31

Study Completion Date

2014-10-31

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Radiosurgery may be able to deliver x-rays directly to the tumor and cause less damage to normal tissue. It is not yet known if radiosurgery is more effective with or without whole-brain radiation therapy in treating brain metastases.

PURPOSE: Randomized phase III trial to compare the effectiveness of radiosurgery with or without whole-brain radiation therapy in treating patients who have brain metastases.

Detailed Description

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OBJECTIVES:

* Compare the overall survival of patients with 1 to 3 cerebral metastases treated with radiosurgery with or without whole brain radiotherapy.
* Compare the time to CNS failure (brain) in patients treated with these regimens.
* Compare the quality of life, duration of functional independence, and long-term neurocognitive status in patients treated with these regimens.
* Compare the post-treatment toxic effects of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to age (60 and over vs under 60), extracranial disease (controlled for more than 3 months vs controlled for 3 months or less), and number of brain metastases (1 vs more than 1). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo radiosurgery.
* Arm II: Patients undergo radiosurgery. Within 14 days, patients then undergo whole brain radiotherapy 5 days a week for 2.5 weeks.

Quality of life is assessed at baseline, the beginning of each treatment, at week 6, every 3 months for 1 year, every 4 months for 1 year, and then every 6 months for 2 years.

Patients are followed at weeks 6 and 12, every 3 months for 9 months, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 480 patients (240 per treatment arm) will be accrued for this study within 5 years.

Conditions

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Metastatic Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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radiosurgery

Patients undergo radiosurgery.

Quality of life is assessed at baseline, the beginning of each treatment, at week 6, every 3 months for 1 year, every 4 months for 1 year, and then every 6 months for 2 years.

Group Type EXPERIMENTAL

radiation therapy

Intervention Type RADIATION

surgery

Intervention Type PROCEDURE

radiosurgery + WBRT

Patients undergo radiosurgery. Within 14 days, patients then undergo whole brain radiotherapy 5 days a week for 2.5 weeks.

Quality of life is assessed at baseline, the beginning of each treatment, at week 6, every 3 months for 1 year, every 4 months for 1 year, and then every 6 months for 2 years.

Patients are followed at weeks 6 and 12, every 3 months for 9 months, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.

Group Type EXPERIMENTAL

radiation therapy

Intervention Type RADIATION

surgery

Intervention Type PROCEDURE

WBRT

Intervention Type RADIATION

Interventions

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radiation therapy

Intervention Type RADIATION

surgery

Intervention Type PROCEDURE

WBRT

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of cerebral metastases meeting all of the following requirements:

* 1-3 de novo lesions
* Metastases must be from a histologically confirmed extracerebral primary site, another metastatic site, or from the metastatic brain lesion(s)
* Each lesion must be less than 3.0 cm by contrasted MRI of the brain
* Lesions must not be within 5 mm of optic chiasm or within the brainstem
* No primary germ cell tumor, small cell carcinoma, or lymphoma
* No leptomeningeal metastases
* Eligible for treatment with gamma knife or linear accelerator-based radiosurgery
* Performance status - ECOG 0-2
* Performance status - Zubrod 0-2
* Not pregnant
* Negative pregnancy test
* Fertile patients must use effective contraception

\* Male patients must continue to use contraception for 3 months after the completion of radiotherapy
* No pacemaker or other MRI-incompatible metal in body
* No known allergy to gadolinium
* Deemed to be at low risk for recurrence from any prior malignancies
* At least 7 days since prior chemotherapy
* Concurrent hormonal agents allowed
* Concurrent steroids allowed
* No prior cranial radiotherapy
* No prior resection of cerebral metastasis
* Concurrent anticonvulsants allowed provided therapeutic serum/plasma level maintained before study intervention
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Alliance for Clinical Trials in Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anthony Asher, MD, FACS

Role: STUDY_CHAIR

Carolina Neurosurgery and Spine Associates

Locations

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University of Alabama at Birmingham Comprehensive Cancer Center

Birmingham, Alabama, United States

Site Status

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status

Foundation for Cancer Research and Education

Phoenix, Arizona, United States

Site Status

Mount Diablo Regional Cancer Center

Concord, California, United States

Site Status

Sutter Cancer Center

Sacramento, California, United States

Site Status

UCSF Comprehensive Cancer Center

San Francisco, California, United States

Site Status

John Muir Comprehensive Cancer Center at John Muir Medical Center

Walnut Creek, California, United States

Site Status

University of Colorado Cancer Center at University of Colorado Health Sciences Center

Aurora, Colorado, United States

Site Status

Yale Comprehensive Cancer Center

New Haven, Connecticut, United States

Site Status

Shands Cancer Center at the University of Florida Health Science Center

Gainesville, Florida, United States

Site Status

University of Illinois Medical Center

Chicago, Illinois, United States

Site Status

Genesis Regional Cancer Center at Genesis Medical Center

Davenport, Iowa, United States

Site Status

Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, United States

Site Status

Josephine Ford Cancer Center at Henry Ford Health System

Detroit, Michigan, United States

Site Status

Siteman Cancer Center at Barnes-Jewish Hospital

St Louis, Missouri, United States

Site Status

John F. Kennedy Medical Center

Edison, New Jersey, United States

Site Status

SUNY Upstate Medical University Hospital

Syracuse, New York, United States

Site Status

Blumenthal Cancer Center at Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Carolina Neurosurgery and Spine Associates

Charlotte, North Carolina, United States

Site Status

American College of Surgeons Oncology Group

Durham, North Carolina, United States

Site Status

Duke Comprehensive Cancer Center

Durham, North Carolina, United States

Site Status

Comprehensive Cancer Center at Wake Forest University

Winston-Salem, North Carolina, United States

Site Status

Cleveland Clinic Taussig Cancer Center

Cleveland, Ohio, United States

Site Status

Penn State Cancer Institute at Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center - Shadyside Hospital

Pittsburgh, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

UPMC St. Margaret

Pittsburgh, Pennsylvania, United States

Site Status

Methodist Cancer Center at Methodist University Hospital

Memphis, Tennessee, United States

Site Status

American Fork Hospital

American Fork, Utah, United States

Site Status

Cancer Center at the University of Virginia

Charlottesville, Virginia, United States

Site Status

Massey Cancer Center at Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

University of Wisconsin Comprehensive Cancer Center

Madison, Wisconsin, United States

Site Status

Medical College of Wisconsin Cancer Center

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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ACOSOG-Z0300

Identifier Type: -

Identifier Source: secondary_id

CDR0000069183

Identifier Type: OTHER

Identifier Source: secondary_id

ACOSOG-Z0300

Identifier Type: -

Identifier Source: org_study_id

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