The Role of Posterior Fossa Irradiation (PFI) Plus Stereotactic Radiosurgery (SRS) for Cerebellar Metastases

NCT ID: NCT00781209

Last Updated: 2008-10-28

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2010-12-31

Brief Summary

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The aggregate of data pertaining to brain metastases suggests that optimal results are achievable with a 2-pronged approach that addresses both the specific focus (with surgery or radiosurgery) and the surrounding brain parenchymal tissue that may harbor micrometastases. Patterns of failure following treatment of metastases that arise in the posterior fossa have not been reliably defined. Although most would agree that radiosurgery alone is not sufficient treatment for focal metastases in the cerebellum, it may be possible to deliver less than WBI as an "expanded port" beyond the SRS volume.

The current study acknowledges that at least two therapeutic modalities are requisite for patients with cerebellar metastases but hypothesizes that it is unnecessary to extend the treatment of ostensibly uninvolved brain tissue beyond the limits of the posterior fossa. In so doing, it is hoped that the putative advantage derived from foregoing whole brain irradiation (e.g., reduction in neurocognitive impairment) will not be at the expense of excessive surpratentorial failure.

Detailed Description

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SCHEMA:

* Posterior Fossa Irradiation as defined by diagnostic MRI and CT simulation.
* 37.5 Gy in 2.5 Gy fractions administered via conformal beams.
* Radiosurgical boost (with dose titrated to parameters of RTOG 9005).
* Contrast enhanced MRI will be obtained at baseline and then at 3, 6, and 12 months following completion of posterior fossa irradiation.
* The Mini Mental Status Examination will be used to evaluate global cognitive function at baseline and then at 3, 6, and 12 months following completion of posterior fossa irradiation.

Conditions

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Neoplasm Metastasis

Keywords

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irradiation stereotactic radiosurgery posterior fossa cerebellar metastases

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Exp

Posterior Fossa Irradiation 37.5 Gy in 2.5 Gy fractions+Radiosurgical boost; Follow up:Contrast enhanced MRI \& Mini Mental Status Examination

Group Type EXPERIMENTAL

Irradiation plus Stereotactic Radiosurgery

Intervention Type PROCEDURE

Posterior Fossa Irradiation-total dose of 37.5 Gy in 2.5 Gy fractions administered via conformal beams.

Radiosurgical boost-total dose administered to each lesion will be titrated to the size of the metastatic focus as follows:

Maximum Tumor Diameter:\<2.0 cm; Assigned Dose:24 Gy. Maximum Tumor Diameter:2.1-3.0 cm;Assigned Dose:18 Gy. Maximum Tumor Diameter:3.1-4.0 cm;Assigned Dose:15 Gy.

Interventions

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Irradiation plus Stereotactic Radiosurgery

Posterior Fossa Irradiation-total dose of 37.5 Gy in 2.5 Gy fractions administered via conformal beams.

Radiosurgical boost-total dose administered to each lesion will be titrated to the size of the metastatic focus as follows:

Maximum Tumor Diameter:\<2.0 cm; Assigned Dose:24 Gy. Maximum Tumor Diameter:2.1-3.0 cm;Assigned Dose:18 Gy. Maximum Tumor Diameter:3.1-4.0 cm;Assigned Dose:15 Gy.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed malignant disease
* All primary tumors exclusive of:

* Small cell lung cancer
* Renal cell cancer (hypernephroma)
* Melanoma
* Sarcoma
* 1-3 intraparenchymal metastases
* Age ≥18 years
* RPA(14) 1 or 2
* Patients who have undergone resection are eligible provided residual disease is evident on imaging
* No clinical or radiographic evidence of progression of extracranial disease in month prior to enrollment on study.

Exclusion Criteria

* Major psychiatric illness
* Lesions in brainstem, midbrain, pons, medulla
* Patient who have undergone complete resection of all known infratentorial disease
* Patients with leptomeningeal metastases
* Patients with hepatic metastases
* Patients with metastases from the following primary tumors are ineligible: Small Cell Lung Cancer; rena Cell Carcinoma; Melanoma; Sarcoma
* Previous cranial irradiation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tel-Aviv Sourasky Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Radiotherapy Department, TASMC

Principal Investigators

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Ben Corn, Prof.

Role: PRINCIPAL_INVESTIGATOR

Radiotherapy Department, TASMC

Locations

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Radiotherapy Department, TASMC

Tel Aviv, , Israel

Site Status

Countries

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Israel

Central Contacts

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Ben Corn, Prof.

Role: CONTACT

Phone: 972-3-6947285

Email: [email protected]

Facility Contacts

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Marina Gurman

Role: primary

Vika Gurevich

Role: backup

Other Identifiers

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TASMC - 08 - BC - 270 - CTIL

Identifier Type: -

Identifier Source: org_study_id