Stereotactic Radiosurgery After Surgery in Treating Patients With Brain Metastases

NCT ID: NCT00814463

Last Updated: 2019-02-26

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

1 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-08-31

Study Completion Date

2009-06-30

Brief Summary

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RATIONALE: Stereotactic radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue. Giving stereotactic radiosurgery after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase II trial is studying how well stereotactic radiosurgery works in treating patients with brain metastases.

Detailed Description

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OBJECTIVES:

Primary

* To estimate the rate of recurrence at the surgical site in patients with brain metastases treated with adjuvant stereotactic radiosurgery (SRS) compared with historical data documenting recurrence at the surgical site after surgery and whole brain radiotherapy (WBRT).

Secondary

* To estimate the rate of salvage WBRT, SRS, or surgery in patients treated with adjuvant SRS alone.
* To estimate the rate of new brain metastases outside of the adjuvant SRS site.
* To estimate patient quality of life after adjuvant SRS alone.
* To assess the effect of surgical intervention and SRS on the preservation of neurocognitive functioning in these patients.
* To determine the clinical significance (if any) of locally recurrent brain metastases at the time of their occurrence (mass effect, cognitive functioning, and other symptoms) in these patients.
* To estimate the rate of death due to neurologic causes, defined as death attributable to the progression of neurological disease.
* To estimate the overall survival of these patients.

OUTLINE: Patients undergo stereotactic radiosurgery over 30-90 minutes.

Quality of life and neurocognitive function are assessed periodically.

After completion of study therapy, patients are followed every 3 months for 1 year and then every 6 months for 1 year.

Conditions

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Metastatic Cancer Unspecified Adult Solid Tumor, Protocol Specific

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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Post-operative SRS

All patients will undergo SRS with the planned target volume (PTV) defined as the resection cavity plus a 3-mm margin after surgical resection of a single brain metastasis. Dose will be prescribed to the maximum isodose line completely encompassing the PTV using the guidelines established in RTOG 9005. All patients will be evaluated for neurocognitive function via Mini-Mental State Examination (MMSE), Quality of Life (QOL) via FACT-Br, and for local recurrence via MRI every 3 months over the course of the study.

Group Type ACTIVE_COMPARATOR

MMSE

Intervention Type BEHAVIORAL

Neurocognitive function via MMSE done every 3 months for length of study.

QOL via FACT-Br

Intervention Type BEHAVIORAL

Quality of Life via FACT-BR every 3 months for length of study.

MRI

Intervention Type PROCEDURE

MRI done every 3 months for the length of the study.

Post-operative SRS

Intervention Type RADIATION

Single fraction SRS is currently a viable treatment option of intracranial metastatic lesions.

Interventions

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MMSE

Neurocognitive function via MMSE done every 3 months for length of study.

Intervention Type BEHAVIORAL

QOL via FACT-Br

Quality of Life via FACT-BR every 3 months for length of study.

Intervention Type BEHAVIORAL

MRI

MRI done every 3 months for the length of the study.

Intervention Type PROCEDURE

Post-operative SRS

Single fraction SRS is currently a viable treatment option of intracranial metastatic lesions.

Intervention Type RADIATION

Other Intervention Names

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Mini-Mental Status Exam Quality of Life Functional Assessment of Cancer Therapy - Brain Magnetic Resonance Imagine SRS

Eligibility Criteria

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Inclusion Criteria

1. Age \>18 years of age.
2. Gross total resection (as verified by the lack of any enhancement in the resection cavity on post-operative MRI) of single brain metastasis confirmed by histology. Patients with up to 4 metastases are eligible if the largest mass is amenable to surgical resection and all non-resected masses are amenable to SRS.
3. Patient must be Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) Class 1 or 2.
4. Life expectancy of at least 3 months.

Exclusion Criteria

1. Radiographic or cytologic evidence of leptomeningeal disease.
2. Patient with incomplete or partial resection.
3. Primary lesion with radiosensitive histology (i.e., small cell carcinoma, germ-cell tumors, lymphoma, leukemia, and multiple myeloma).
4. Patients with a resection cavity \> 4 cm in maximal extent in any plane on contrasted MRI scan.
5. Lesion located in anatomic regions which are not amenable to SRS including the brain stem and optic apparatus.
6. Pregnant or need to breast feed during the study period.
7. Uncontrolled intercurrent illness including, but not limited to symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness.
8. Brain surgery other than for resection of metastasis.
9. Previous brain radiotherapy.
10. Contraindication to SRS, WBRT, or MRI.
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

Duke University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John H. Sampson, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Hamidreza Aliabadi, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University

John P. Kirkpatrick, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University

James E. Herndon, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

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Duke Comprehensive Cancer Center

Durham, North Carolina, United States

Site Status

Countries

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United States

Other Identifiers

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DUMC-PRO00004373

Identifier Type: OTHER

Identifier Source: secondary_id

CDR0000630239

Identifier Type: -

Identifier Source: secondary_id

Pro00004373

Identifier Type: -

Identifier Source: org_study_id

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