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
WITHDRAWN
Clinical Phase
NA
Study Classification
INTERVENTIONAL
Study Start Date
2013-06-30
Study Completion Date
2015-08-31
Brief Summary
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The purpose of this study is to determine if Proton Therapy can provide effective and safe treatment for Malignant Peripheral Nerve Sheath Tumors of the spine and Neurofibromas of the spine.
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Detailed Description
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Proton therapy may provide the benefits of local control or palliation, while reducing the risk associated with photon radiation, by delivering therapeutic doses to a well-defined target area with significant reduction in the integral dose. A dosimetry comparison of protons and photons at the University of Florida Proton Therapy Institute confirmed the feasibility of proton irradiation of these tumors with less exposure of normal tissue to radiation than expected with photon techniques. This reduced radiation exposure to uninvolved normal tissues is expected to decrease the risk of radiation-induced second malignancies and neoplasms.
Conditions
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Nerve Sheath Tumors
Neurofibroma
Study Design
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Allocation Method
NON_RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
TREATMENT
Blinding Strategy
NONE
Study Groups
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Proton Radiation for MPNST
Proton radiation 30 cobalt gray equivalent(CGE)at 6 CGE per fraction
Group Type
EXPERIMENTAL
Proton Radiation for MPNST
Intervention Type
RADIATION
30 CGE at 6 CGE/Fx
Proton Radiation for neurofibromas
Proton radiation 25 cobalt gray equivalent(CGE) at 5 CGE per fraction
Group Type
EXPERIMENTAL
Proton Radiation for neurofibromas
Intervention Type
RADIATION
25 CGE at 5 CGE/Fx
Interventions
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Proton Radiation for MPNST
30 CGE at 6 CGE/Fx
Intervention Type
RADIATION
Proton Radiation for neurofibromas
25 CGE at 5 CGE/Fx
Intervention Type
RADIATION
Eligibility Criteria
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Inclusion Criteria
* MPNSTs that are biopsy-positive and resected, subtotally resected or unresectable.
* Symptomatic (pain, numbness, or weakness) NF1 neurofibromas that are biopsy-positive and unresectable or subtotally resected.
* Symptomatic NF1 neurofibromas that are unbiopsied and PET-negative, if the patient refuses biopsy/surgery or is medically inoperable.
* Asymptomatic NF1 neurofibromas with radiologic progression after surgery.
* PET-positive, unbiopsied lesions in NF1 patients who refuse biopsy/surgery or are medically inoperable.
* Symptomatic (pain, numbness, or weakness) NF1 neurofibromas that are biopsy-positive and unresectable or subtotally resected.
* Symptomatic NF1 neurofibromas that are unbiopsied and PET-negative, if the patient refuses biopsy/surgery or is medically inoperable.
* Asymptomatic NF1 neurofibromas with radiologic progression after surgery.
* PET-positive, unbiopsied lesions in NF1 patients who refuse biopsy/surgery or are medically inoperable.
Exclusion Criteria
* Spinal instability.
* Metal stabilization hardware within the target area.
* Previously irradiated at this disease site.
* Spinal cord compression with complete loss of function.
* Metal stabilization hardware within the target area.
* Previously irradiated at this disease site.
* Spinal cord compression with complete loss of function.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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University of Florida
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Randal H Henderson, MD
Role: PRINCIPAL_INVESTIGATOR
University of Florida Proton Therapy Institute
References
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Hottinger AF, Khakoo Y. Neuro-oncology of Neurofibromatosis Type 1. Curr Treat Options Neurol. 2009 Jul;11(4):306-14. doi: 10.1007/s11940-009-0034-4.
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Friedman JM, Birch PH. Type 1 neurofibromatosis: a descriptive analysis of the disorder in 1,728 patients. Am J Med Genet. 1997 May 16;70(2):138-43. doi: 10.1002/(sici)1096-8628(19970516)70:23.0.co;2-u.
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Cnossen MH, de Goede-Bolder A, van den Broek KM, Waasdorp CM, Oranje AP, Stroink H, Simonsz HJ, van den Ouweland AM, Halley DJ, Niermeijer MF. A prospective 10 year follow up study of patients with neurofibromatosis type 1. Arch Dis Child. 1998 May;78(5):408-12. doi: 10.1136/adc.78.5.408.
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Mautner VF, Asuagbor FA, Dombi E, Funsterer C, Kluwe L, Wenzel R, Widemann BC, Friedman JM. Assessment of benign tumor burden by whole-body MRI in patients with neurofibromatosis 1. Neuro Oncol. 2008 Aug;10(4):593-8. doi: 10.1215/15228517-2008-011. Epub 2008 Jun 17.
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Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O. Long-term outcome after removal of spinal neurofibroma. J Neurosurg. 1995 Apr;82(4):572-7. doi: 10.3171/jns.1995.82.4.0572.
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BACKGROUND
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Tonsgard JH. Clinical manifestations and management of neurofibromatosis type 1. Semin Pediatr Neurol. 2006 Mar;13(1):2-7. doi: 10.1016/j.spen.2006.01.005.
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Needle MN, Cnaan A, Dattilo J, Chatten J, Phillips PC, Shochat S, Sutton LN, Vaughan SN, Zackai EH, Zhao H, Molloy PT. Prognostic signs in the surgical management of plexiform neurofibroma: the Children's Hospital of Philadelphia experience, 1974-1994. J Pediatr. 1997 Nov;131(5):678-82. doi: 10.1016/s0022-3476(97)70092-1.
Reference Type
BACKGROUND
Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer. 1986 May 15;57(10):2006-21. doi: 10.1002/1097-0142(19860515)57:103.0.co;2-6.
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Evans DG, Baser ME, McGaughran J, Sharif S, Howard E, Moran A. Malignant peripheral nerve sheath tumours in neurofibromatosis 1. J Med Genet. 2002 May;39(5):311-4. doi: 10.1136/jmg.39.5.311.
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Ferner RE, Gutmann DH. International consensus statement on malignant peripheral nerve sheath tumors in neurofibromatosis. Cancer Res. 2002 Mar 1;62(5):1573-7.
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Chao RC, Pyzel U, Fridlyand J, Kuo YM, Teel L, Haaga J, Borowsky A, Horvai A, Kogan SC, Bonifas J, Huey B, Jacks TE, Albertson DG, Shannon KM. Therapy-induced malignant neoplasms in Nf1 mutant mice. Cancer Cell. 2005 Oct;8(4):337-48. doi: 10.1016/j.ccr.2005.08.011.
Reference Type
BACKGROUND
Stiller CA, Chessells JM, Fitchett M. Neurofibromatosis and childhood leukaemia/lymphoma: a population-based UKCCSG study. Br J Cancer. 1994 Nov;70(5):969-72. doi: 10.1038/bjc.1994.431.
Reference Type
BACKGROUND
Huson SM, Compston DA, Harper PS. A genetic study of von Recklinghausen neurofibromatosis in south east Wales. II. Guidelines for genetic counselling. J Med Genet. 1989 Nov;26(11):712-21. doi: 10.1136/jmg.26.11.712.
Reference Type
BACKGROUND
Sharif S, Ferner R, Birch JM, Gillespie JE, Gattamaneni HR, Baser ME, Evans DG. Second primary tumors in neurofibromatosis 1 patients treated for optic glioma: substantial risks after radiotherapy. J Clin Oncol. 2006 Jun 1;24(16):2570-5. doi: 10.1200/JCO.2005.03.8349.
Reference Type
BACKGROUND
Papageorgio C, Seiter K, Feldman EJ. Therapy-related myelodysplastic syndrome in adults with neurofibromatosis. Leuk Lymphoma. 1999 Feb;32(5-6):605-8. doi: 10.3109/10428199909058420.
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Gerszten PC, Burton SA, Ozhasoglu C, McCue KJ, Quinn AE. Radiosurgery for benign intradural spinal tumors. Neurosurgery. 2008 Apr;62(4):887-95; discussion 895-6. doi: 10.1227/01.neu.0000318174.28461.fc.
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Karabatsou K, Kiehl TR, Wilson DM, Hendler A, Guha A. Potential role of 18fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating benign neurofibroma from malignant peripheral nerve sheath tumor associated with neurofibromatosis 1. Neurosurgery. 2009 Oct;65(4 Suppl):A160-70. doi: 10.1227/01.NEU.0000337597.18599.D3.
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Ferner RE, Golding JF, Smith M, Calonje E, Jan W, Sanjayanathan V, O'Doherty M. [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a diagnostic tool for neurofibromatosis 1 (NF1) associated malignant peripheral nerve sheath tumours (MPNSTs): a long-term clinical study. Ann Oncol. 2008 Feb;19(2):390-4. doi: 10.1093/annonc/mdm450. Epub 2007 Oct 11.
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Warbey VS, Ferner RE, Dunn JT, Calonje E, O'Doherty MJ. [18F]FDG PET/CT in the diagnosis of malignant peripheral nerve sheath tumours in neurofibromatosis type-1. Eur J Nucl Med Mol Imaging. 2009 May;36(5):751-7. doi: 10.1007/s00259-008-1038-0. Epub 2009 Jan 14.
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BACKGROUND
Wentworth S, Pinn M, Bourland JD, Deguzman AF, Ekstrand K, Ellis TL, Glazier SS, McMullen KP, Munley M, Stieber VW, Tatter SB, Shaw EG. Clinical experience with radiation therapy in the management of neurofibromatosis-associated central nervous system tumors. Int J Radiat Oncol Biol Phys. 2009 Jan 1;73(1):208-13. doi: 10.1016/j.ijrobp.2008.03.073. Epub 2008 Aug 5.
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Chopra R, Morris CG, Friedman WA, Mendenhall WM. Radiotherapy and radiosurgery for benign neurofibromas. Am J Clin Oncol. 2005 Jun;28(3):317-20. doi: 10.1097/01.coc.0000156923.52181.3d.
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Sahgal A, Chou D, Ames C, Ma L, Lamborn K, Huang K, Chuang C, Aiken A, Petti P, Weinstein P, Larson D. Image-guided robotic stereotactic body radiotherapy for benign spinal tumors: theUniversity of California San Francisco preliminary experience. Technol Cancer Res Treat. 2007 Dec;6(6):595-604. doi: 10.1177/153303460700600602.
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Schadev S, Dodd RL, Chang SD, Soltys SG, Adler JR, Luxton G, Choi CYH, Tupper LA, Gibbs IC. Stereotactic Radiosurgery Yields Long-term Control for Benign Intradural, Extramedullary Spine Tumors. Int J Radiat Oncol Biol Phys 2009; 75:101 (Abstract)
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Korones DN, Padowski J, Factor BA, Constine LS. Do children with optic pathway tumors have an increased frequency of other central nervous system tumors? Neuro Oncol. 2003 Apr;5(2):116-20. doi: 10.1093/neuonc/5.2.116.
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Other Identifiers
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UFPTI 1101-NF01
Identifier Type: -
Identifier Source: org_study_id
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