Comparative Evaluation of Two Different Radiosurgery

NCT ID: NCT02355613

Last Updated: 2022-05-04

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

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-12-15

Study Completion Date

2021-07-31

Brief Summary

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Randomized double arm phase III study to evaluate feasibility and safety of Gamma Knife radiosurgery and Linac Based (Edge) radiosurgery in brain metastatic patients

Detailed Description

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This is a prospective double arm phase III study to evaluate cerebral side effects following radiosurgery delivered by Gamma Knife Perfexion and Linac Based EDGE. In particular our primary objective is to evaluate rate of symptomatic radionecrosis from the two different modalities of radiosurgery.

Conditions

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Metastases to Brain

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 with Gamma Knife Perfexion

A single dose of 24 Gy at 50% isodose will be prescribed at metastases with diameter ≤ 20 mm, while a dose of 20 Gy at 50% isodose will be prescribed for metastases with diameter 21-30 mm

Group Type ACTIVE_COMPARATOR

Radiosurgery with Gamma Knife Perfexion

Intervention Type RADIATION

Gamma Knife Radiosurgery is a very precise form of therapeutic radiology. Even though it is called surgery, a Gamma Knife procedure does not involve actual surgery but it uses 192 isocentric beams of highly-focused gamma rays (60-Co) to treat small to medium size lesions. Minimum beam size is 4 mm. This procedure is frame based.

Linac-based Radiosurgery with EDGE

A single dose of 24 Gy will be prescribed at mean dose to PTV at metastases with diameter ≤ 20 mm, while a dose of 20 Gy will be prescribed for metastases with diameter 21-30 mm

Group Type ACTIVE_COMPARATOR

Linac-based Radiosurgery with EDGE

Intervention Type RADIATION

EDGE linear accelerator from Varian (Varian, Palo Alto, USA) is a C-arm machine specifically developed for radiosurgery frameless treatment. The characteristics of this linac are a high level of precision and the possibility to include multiple positioning systems for stereotactical treatments, among which Cone Beam CT (CBCT), the Optical Surface Monitoring System (OSMS), and Calypso.

Interventions

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Radiosurgery with Gamma Knife Perfexion

Gamma Knife Radiosurgery is a very precise form of therapeutic radiology. Even though it is called surgery, a Gamma Knife procedure does not involve actual surgery but it uses 192 isocentric beams of highly-focused gamma rays (60-Co) to treat small to medium size lesions. Minimum beam size is 4 mm. This procedure is frame based.

Intervention Type RADIATION

Linac-based Radiosurgery with EDGE

EDGE linear accelerator from Varian (Varian, Palo Alto, USA) is a C-arm machine specifically developed for radiosurgery frameless treatment. The characteristics of this linac are a high level of precision and the possibility to include multiple positioning systems for stereotactical treatments, among which Cone Beam CT (CBCT), the Optical Surface Monitoring System (OSMS), and Calypso.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Age 18 - 85 years
* 1 - 4 brain metastases
* Karnofsky performance status (KPS) ≥70
* RPA 1 or 2
* Histopathologically confirmation of primary solid tumor
* Estimated survival ≥ 3 months as GPA score
* Written informed consent

Exclusion Criteria

* Prior WBRT
* Age \> 85 years
* KPS \< 70
* RPA 3
* Diagnosis of small cell lung cancer (SCLC) or Lymphoproliferative disease
* Use of Avastin for at least 2 months after radiosurgery
* Pregnant women
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituto Clinico Humanitas

OTHER

Sponsor Role lead

Responsible Party

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Michele Tedeschi

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marta Scorsetti, MD

Role: PRINCIPAL_INVESTIGATOR

Istituto Clinico Humanitas

Locations

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Istituto Clinico Humanitas

Rozzano, MI, Italy

Site Status

Countries

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Italy

References

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Scorsetti M, Navarria P, Cozzi L, Clerici E, Bellu L, Franceschini D, Marzo AM, Franzese C, Torri V, Reggiori G, Lobefalo F, Raspagliesi L, Attuati L, Pessina F, Franzini A, Picozzi P, Tomatis S. Radiosurgery of limited brain metastases from primary solid tumor: results of the randomized phase III trial (NCT02355613) comparing treatments executed with a specialized or a C-arm linac-based platform. Radiat Oncol. 2023 Feb 7;18(1):28. doi: 10.1186/s13014-023-02216-5.

Reference Type DERIVED
PMID: 36750848 (View on PubMed)

Other Identifiers

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1268

Identifier Type: -

Identifier Source: org_study_id

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