Multicentre Medical-economic Study Evaluating the Efficacy of Adding ZOlédronique Acid to STERéotaxique Radiotherapy in the Treatment of Vertebral Metastases

NCT ID: NCT03951493

Last Updated: 2022-04-28

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

PHASE3

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-23

Study Completion Date

2023-11-01

Brief Summary

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Hypo-fractured radiotherapy in stereotactic conditions (RSHF) of bone metastases allows high doses to be delivered to the affected bone segment while sparing adjacent healthy tissues as well as possible. In addition, it not only reduces pain and prevents spinal cord compression, but also improves long-term control of metastatic disease.

Zoledronic acid reduces bone complications. The economic literature shows that stereotactic radiotherapy, like zoledronic acid, are cost-effective strategies in these indications. The objective of this research project is to evaluate the efficiency of adding zoledronic acid to stereotactic radiotherapy in the treatment of vertebral metastases.

Detailed Description

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Conditions

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Vertebral Metastasis

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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RSHF + zoledronic acid

Patients receive RSHF according to : 30 Gy in 5 fractions of 6 Gy spaced 48 hours or 27 Gy in 3 fractions of 9 Gy spaced 48 hours or 20 Gy in 1 fraction. combined with zoledronic acid (4 mg IV slow monthly for 12 months, dose adjusted according to creatinine clearance).

Group Type EXPERIMENTAL

Zoledronic Acid 4Mg Solution for Injection + Hypo-fractured radiotherapy in stereotactic conditions

Intervention Type COMBINATION_PRODUCT

All patients receive radiotherapy i.e. treatment on D1, D3 and D5.

Several radiotherapy schemes are possible:

* 20 Gy in 1 fraction;
* 27 Gy in 3 fractions of 9 Gy
* 30 Gy in 5 fractions of 6 Gy. All patients in the experimental arm receive an intravenous injection of at least 15 minutes of 4 mg zoledronic acid every month for 12 months.

The first injection must be made no more than 3 weeks before the first day of radiotherapy. It can be performed up to J1 of radiotherapy.

The injections will be carried out either at the patient's home by the nurses or in the investigator centre.

RSHF

Patients receive only RSHF according to : 30 Gy in 5 fractions of 6 Gy spaced 48 hours or 27 Gy in 3 fractions of 9 Gy spaced 48 hours or 20 Gy in 1 fraction.

Group Type ACTIVE_COMPARATOR

Hypo-fractured radiotherapy in stereotactic conditions

Intervention Type RADIATION

All patients receive radiotherapy i.e. treatment on D1, D3 and D5.

Several radiotherapy schemes are possible:

* 20 Gy in 1 fraction;
* 27 Gy in 3 fractions of 9 Gy
* 30 Gy in 5 fractions of 6 Gy.

Interventions

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Zoledronic Acid 4Mg Solution for Injection + Hypo-fractured radiotherapy in stereotactic conditions

All patients receive radiotherapy i.e. treatment on D1, D3 and D5.

Several radiotherapy schemes are possible:

* 20 Gy in 1 fraction;
* 27 Gy in 3 fractions of 9 Gy
* 30 Gy in 5 fractions of 6 Gy. All patients in the experimental arm receive an intravenous injection of at least 15 minutes of 4 mg zoledronic acid every month for 12 months.

The first injection must be made no more than 3 weeks before the first day of radiotherapy. It can be performed up to J1 of radiotherapy.

The injections will be carried out either at the patient's home by the nurses or in the investigator centre.

Intervention Type COMBINATION_PRODUCT

Hypo-fractured radiotherapy in stereotactic conditions

All patients receive radiotherapy i.e. treatment on D1, D3 and D5.

Several radiotherapy schemes are possible:

* 20 Gy in 1 fraction;
* 27 Gy in 3 fractions of 9 Gy
* 30 Gy in 5 fractions of 6 Gy.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Cancer with inoperable thoracic and/or lumbar vertebral metastasis;
* Age ≥ 18 years old ;
* Life expectancy greater than 1 year;
* OMS or PS ≤ 2 ;
* Effective contraception for women of childbearing age;
* Patient information and free, informed and written consent, signed by the patient and investigator;
* Patient affiliated or beneficiary of the social security system.

Exclusion Criteria

* Cancer with inoperable thoracic and/or lumbar vertebral metastasis;
* Painful patient unable to maintain a lying position for 30 minutes despite analgesic treatment;
* Patient who has received external irradiation from the proposed irradiation area \> 20 Gy ;
* Signs of neurological compression;
* Spinal cord compression or epidural damage requiring surgery before radiotherapy;
* Clinically significant hypersensitivity to zoledronic acid, other bisphosphonates or any excipient;
* History of osteonecrosis of the maxilla or bone exposure or delayed healing after dental surgery;
* Previous (less than 2 years) or ongoing treatment with a bisphosphonate;
* Creatinine clearance \< 30 ml/min;
* Pregnant or breastfeeding woman;
* Patient protected or under guardianship or incapable of giving consent;
* Impossibility to submit to the medical follow-up of the trial for geographical, social or psychological reasons.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Cancerologie de l'Ouest

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stéphane SUPIOT, MD

Role: STUDY_DIRECTOR

ICO site SAINT HERBLAIN

Locations

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Institut BERGONIE

Bordeaux, , France

Site Status RECRUITING

Institut de Cancérologie de Lorraine

Nancy, , France

Site Status RECRUITING

Hôpital Privé du Confluent

Nantes, , France

Site Status NOT_YET_RECRUITING

Centre de Haute Energie

Nice, , France

Site Status NOT_YET_RECRUITING

Hopital Lyon Sud

Pierre-Bénite, , France

Site Status RECRUITING

Centre Henri Becquerel

Rouen, , France

Site Status RECRUITING

Stéphane SUPIOT

Saint-Herblain, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Stéphane SUPIOT, MD

Role: CONTACT

+33240679900

Facility Contacts

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Stéphanie BATARD, MD

Role: primary

JEAN-CHRISTOPHE FAIVRE, MD

Role: primary

Xavier BUTHAUD, MD

Role: primary

René-Jean BENSADOUN, MD

Role: primary

Ariane LAPIERRE, MD

Role: primary

SEBASTIEN THUREAU, MD

Role: primary

Stéphane SUPIOT, MD

Role: primary

+33240679900

Other Identifiers

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ICO-N-2018-14

Identifier Type: -

Identifier Source: org_study_id

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