Improving Therapeutic Ratio With Hypo Fractionated Stereotactic Radiotherapy for Brain Metastases

NCT ID: NCT05346367

Last Updated: 2024-03-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

130 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-18

Study Completion Date

2027-03-31

Brief Summary

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Randomized phase II trial. The study aims to investigate a different and potentially safer radio therapeutic treatment method for brain metastases. The current standard of stereotactic radiotherapy (SRT) in one or three fractions is compared to fractionated stereotactic radiotherapy (fSRT) in five fractions.

Detailed Description

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Randomized phase II trial. Stereotactic radiotherapy is one of the most frequently chosen treatment options for brain metastases. There are an increasing number of long term survivors. Brain necrosis (e.g. radio necrosis) is the most important long term side effect of the treatment, occurring in up to 40% of patients, dependent on the size of the metastasis and delivered radiotherapy dose. Retrospective studies have shown that the incidence of radio necrosis, as well as local tumor recurrence, can be decreased with a risk difference of around 20% by administrating fractionated stereotactic radiotherapy (fSRT, e.g. five fractions) over single fraction stereotactic radiotherapy, especially in large brain metastases. In this trial, one group is treated with SRT in one or three fractions. The other group is treated with fSRT in five fractions. Survival, toxicity and patient reported quality of life are monitored.

Conditions

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Brain Metastases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1:1 randomization
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SRT (stereotactic radiotherapy)

stereotactic radiotherapy in 1 or 3 fractions of 8 Gy up to 15-24 Gy

Group Type ACTIVE_COMPARATOR

SRT

Intervention Type RADIATION

SRT

fSRT (hypo fractionated stereotactic radiotherapy)

hypo fractionated stereotactic radiotherapy in 5 fractions of 7 Gy up to 35 Gy. Brain stem metastases 5 fractions of 6 Gy up to 30 Gy

Group Type EXPERIMENTAL

fSRT

Intervention Type RADIATION

fSRT

Interventions

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SRT

SRT

Intervention Type RADIATION

fSRT

fSRT

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* At least one brain metastasis of large cell cancer suitable for SRT
* Karnofsky Performance Status ≥ 70
* Ability to provide written informed consent
* New brain metastases during follow-up after surgery allowed (when outside of resection cavity area)
* New brain metastases during follow-up after previous SRT allowed (when outside of previous irradiation field)

Exclusion Criteria

* Contra-indication for MRI scan
* Primary tumor of small cell lung cancer, germinoma or lymphoma
* Prior whole brain radiotherapy or SRT on the current target brain metastases (in field re-irradiation)
* Presence of leptomeningeal metastases
* Previous inclusion in the SAFESTEREO study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haaglanden Medical Centre

OTHER

Sponsor Role lead

Responsible Party

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Jaap Zindler

Principal Investigator, MD, PhD, radiation oncologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jaap D Zindler, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Haaglanden MC

Locations

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Haaglanden Medisch Centrum

Leidschendam, South Holland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Jaap D Zindler, MD, PhD

Role: CONTACT

+31-88-9792013

Mirjam Mast, PhD

Role: CONTACT

+31-88-9792013

Facility Contacts

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Jaap Zindler, Dr

Role: primary

Ursula Fisscher, PhD

Role: backup

References

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Crouzen JA, Petoukhova AL, Broekman MLD, Fiocco M, Fisscher UJ, Franssen JH, Gadellaa-van Hooijdonk CGM, Kerkhof M, Kiderlen M, Mast ME, van Rij CM, Nandoe Tewarie R, van de Sande MAE, van der Toorn PPG, Vlasman R, Vos MJ, van der Voort van Zyp NCMG, Wiggenraad RGJ, Wiltink LM, Zindler JD. SAFESTEREO: phase II randomized trial to compare stereotactic radiosurgery with fractionated stereotactic radiosurgery for brain metastases. BMC Cancer. 2023 Mar 25;23(1):273. doi: 10.1186/s12885-023-10761-1.

Reference Type DERIVED
PMID: 36964529 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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2021-115LR

Identifier Type: -

Identifier Source: org_study_id

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