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Recruiting NCT02747303

Frameless Stereotactic Radiosurgery for Intact Brain Metastases

Phase II Interventional Brain Metastases

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Stereotactic Radiosurgery.
Who it may be relevant to
Registry conditions: Brain Metastases. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

The Clinical Relevance of Margins in Frameless Stereotactic Radiosurgery for Intact Brain Metastases: a Randomized Trial of 0 vs 2 mm Margins

Overview

This is a randomized study to determine if not treating planning target volume (PTV) margins during radiation therapy worsens progression free survival rates in patients with brain metastases.

Interventions

  • Procedure Stereotactic Radiosurgery
    The SRS dose will depend on the maximum diameter of the gross tumor volume (GTV)

Primary outcome measures

  • Progression free survival (PFS) rates estimated by the Kaplan-Meier method at 6 months [Time frame: 6 months]
Secondary outcome measures (10)
  • Progression free survival (PFS) rates estimated by the Kaplan-Meier method [Time frame: 2 years]
  • Overall survival rates [Time frame: 2 years]
  • Rates of radiation necrosis [Time frame: 2 years]
  • Rates of pseudoprogression [Time frame: 2 years]
  • Local failure rates [Time frame: 2 years]
  • Rate of acute central nervous system (CNS) Common Terminology Criteria for Adverse Events (CTCAE) v4.0 grade 2 and higher toxicities [Time frame: 90 days]
  • Rate of late central nervous system (CNS) Common Terminology Criteria for Adverse Events (CTCAE) v4.0 grade 2 and higher toxicities [Time frame: 2 years]
  • Rates of distant intracranial failure [Time frame: 2 years]
  • Rates of salvage therapy [Time frame: 2 years]
  • Association between dose and risk of radionecrosis or pseudoprogression [Time frame: 2 years]

Eligibility criteria

Inclusion criteria

  • Adult patients (≥ 18 years old) with an ECOG Performance Status 0-2 and a life expectancy of 3 months or more.
  • Histologically confirmed systemic malignancy with gadolinium contrast-enhanced MRI scan demonstrating 1-5 intraparenchymal brain metastases.
  • Well-circumscribed, measureable intraparenchymal brain lesion(s) with maximum tumor diameter ≤3.0 cm. If multiple lesions are present, the other(s) must not exceed 3.0 cm in maximum diameter. At least one lesion must be ≥1.0 cm in maximum diameter and ≥0.5 cm in a perpendicular diameter to be considered measurable disease.
  • Negative urine or serum pregnancy test done ≤ 14 days prior to CT simulation, for women of child-bearing potential only.
  • Ability to understand and willingness to sign a written informed consent document.

Exclusion criteria

  • Diagnosis of germ cell tumor, small cell carcinoma or hematologic malignancy.
  • Metastases in the brain stem, midbrain, pons, medulla, or within 7 mm of the optic apparatus (optic nerves, chiasm and optic tracts).
  • Diagnosis of leptomeningeal disease.
  • Prior cranial radiotherapy within 90 days of trial enrollment or prior SRS at any time to any lesion to be treated on protocol
  • Chemotherapy (including oral agents and targeted agents) or immunotherapy given within 14 days of SRS. Hormonal therapy is permitted. For Her2+ breast cancer patients, anti-Her2 therapy cannot be given within 14 days of SRS. Patients who are scheduled to receive trastuzumab emtansine after SRS cannot be enrolled.
  • Contraindications to gadolinium contrast-enhanced MRI (eg, non-compatible pacemaker, eGFR<30, gadolinium allergy).

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Open label
Primary purpose
Treatment

Study locations

United States · 1 center
  • University of Chicago — Chicago

Identifiers

NCT: NCT02747303 · IRB15-1476

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗