Carbon Ion Radiotherapy for Atypical Meningiomas (MARCIE)
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Purpose
Treatment standard for patients with atypical or anaplastic meningioma is neurosurgical resection. With this approach, local control ranges between 50 and 70%, depending on resection status. A series or smaller studies has shown that postoperative radiotherapy in this patient population can increase progression-free survival, which translates into increased overall survival. However, meningiomas are known to be radioresistant tumors, and radiation doses of 60 Gy or higher have been shown to be necessary for tumor control.
Carbon ions offer physical and biological characteristics. Due to their inverted dose profile and the high local dose deposition within the Bragg peak precise dose application and sparing of normal tissue is possible. Moreover, in comparison to photons, carbon ions offer an increased relative biological effectiveness (RBE), which can be calculated between 2 and 5 depending on the cell line as well as the endpoint analyzed.
First data obtained within the Phase I/II trial performed at GSI in Darmstadt on carbon ion radiotherapy for patients with high-risk meningiomas has shown safety, and treatment results are promising.
Therefore, in the current Phase II-MARCIE-Study a carbon ion boost will be applied to the macroscopic tumor (gross tumor volume, GTV) in conjunction with photon radiotherapy to the clinical target volume (CTV) in patients with atypical meningiomas after incomplete resection or biopsy.
Primary endpoint is progression-free survival rate, secondary endpoints are overall survival, safety and toxicity.
| Condition | Intervention | Phase |
|---|---|---|
|
Meningioma |
Radiation: Carbon Ion Radiotherapy |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Treatment of Patients With Atypical Meningiomas Simpson Grade 4 and 5 With a Carbon Ion Boost in Combination With Postoperative Photon Radiotherapy: A Phase II Trial |
- Progression-free survival [ Time Frame: Progression-free survival at 3 years ] [ Designated as safety issue: No ]
- Overall Survival [ Time Frame: Overall Survival at 3 years ]
| Estimated Enrollment: | 40 |
| Study Start Date: | August 2010 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Carbon Ion Radiotherapy Boost
Carbon Ion Boost to the Macroscopic Tumor visible on contrast-enhanced MR-Imaging
|
Radiation: Carbon Ion Radiotherapy
Carbon Ion Boost 18 Gy E in single Fractions of 3 Gy E
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- histologically confirmed atypical meningioma
- macroscopic tumor after biopsy or subtotal resection
- Simpson Grade 4 or 5
- prior photon radiotherapy to the clinical target volume (CTV) of 48-52 Gy
- beginning of study treatment no later than 12 weeks after surgery
- age ≥ 18 years of age
- Karnofsky Performance Score ≥ 60
- For women with childbearing potential, adequate contraception
- Ability of subject to understand character and individual consequences of the clinical trial
- Written informed consent (must be available before enrolment in the trial)
Exclusion Criteria:
- refusal of the patients to take part in the study
- previous radiotherapy of the brain
- optic nerve sheath meningioma (ONSM)
- time interval of > 12 weeks after primary diagnosis (neurosurgical intervention) and beginning of study treatment
- Patients who have not yet recovered from acute toxicities of prior therapies
- Known carcinoma < 5 years ago (excluding Carcinoma in situ of the cervix, basal cell carcinoma, squamous cell carcinoma of the skin) requiring immediate treatment interfering with study therapy
- Pregnant or lactating women
- Participation in another clinical study or observation period of competing trials, respectively
Contacts and Locations| Contact: Jürgen Debus, MD PhD | +49-6221-56- ext 8201 | juergen.debus@med.uni-heidelberg.de |
| Contact: Stephanie E Combs, MD | +49-6221-56- ext 8202 | stephanie.combs@med.uni-heidelberg.de |
| Germany | |
| University Hospital of Heidelberg, Radiation Oncology | |
| Heidelberg, Germany, 69120 | |
More Information
No publications provided by University Hospital Heidelberg
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Prof. Dr. Dr. Jürgen Debus, Department of Radiation Oncology, University Hospital of Heidelberg |
| ClinicalTrials.gov Identifier: | NCT01166321 History of Changes |
| Other Study ID Numbers: | MARCIE, 2009-016683-36 |
| Study First Received: | July 20, 2010 |
| Last Updated: | July 30, 2010 |
| Health Authority: | Germany: Federal Office for Radiation Protection |
Keywords provided by University Hospital Heidelberg:
|
Atypical Meningioma |
Additional relevant MeSH terms:
|
Meningioma Neoplasms, Nerve Tissue Neoplasms by Histologic Type Neoplasms Neoplasms, Vascular Tissue |
Meningeal Neoplasms Central Nervous System Neoplasms Nervous System Neoplasms Neoplasms by Site Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013