Hippocampus Avoidance PCI vs PCI (HA-PCI vs PCI)

This study is currently recruiting participants. (see Contacts and Locations)
Verified January 2013 by The Netherlands Cancer Institute
Dutch Cancer Society
Information provided by (Responsible Party):
The Netherlands Cancer Institute
ClinicalTrials.gov Identifier:
First received: January 29, 2013
Last updated: January 15, 2014
Last verified: January 2013

Using Intensity Modulated radiotherapy it is possible to treat the entire brain to standard dosages of whole-brain radiation, while keeping the radiation dose to the hippocampus low. However, a clear relationship between radiation dose and damage to the hippocampal stem cells has not been established yet.

This study is initiated to investigate the early and delayed neurotoxicity of PCI and to assess in a randomised design the benefits and risks of sparing the hippocampus in Small Cell Lung Cancer patients who receive PCI.

Condition Intervention Phase
Small Cell Lung Cancer
Lung Cancer
Radiation: Radiation Prophylactic Cranial Irradiation
Radiation: Radiation Hippocampal Avoidance PCI
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Crossover Assignment
Masking: Single Blind (Subject)
Primary Purpose: Treatment
Official Title: Prophylactic Cranial Irradiation With or Without Hippocampal Avoidance in SCLC a Randomized Phase III Trial

Resource links provided by NLM:

Further study details as provided by The Netherlands Cancer Institute:

Primary Outcome Measures:
  • neurocognitive decline [ Time Frame: 4 months ] [ Designated as safety issue: Yes ]
    Each patient's total recall score recorded at 4 months will be compared to baseline and dichotomized into success (decline less or equal 5 points) or failure (decline more than 5 points). The difference between the groups, in terms of dichotomized decline will be tested by means of the Fisher's exact test. A p-value less than 0.049 will be considered significant. The primary analysis will be based on an intention-to-treat principle.

Secondary Outcome Measures:
  • safety [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
    Brain metastases Time from randomization to the occurrence of brain metastases will be calculated and depicted in a cumulative incidence plot. Sensitivity analysis will be performed to assess the value of PCI vs HA-PCI treatment once considering patients dying without distant brain metastases to be censored and once using competing risk analysis considering distant metastases and death as separate events

Estimated Enrollment: 168
Study Start Date: April 2013
Estimated Study Completion Date: June 2021
Estimated Primary Completion Date: June 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Prophylactic Cranial Irradiation
Radiation. Prophylactic Cranial Irradiation: 10 times 2.5 Gy (total 25 Gy)
Radiation: Radiation Prophylactic Cranial Irradiation
Experimental: Hippocampal Avoidance PCI
Radiation. Hippocampal Avoidance PCI. 10 times 2.5 Gy (total 25 Gy).
Radiation: Radiation Hippocampal Avoidance PCI


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • − Small Cell Lung Cancer patients (stage I-III or stage IV without clinical or radiological evidence of brain metastases) candidate for PCI, i.e. without progressive disease after chemo-radiotherapy in stage I-III or after a remission after chemotherapy in stage IV

    • Sufficient proficiency in Dutch

Exclusion Criteria:

  • Prior radiotherapy to the brain
  • Clinical evidence for brain metastases or primary brain tumors− Evidence of progressive extracranial metastatic disease
  • Previous malignancy < 2 years ago except for adequately treated basal cell carcinoma of the skin and carcinoma in situ of the cervix
  • Any systemic anticancer treatment during PCI or within 3 weeks before start PCI
  • Pregnancy or lactation
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01780675

Contact: Jose Belderbos, MD, PhD +31 20 512 2174 j.belderbos@nki.nl
Contact: Sanne Schagen, PhD + 31 20 512 2328 s.schagen@nki.nl

The Netherlands Cancer Institute Recruiting
Amsterdam, Netherlands, 1066CX
Contact: Jose Belderbos, MD, PhD    +31 20 512 2135    j.belderbos@nki.nl   
Contact: Sanne Schagen, PhD    +31 20 512 2328    s.schagen@nki.nl   
Principal Investigator: Jose Belderbos, MD, PhD         
Catharina Ziekenhuis Not yet recruiting
Eindhoven, Netherlands, 5623EJ
Contact: Katrien de Jaeger, MD, PhD    +31 40 239 6400    katrien.d.jaeger@catharinaziekenhuis.nl   
Principal Investigator: Katrien de Jaeger, MD, PhD         
Sponsors and Collaborators
The Netherlands Cancer Institute
Dutch Cancer Society
Principal Investigator: Jose Belderbos, MD, PhD The Netherlands Cancer Institute
  More Information

No publications provided

Responsible Party: The Netherlands Cancer Institute
ClinicalTrials.gov Identifier: NCT01780675     History of Changes
Other Study ID Numbers: M12PHA, unknown
Study First Received: January 29, 2013
Last Updated: January 15, 2014
Health Authority: Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)

Keywords provided by The Netherlands Cancer Institute:
Prophylactic Cranial Irradiation
Hippocampal Avoidance Prophylactic Cranial Irradiation

Additional relevant MeSH terms:
Lung Neoplasms
Small Cell Lung Carcinoma
Bronchial Neoplasms
Carcinoma, Bronchogenic
Lung Diseases
Neoplasms by Site
Respiratory Tract Diseases
Respiratory Tract Neoplasms
Thoracic Neoplasms

ClinicalTrials.gov processed this record on October 23, 2014