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Adjuvant Radiation Therapy in Treating Patients With Brain Metastases

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ClinicalTrials.gov Identifier: NCT00002899
Recruitment Status : Terminated (Low accrual)
First Posted : January 27, 2003
Last Update Posted : July 2, 2012
Sponsor:
Information provided by (Responsible Party):
European Organisation for Research and Treatment of Cancer - EORTC

Brief Summary:

RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Adjuvant radiation therapy may kill any remaining tumor cells following surgery or radiosurgery for brain metastases.

PURPOSE: This randomized phase III trial is studying surgery or radiosurgery alone to see how well it works compared to surgery or radiosurgery and whole-brain radiation therapy in treating brain metastases in patients with solid tumors.


Condition or disease Intervention/treatment Phase
Metastatic Cancer Procedure: adjuvant therapy Radiation: radiation therapy Radiation: stereotactic radiosurgery Phase 3

Detailed Description:

OBJECTIVES:

Primary

  • Investigate the efficacy and toxicity of adjuvant whole brain radiotherapy after prior surgical resection or radiosurgery of 1 to 3 brain metastases from solid tumor in patients with good performance status and controlled systemic cancer.

Secondary

  • Determine overall survival and progression-free survival of patients treated on this protocol.
  • Determine time to neurologic progression in patients treated on this protocol.
  • Determine quality of life of patients treated on this protocol.

OUTLINE: This is a randomized, multicenter study. Patients are stratified by participating center, number of brain metastases (single vs multiple), type of primary tumor (stable systemic cancer vs synchronous or unknown primary), WHO performance status (0-1 vs 2), and treatment (prior surgical resection vs planned radiosurgery).

Patients who have undergone complete surgical resection are randomized to 1 of 2 treatment arms within 4 weeks after surgery.

  • Arm I: Patients undergo adjuvant whole brain radiotherapy (WBRT).
  • Arm II: Patients do not receive adjuvant radiotherapy. Patients planning to undergo radiosurgery are randomized to 1 of 2 treatment arms.
  • Arm III: Patients undergo radiosurgery followed by adjuvant WBRT within 4 weeks after surgery.
  • Arm IV: Patients undergo radiosurgery alone. Quality of life is assessed at baseline, at 8 weeks, and then every 3 months thereafter.

After completion if study treatment, patients are followed at 8 weeks and then every 3 months thereafter.

PROJECTED ACCRUAL: A total of 340 patients (85 per treatment arm) will be accrued for this study within 3.5 years.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 340 participants
Allocation: Randomized
Primary Purpose: Treatment
Official Title: Phase III Trial on Convergent Beam Irradiation of Cerebral Metastases
Study Start Date : November 1996
Actual Primary Completion Date : November 2007



Primary Outcome Measures :
  1. Survival with a WHO performance status 0-2 as measured by Logrank at 8 weeks after completion of study treatment, and then every 3 months until death

Secondary Outcome Measures :
  1. Overall survival as measured by Logrank at 8 weeks after completion of study treatment, and then every 3 months until death
  2. Progression-free survival as measured by Logrank 8 weeks after completion of study treatment, and then every 3 months until death
  3. Time to neurological progression as measured by Logrank 8 weeks after completion of study treatment, and then every 3 months until death
  4. Acute toxicity as measured by EORTC and RTOG scale 8 weeks after completion of study treatment, and then every 3 months until death
  5. Late toxicity as measured by Subjective, Objective, Management and Analytic/Late Effects on Normal Tissues (SOMA/LENT) scale 8 weeks after completion of study treatment, and then every 3 months until death
  6. Quality of life as measured by QLQ-C30 and BN-25 8 weeks after completion of study treatment, and then every 3 months until death


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of brain metastases from a histologically confirmed primary or metastatic extracranial tumor, meeting 1 of the following criteria:

    • Stable systemic cancer for the last 3 months (achieved by surgery, radiotherapy, chemotherapy, or hormonal therapy), defined as absence of symptomatic or radiological progression
    • Asymptomatic synchronous primary tumor (treatable by surgery, radiotherapy, chemotherapy, or hormonal therapy)

      • No metastases outside the CNS
    • Unknown primary tumor
  • Must have one to three brain lesions, confirmed by enhanced MRI prior to radiosurgery or surgery

    • No brain stem metastases
    • No leptomeningeal metastases
    • No brain metastases from small cell lung cancer, lymphoma, leukemia, myeloma, or germ cell tumors
  • Patients planning to undergo radiosurgery must meet the following criteria:

    • Largest diameter ≤ 3.5 cm for single metastasis
    • Largest diameter ≤ 2.5 cm for multiple metastases
    • Stereotactic biopsy required if not extracranial tumor (unknown primary tumor) OR extracranial diagnosis made more than 4 years previously
  • Prior neurosurgery patients must have undergone complete surgical resection
  • No recurrent brain metastases after prior surgery and/or radiosurgery and/or brain radiotherapy

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • WHO 0-2 (may be assessed under steroid therapy)

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • See Disease Characteristics
  • No concurrent chemotherapy during whole brain radiotherapy

Endocrine therapy

  • See Disease Characteristics

Radiotherapy

  • See Disease Characteristics

Surgery

  • See Disease Characteristics

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00002899


  Show 33 Study Locations
Sponsors and Collaborators
European Organisation for Research and Treatment of Cancer - EORTC
Investigators
Study Chair: Rolf-Peter Mueller, MD Medizinische Universitaetsklinik I at the University of Cologne
Study Chair: Riccardo Soffietti, MD Universita Degli Studi di Turin

Publications of Results:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: European Organisation for Research and Treatment of Cancer - EORTC
ClinicalTrials.gov Identifier: NCT00002899     History of Changes
Other Study ID Numbers: EORTC-22952-26001
EORTC-22952
EORTC-26001
First Posted: January 27, 2003    Key Record Dates
Last Update Posted: July 2, 2012
Last Verified: June 2012

Keywords provided by European Organisation for Research and Treatment of Cancer - EORTC:
tumors metastatic to brain

Additional relevant MeSH terms:
Neoplasm Metastasis
Neoplastic Processes
Neoplasms
Pathologic Processes