Phase II Trial of Stereotactic Radiosurgery Boost Following Surgical Resection for Brain Metastases
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ClinicalTrials.gov Identifier: NCT00587964 |
Recruitment Status :
Completed
First Posted : January 8, 2008
Results First Posted : February 22, 2016
Last Update Posted : February 22, 2016
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For patients who have one or two metastases in the brain, the tumor(s) can often be removed with surgery to relieve symptoms from the tumor(s) and to improve survival. However, about half of all patients who have the tumor(s) removed with surgery will develop regrowth (recurrence) of the tumor. To prevent this regrowth of tumor, some patients receive radiation to the entire brain (whole brain radiation) after surgery. This involves daily treatment for about two to three weeks, and may cause long-term neurological problems, such as memory loss.
Stereotactic radiosurgery (SRS) is sometimes used instead of surgery to treat brain metastasis. This involves the use of a special head frame and sophisticated computer programs that enable us to deliver a high dose of radiation to a small focused area of the brain in only one treatment.
Research has shown that the results of treatment with SRS are as good as surgical removal of the tumor. SRS and surgical resection are considered the standard options for the treatment of brain metastases. This Phase II clinical trial is studying the combination of these two techniques. The purpose of this study is to evaluate the use of SRS following surgical removal of brain metastases. The outcomes we will be looking at are tumor regrowth after treatment and side effects of treatment.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Brain Metastasis Bladder Cancer Breast Cancer Cervical Cancer Colon Cancer HEENT Cancer Lung Cancer Melanoma Pancreatic Cancer Prostate Cancer Rectal Cancer Sarcoma Testicular Cancer | Radiation: Stereotactic Radiosurgery | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 51 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Phase II Trial of Stereotactic Radiosurgery Boost Following Surgical Resection for Brain Metastases |
Study Start Date : | June 2004 |
Actual Primary Completion Date : | January 2009 |
Actual Study Completion Date : | January 2009 |

Arm | Intervention/treatment |
---|---|
Experimental: Treatment |
Radiation: Stereotactic Radiosurgery
All patients would undergo craniotomy and the goal of surgery in all cases would be total removal of the metastases. The patient will initially receive premedication with 0.5- 1mg of Ativan orally prior to SRS procedure. Subsequently, the patient will have the stereotactic head ring placement under local anesthesia. A peripheral IV will be placed for administration of the intravenous contrast. Thin-section CT images will be obtained with intravenous contrast with head ring in place for the purpose of treatment planning. A fusion program will be used to combine the recently obtained MRI images along with the CT scans. The target volume as well as the critical structures will be contoured. SRS would be delivered using either the Brain Lab or Radionics Radiosurgery planning and delivery system. Patients would receive a single treatment ranging from 15-22 GY. Other Name: SRS |
- Local Control [ Time Frame: 1 year ]
following a combination of stereotactic radiosurgery and surgical resection for brain metastases; to determine the incidence of the brain injury following the combination therapy. Local control: Absence of radiographic evidence of tumor at the site of therapy constitutes local control of the treated disease.Recurrence in the treated region: The reappearance of tumor on any MRI or CT scan at the site of treatment constitutes recurrent disease at the treated region. Recurrence outside the treated region: The development of new intracranial metastatic foci or leptomeningeal disease constitutes recurrence outside the treated region. Leptomeningeal disease will be documented by a positive CSF cytology, abnormal myelogram or spinal MRI.
No evidence of disease: Absence of clinical or radiographic evidence of tumor both at the site of therapy and elsewhere in the brain constitutes no evidence of disease.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically confirmed malignancy with the presence of one or two intraparenchymal brain metastases (newly diagnosed patients may be registered based on radiologic confirmation if pathology is unavailable)
- Age ≥ 18 years
- Karnofsky performance status ≥ 70
- Neurologic Function Status 0-2
- Patients may have extracranial sites of metastatic disease
- Adequate bone marrow reserve (hemoglobin ≥ 8 grams, absolute neutrophil count ≥ 1000/mm3, platelets ≥ 50,000/mm3)
- Patient must sign a study specific informed consent form.
Exclusion Criteria:
- Major medical illness including poor cardiac, pulmonary or renal status which would result in patient being a high risk candidate for neurosurgical procedure
- Inability to obtain histologic proof of malignancy
- Patients with leptomeningeal metastases documented by MRI or CSF evaluation Patients with metastases within 10 mm of the optic apparatus so that some portion of the optic nerve or chiasm would be included in the high dose SRS boost field
- Patients with metastases in the brainstem, midbrain, pons, or medulla
- Patients with small cell lung cancer, germ-cell tumors, lymphoma, leukemia and multiple myeloma are not eligible
- Younger than 18 years of age
- Karnofsky performance status of ≤ 60
- Prior history of whole brain radiation therapy
- Concomitant use of chemotherapy or targeted biological therapy (within a week of the SRS treatment)
- ≥ 3 metastases in the brain
- Allergy to both CT and MR contrast dyes
- Platelet count of < 100,000 or coagulation disorders that cannot be corrected or would render the surgery a high-risk procedure

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): NCT00587964
United States, New York | |
Memorial Sloan-Kettering Cancer Center | |
New York, New York, United States, 10065 |
Principal Investigator: | Kathryn Beal, MD | Memorial Sloan Kettering Cancer Center |
Responsible Party: | Memorial Sloan Kettering Cancer Center |
ClinicalTrials.gov Identifier: | NCT00587964 |
Other Study ID Numbers: |
04-061 |
First Posted: | January 8, 2008 Key Record Dates |
Results First Posted: | February 22, 2016 |
Last Update Posted: | February 22, 2016 |
Last Verified: | January 2016 |
Cancer Brain Metastasis Radiosurgery Bladder cancer Breast cancer Cervical cancer Colon cancer HEENT cancer |
Lung cancer Melanoma Pancreatic cancer Prostate cancer Rectal cancer Sarcoma Testicular cancer Radiation |
Prostatic Neoplasms Melanoma Neoplasm Metastasis Pancreatic Neoplasms Sarcoma Rectal Neoplasms Uterine Cervical Neoplasms Colonic Neoplasms Urinary Bladder Neoplasms Brain Neoplasms Testicular Neoplasms Neoplasms by Site Neoplasms Genital Neoplasms, Male Urogenital Neoplasms |
Prostatic Diseases Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms, Nerve Tissue Nevi and Melanomas Neoplastic Processes Pathologic Processes Digestive System Neoplasms Endocrine Gland Neoplasms Digestive System Diseases Pancreatic Diseases Endocrine System Diseases Neoplasms, Connective and Soft Tissue |