Working… Menu

Dexamethasone for Pain Flare After Radiotherapy of Painful Bone metastasesZonMW 11510009

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01669499
Recruitment Status : Completed
First Posted : August 21, 2012
Last Update Posted : November 16, 2016
ZonMw: The Netherlands Organisation for Health Research and Development
Information provided by (Responsible Party):
A. de Graeff, UMC Utrecht

Brief Summary:
Cancer patients with pain due to bone metastases are often treated with external irradiation in order to reduce pain. However, patients may experience a temporary increase of pain shortly after irradiation, a so-called pain flare. This study investigates whether a short course of a drug called dexamethasone may prevent the occurrence of a pain flare. Patients, who are irradiated for painful bone metastases are randomized into three groups. Group 1 receives placebo during four days, group 2 receives dexamethasone on the day of the irradiation and placebo during three days, and group 3 receives dexamethasone during four days. All patients complete a questionnaire on pain, side-effects of treatment and quality of life during 14 days and after four weeks. This study will define whether dexamethasone decreases the occurrence of a pain flare after irradiation for painful bone metastases, and, if so, whether four days of treatment with dexamethasone is better dan one day of treatment.

Condition or disease Intervention/treatment Phase
Bone Metastases Drug: Dexamethasone acetate Drug: Placebo Phase 3

Show Show detailed description

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 411 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Supportive Care
Official Title: Dexamethasone for the Prevention of a Pain Flare After Palliative Radiotherapy for Painful Bone Metastases: a Multi-center Double-blind Placebo-controlled Randomized Study
Study Start Date : January 2012
Actual Primary Completion Date : April 2016
Actual Study Completion Date : April 2016

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Placebo Comparator: Placebo
Placebo on day 0-3
Drug: Placebo
Active Comparator: Dexamethasone acetate day 0
8 mg dexamethasone on day 0
Drug: Dexamethasone acetate
Drug: Placebo
Active Comparator: Dexamethasone acetate day 0-3
8 mg dexamethasone on day 0-3
Drug: Dexamethasone acetate

Primary Outcome Measures :
  1. The occurrence of a pain flare. [ Time Frame: Within 2 weeks after irradiation ]
    A pain flare is defined by a two-point increase after radiotherapy of the worst pain score on Pain flare is defined as an 11-point scale of 0 (no pain) to 10 (worst imaginable pain) compared to baseline without a decrease in analgesic intake, or a 25% increase in analgesic intake without decrease in worst pain score (according to international bone metastases consensus guidelines) (Chow 2007).

Secondary Outcome Measures :
  1. Pain scores [ Time Frame: Days 1-14 and 28 ]
    Pain scores as measured by BPI

  2. Quality of life [ Time Frame: Days 7, 14 and 28 ]
    As measured by the quality of life scale of the EORTC PAL15

  3. Side effects [ Time Frame: Day 1-14 ]
    As measured by questionnaire

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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

Inclusion Criteria:

  • Patients of 18 years or older
  • Uncomplicated painful bone metastases
  • Primary malignancy is a solid tumour • Pain intensity on a numeric rating scale of 2-8
  • No immediately expected change in the analgesic regimen.
  • Indication for single or short course radiotherapy
  • Able to fill out Dutch questionnaires
  • Able to follow instructions
  • Informed consent provided

Exclusion Criteria:

  • Patients with hematological malignancy
  • Multliple sites to be irradiated
  • Patients who have been treated before with palliative radiotherapy for painful bone metastases
  • Current use of steroids (dexamethasone, prednisolone or other), or use up to less than a week before randomization
  • Long-term schedule radiotherapy (>6 fractions)
  • Life expectancy shorter than 8 weeks
  • Karnofsky Performance Score of 40 or less

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 identifier (NCT number): NCT01669499

Layout table for location information
Leiden University Medical Centre
Leiden, Zuid-Holland, Netherlands, 2333 ZA
University Medical Center Utrecht
Utrecht, Netherlands, 3485 CX
Sponsors and Collaborators
UMC Utrecht
ZonMw: The Netherlands Organisation for Health Research and Development
Layout table for investigator information
Principal Investigator: Alexander de Graeff, MD, PhD Medical Oncologist
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information
Responsible Party: A. de Graeff, Associate professor, UMC Utrecht Identifier: NCT01669499    
Other Study ID Numbers: ZonMW 11510009
First Posted: August 21, 2012    Key Record Dates
Last Update Posted: November 16, 2016
Last Verified: November 2016
Keywords provided by A. de Graeff, UMC Utrecht:
Bone metastases, radiotherapy, dexamethasone, pain flare
Additional relevant MeSH terms:
Layout table for MeSH terms
Neoplasm Metastasis
Bone Neoplasms
Bone Marrow Diseases
Neoplastic Processes
Pathologic Processes
Neoplasms by Site
Bone Diseases
Musculoskeletal Diseases
Hematologic Diseases
Dexamethasone acetate
BB 1101
Anti-Inflammatory Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action