Status:
RECRUITING
Radiosurgery With or Without Whole Brain Radiation for Multiple Metastases
Lead Sponsor:
Sunnybrook Health Sciences Centre
Conditions:
Brain Metastases
Eligibility:
All Genders
18+ years
Brief Summary
This clinical study is a parallel, prospective observational single-centre trial in patients presenting with 5 to 30 brain metastases. Patients to receive either stereotactic radiosurgery (SRS) alone ...
Detailed Description
The current standard of care for patients with limited brain metastases (1 to 4) is stereotactic radiosurgery (SRS) alone. This has evolved from the traditional standard of care in treating patients w...
Eligibility Criteria
Inclusion
- Histologic or cytologic diagnosis of non-hematopoietic malignancy (excluding germ cell malignancies and small cell carcinoma).
- Patients with ≥ 5 but ≤ 30 de novo brain metastases seen on a diagnostic-quality contrast-enhanced MRI obtained within 30 days prior to enrollment (or randomization if previously randomized). Patients who are found to have 31-50 metastatic lesions at the time of treatment planning may still participate in the study. Disease progression such that \> 50 brain metastases are detected after initial MRI prior to enrollment but before SRS will be treated off-protocol as per discretion of the treating physician.
- Patients with ≥ 5 but ≤ 30 new brain metastases who have undergone prior SRS for 4 or less brain metastases with stable intracranial disease as per diagnostic MRI for at least 6 months post last course of SRS. Patients who are found to have 31-50 new metastatic lesions at the time of treatment planning may still participate in the study. Disease progression such that \> 50 new brain metastases are detected after initial MRI prior to enrollment but before SRS will be treated off-protocol as per discretion of the treating physician.
- Age ≥ 18.
- Karnofsky Performance Status (KPS) ≥ 70.
- Baseline HVLT-R above ≥ 6
- Patients must be able to tolerate WBRT, and all brain lesions must be eligible for treatment with SRS as determined by the radiation oncologist.
- Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate.
- Patient is able to read, speak, and understand (i.e. sufficiently fluent) English in order to allow completion and meaningful analyses of the neurocognitive tests and quality of life questionnaires.
- Patients must be accessible for treatment and follow up. Investigators must assure themselves the patients registered on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
- Patients who are on immunotherapy must have immunotherapy held at least 1 week before and after completion of radiotherapy. Other targeted agents/therapy must be held at least 1 day before and after SRS. Systemic chemotherapy must be held one week prior to treatment and re-started one week after treatment is complete.
- Protocol treatment is to begin within 4 weeks of patient enrollment (or randomization if previously randomized).
Exclusion
- Patients with brain metastases resulting from germ cell malignancies, small cell carcinoma, or hematologic malignancies.
- Prior SRS for 5 or more brain metastases or any SRS for brain metastases within the last 6 months.
- Any prior WBRT or radiotherapy for brain metastases such that the study interventions cannot be delivered.
- Prior surgical resection of metastatic cancer from the brain.
- Patients with evidence of leptomeningeal disease.
- Patients who have a pacemaker or other contraindications, such that gadolinium-enhanced MRI cannot be performed or treatment cannot be delivered safely.
- Patients who have received chemotherapy or immunotherapy within 1 week prior to administration of protocol radiotherapy or who are expected / planned to receive chemotherapy within one week of completing protocol radiotherapy.
- Patients with \< 5 or \> 30 de novo or new brain metastases at time of enrollment, or \> 50 brain metastases at time of treatment planning.
- Patients who are pregnant (women of child-bearing age must have negative pregnancy urine test within 7 days of enrollment or randomization).
Key Trial Info
Start Date :
October 20 2020
Trial Type :
OBSERVATIONAL
Allocation :
ESTIMATED
End Date :
December 1 2025
Estimated Enrollment :
126 Patients enrolled
Trial Details
Trial ID
NCT03775330
Start Date
October 20 2020
End Date
December 1 2025
Last Update
May 18 2025
Active Locations (1)
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1
Sunnybrook Odette Cancer Centre
Toronto, Ontario, Canada, M4N 3M5