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A Study of Kyphoplasty and Vertebroplasty in the Treatment of Spine Metastases

Phase 2
Terminated
Conditions
Spine Metastasis
Solid Tumors
Interventions
Device: Conventional vertebroplasty
Device: Kyphoplasty
Registration Number
NCT02700308
Lead Sponsor
Centre Leon Berard
Brief Summary

Conventional vertebroplasty is an effective option in the treatment of bone lesions (osteoporotic and neoplastic). It is indicated as an analgesic treatment and aims at reinforcing a compressed vertebrae or at risk of fracture.

The main adverse event related to vertebroplasty use is the cement leakages that might be responsible for significant clinical impairments.

Kyphoplasty is a recent alternative strategy of vertebroplasty, based on the insertion on balloon through the needle into the targeted vertebrae and then inflation of the balloon prior to cement injection into the space.

In an osteoporotic setting, kyphoplasty allow reducing the incidence of cement leakage.

To date, no data from randomized study are available in the population of cancer patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
31
Inclusion Criteria
  • Diagnosis of cancer other than malignant hemopathies, myeloma, brain tumors, germ-cell tumors and bone sarcomas;
  • 2 metastatic sites or more;
  • Spine metastasis between T1 and L5 with reduction of vertebrae of 20% at least;
  • Indication of cementoplasty of 1 to 6 vertebrae defined by 1 of the following:
  • Pain equal or greater than 4/10 at Visual Analogic Scale
  • Unstable vertebrae (SINS score equal or greater than 7;
  • Performance Status of the Eastern Cooperative Oncology Group : 0, 1 or 2
Exclusion Criteria
  • Contraindication to vertebroplasty, including contraindication to cement use;
  • Patient already treated by vertebroplasty within the past 3 months (1 patient can not be allocated twice in this study);
  • Previous focal treatment of the targeted vertebrae (vertebroplasty, percutaneous radiofrequency, embolization);
  • Neurological deficit due to medullar or radicular compression;
  • Participation to another clinical trial with an analgesic intent.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional vertebroplastyConventional vertebroplastyConventional vertebroplasty (device's trade at the discretion of the investigator)
KyphoplastyKyphoplastyVertebroplasty with balloon placement and inflation prior to cement injection (device's trade at the discretion of the investigator)
Primary Outcome Measures
NameTimeMethod
Success rate for each strategy3 months after the procedure

The success rate will be calculated with the proportion of patients without cement leakage

Secondary Outcome Measures
NameTimeMethod
Quality of Life in both arms at Day 2121 days after procedure

Quality of Life will be assessed with the Dallas questionnaire for spinal pain

Height of the targeted vertebrae3 months after the procedure
Quality of Life in both arms at the end oh study3 months after the procedure

Quality of Life will be assessed with the Dallas questionnaire for spinal pain

Height of the patient3 months after the procedure
Analgesic properties of the strategies at 21 days21 days after the procedure

Pain will be assessed using a Visual Analogic Scale

Size of cement leakage3 months after the procedure

Size will be described as significant or not significant as per investigator judgement

Symptoms associated with cement leakage3 months after the procedure

Symptoms associated with cement leakage will be tolerance events that are stated by the investigator as related to a cement leakage

Analgesic properties of the strategies at the end of the study3 months after the procedure

Pain will be assessed using a Visual Analogic Scale

Type of cement leakage (vascular versus cortical localisation)3 months after the procedure

Location will be described as vascular or cortical using the imaging assessments

Kyphotic angle3 months after the procedure
Analgesic properties of the strategies the day after the procedureThe day after the procedure

Pain will be assessed using a Visual Analogic Scale

Tolerance profile of the strategiesThrough study completion

Tolerance will be evaluated according to the National Cancer Institute - Common Terminology Criteria Adverse Event grading scale version 4

Correlation between volume of cement injected and the level of pain relief using the Visual Analogic Scale3 months after the procedure

Trial Locations

Locations (2)

Centre Léon Bérard

🇫🇷

Lyon, France

Hopital Nord

🇫🇷

Saint-Étienne, France

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