Dose Escalation for Larger Brain Metastases: Phase I/II Study
试验速览
- 阶段
- 1 期
- 状态
- 进行中（未招募）
- 入组人数
- 33
- 试验地点
- 1
- 主要终点
- Maximum-tolerated dose based on the incidence of dose-limiting toxicity (DLT) defined as any grade III or IV toxicity as assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase I)
研究概览
简要总结
This phase I/II trial studies the side effects and the best dose of stereotactic radiosurgery and to see how well it works in treating patients with large brain metastases. Radiosurgery can send x-rays directly to the tumor and cause less damage to normal tissue.
详细描述
PRIMARY OBJECTIVES:
I. To determine the incidence of acute and long-term toxicities with increasing dose of stereotactic radiosurgery (SRS). (Phase I) II. To determine if local control may be improved with increasing doses of SRS. (Phase II)
SECONDARY OBJECTIVES:
I. To determine the risk of acute and long-term toxicity with increasing dose of SRS. (Phase II) II. To determine if there is increased neurocognitive toxicity with increased dose of SRS.
III. To determine the rate of radiation necrosis/steroid dependency. IV. To determine if quality of life is affected more by tumor recurrence versus radiation necrosis. This includes assessment of progression free survival, overall survival, local failure, and number of patients who receive bevacizumab, laser interstitial thermal therapy, or surgery for presumed radiation necrosis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Any patient undergoing SRS for brain metastases
- •Lesions to be treated under this protocol must be > 2 cm, but =< 4.0 cm in diameter
- •Patients may have had prior therapy including:
- •Whole brain radiation therapy (WBRT) > 3 months ago
- •SRS to other brain metastases
- •Patients with newly diagnosed brain metastases are eligible as long as they are not planned for WBRT upfront
- •Any primary is eligible with exception of small cell lung cancer, lymphoma, and germ cell histologies
- •Patient must be able to provide written informed consent
排除标准
- •Patients receiving SRS to resection bed
- •Planned concurrent WBRT
- •Leptomeningeal metastases
- •Small cell lung cancer, lymphoma, and germ cell histologies
- •Inability to participate in study activities due to physical or mental limitations
- •Inability or unwillingness to return for all the required follow-up visits
- •Conformality index 2.0 or less cannot be achieved, or homogeneity index is > 2.0
- •Unable to deliver 10 Gray (Gy) or less to optic nerve/chiasm
- •Brainstem location is excluded from this study
研究组 & 干预措施
Treatment (SRS)
Patients undergo SRS guided by CT and MRI.
干预措施: stereotactic radiosurgery (Radiation)
Treatment (SRS)
Patients undergo SRS guided by CT and MRI.
干预措施: quality-of-life assessment (Procedure)
Treatment (SRS)
Patients undergo SRS guided by CT and MRI.
干预措施: cognitive assessment (Procedure)
结局指标
主要结局
Maximum-tolerated dose based on the incidence of dose-limiting toxicity (DLT) defined as any grade III or IV toxicity as assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (Phase I)
时间窗: Up to 4 months
Response associated with increased dose of SRS as assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) (Phase II)
时间窗: Up to 2 years
次要结局
- Incidence of adverse events as assessed by CTCAE version 4.0 (Phase II)(Up to 2 years)
- Quality of life (QOL) as assessed by the Functional Assessment of Cancer Therapy-Brain (FACT-BR) and the European Organization for Research and Treatment (EORTC)- Quality of Life Questionnaire Core 30 (QLQ30)(Up to 12 months)