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HFSRT With Concurrent TMZ for Large BMs

Phase 3
Conditions
Brain Metastases
Radiotherapy
Chemotherapy
Interventions
Radiation: hypofractionated radiotherapy
Registration Number
NCT03778541
Lead Sponsor
Chinese Academy of Medical Sciences
Brief Summary

A multi-center randomized phase III trial was conducted to investigate the feasibility and safety of adding temozolomide to hypofractionated stereotactic radiotherapy for large brain metastases.

Detailed Description

A previous single arm phase II trial and propensity- matched study of our institution have shown that HFSRT combined with concurrent TMZ was safe and efficient for patients with BMs of ≥ 6cc in volume. The 1-year local control, intracranial progression free survival, progression free survival and overall survival rates were better than HFSRT alone group. Thus, the investigator conducted this randomized phase III trial to broad the sample size and verify our previous results. To finish the study in time, the investigator designed a multi-center trial.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
224
Inclusion Criteria
  • histologic or cytological diagnosis of primary tumor and conformed brain metastases by enhanced MRI or CT;
  • the number of BMs ≤ 3
  • the tumor volume ≥6cc, or maximum diameter of BMs≥ 3cm;
  • Karnofsky performance score (KPS)≥60, or KPS≥40 but simply caused by BMs;
  • Age: 18-75 years old;
  • Adequate function of major organs, and blood test reached the following level: WBC≥4.0x109/L, NEU≥1.5x109/L Hemoglobin≥110 g/L, Platelets≥100 x109/L; Liver function test results<1.5 times the institutional upper limit of normal (ULN); BUN and Cr: within the normal range.
Exclusion Criteria
  • patient with other clinically significant diseases (e.g. myocardial infarction within the past 6 months, severe arrhythmia);
  • unable or unwilling to comply with the study protocol;
  • patient whose survival expectancy was less than 3 months;
  • the large BM locates in brainstem;
  • patient who anticipated in other clinical trials of brain metastases;
  • the large lesions have been treated with SRT in other hospitals;
  • pregnant patients or female patients whose HCG is positive.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CRT grouphypofractionated radiotherapypatients with brain metastases of more than 6 cc and treated with fractionated stereotactic radiotherapy plus concomitant Temozolomide.
RT grouphypofractionated radiotherapypatients with brain metastases of more than 6 cc and treated with fractionated stereotactic radiotherapy alone.
CRT groupTemozolomidepatients with brain metastases of more than 6 cc and treated with fractionated stereotactic radiotherapy plus concomitant Temozolomide.
Primary Outcome Measures
NameTimeMethod
intracranial progression free survival (IPFS) rateup to 2 years

IPFS was defined as the interval from the beginning of radiation to any intracranial progression

Secondary Outcome Measures
NameTimeMethod
local control rateup to 2 years

the control rate of treated lesions

Brain metastasis-specific survival (BMSS) rateup to 2 years

BMSS was defined as the internal from the beginning of RT to death caused by BM

overall survival (OS) rateup to 2 years

OS was defined as the internal from the beginning of RT to death caused by any reason

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 and NRG/RTOG CNS toxicities criteriaacute toxicities: up to 3 months after RT; Late toxicities: up to 2 years after RT

the toxicities caused by RT and (or) Chemotherapy

Trial Locations

Locations (1)

Chinese Academy of Medical Sciences

🇨🇳

Beijing, Beijing, China

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