A Phase II Study on the Toxicity and Efficacy of a Normal Tissue Tolerance Adapted, 5 Fraction Stereotactic Body Radiation Therapy (SBRT) Regimen, for Extra-Cranial Oligometastases
Overview
- Phase
- Phase 2
- Intervention
- Radiation: 50Gy in 5 fr (max) to 25 Gy in 5 fr (min). Dose adapted to deliver the highest dose level while respecting normal tissue tolerance
- Conditions
- Solid Tumors With Oligometastatic Spread
- Sponsor
- University Health Network, Toronto
- Enrollment
- 138
- Locations
- 1
- Primary Endpoint
- Proportion of patients with lack of progressive disease for the index site at 1 year
- Status
- Completed
- Last Updated
- last month
Overview
Brief Summary
This is a prospective Phase II study.The purpose of this study is to monitor the side effects and treatment outcomes of delivering higher doses of radiation therapy to the tumour, while limiting the dose of radiation to the normal tissues. This will be done using a 5 day treatment schedule.
The characteristics of patients whose disease remains confined to limited areas in the long term, compared with those who do not will also be described.
Detailed Description
Endpoints are to describe: the proportion of patients with local control for the index site at 1 year; the number of index lesion(s) with local control at 1 year; acute and late AEs related to SBRT; time to local progression for the index site; time to distant disease progression; symptom and QoL profile; median survival.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Any solid tumors are eligible. Lymphoma, myeloma and germ cell tumors are excluded.
- •Histological confirmation of neoplastic disease either from original primary or metastatic sites is required.
- •Radiological diagnosis of oligometastastic metastatic disease is accepted if considered clinically acceptable. Histological confirmation is not mandatory.
- •Oligometastatic disease, maximum of 5 lesions.
- •At least one lesion is suitable for stereotactic body radiotherapy
- •All known sites of disease have plans for local ablative management (see section management plan for definitions) within 3 months
- •At least 18 yrs old
Exclusion Criteria
- •Previous radiotherapy to the intended treatment site
- •Patient cannot tolerate physical set up required for SBRT
- •Active bowel obstruction, if treating abdominal/pelvic site
- •Chemotherapy within 2 weeks of intended radiation therapy
- •Treatment plan respecting normal tissue tolerances using dose fractionation specified within the protocol cannot be achieved
- •Pregnancy
Arms & Interventions
Stereotactic Body Radiation Therapy
All patients will be treated with SBRT 1-2 weeks after radiotherapy planning scans. Therapy will be given once daily, over 5 consecutive working days according to standard practice.
Intervention: Radiation: 50Gy in 5 fr (max) to 25 Gy in 5 fr (min). Dose adapted to deliver the highest dose level while respecting normal tissue tolerance
Outcomes
Primary Outcomes
Proportion of patients with lack of progressive disease for the index site at 1 year
Time Frame: 10 years
CT will be used for evaluation of the status of the local disease at the index site.
Secondary Outcomes
- Time to local progression for the index site(s)(10 years)
- Acute toxicity within 90 days of first fraction of radiotherapy(10 years)
- Time to distant disease progression (beyond known sites of oligometastases at time of study entry)(10 years)
- Describe symptom profile(10 Years)
- Examine radiotherapy parameters (outlined in Appendix J) for local control of index site(s) and toxicities(10 years)
- Number of index lesion(s) with lack of progressive disease at 1 year.(10 years)
- Late toxicity occuring beyond 90 days related to SBRT.(10 year)