跳至主要内容
临床试验/NCT01227954
NCT01227954已完成2 期

A Phase II Trial of Hippocampal Avoidance During Whole Brain Radiotherapy for Brain Metastases

Radiation Therapy Oncology Group63 个研究点 分布在 1 个国家目标入组 113 人开始时间: 2011年3月1日最近更新:
适应症
干预措施

试验速览

阶段
2 期
状态
已完成
入组人数
113
试验地点
63
主要终点
Percent Change in Delayed Recall at 4 Months as Measured by the Hopkins Verbal Learning Test-Revised (HVLT-R)

研究概览

简要总结

RATIONALE: Radiation therapy uses high energy x-rays to kill tumor cells.

PURPOSE: This phase II trial is studying how well avoiding the hippocampus during whole-brain radiation therapy works in treating patients with brain metastases.

详细描述

OBJECTIVES:

Primary

  • Evaluate delayed recall as assessed by the Hopkins Verbal Learning Test-Revised (HVLT-R) at 4 months after hippocampal avoidance during whole-brain radiotherapy (HA-WBRT) in patients with brain metastasis.

Secondary

  • Evaluate auditory and visual learning and memory, as assessed by two CogState tests (International Shopping List Test and One Card Learning Test), after HA-WBRT in these patients.
  • Compare psychometric properties of the 2 CogState tests to the HVLT-R for the assessment of memory decline after HA-WBRT in these patients.
  • Evaluate health-related quality of life [as assessed by the Functional Assessment of Cancer Therapy with Brain Subscale (FACT-BR) and the Barthel Index of Activities of Daily Living (ADLs)] after HA-WBRT in these patients.
  • Evaluate time to radiographic progression after HA-WBRT in these patients.
  • Evaluate overall survival of these patients after HA-WBR.
  • Evaluate the adverse events of HA-WBR.
  • Evaluate predictive biomarkers of cognitive function.

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 120 Years(Adult, Older Adult)
性别
All
接受健康志愿者
否

入选标准

  • •Histologically or cytologically confirmed non-hematopoietic malignancy within the past 5 years
  • •If histologic proof of malignancy is from > 5 years ago, then a more recent pathological confirmation is required (e.g., from systemic metastatic or brain metastasis)
  • •Patients with metastasis of unknown primary tumor are permitted
  • •Measurable brain metastasis outside a 5-mm margin around either hippocampus on gadolinium contrast-enhanced MRI obtained within the past 30 days
  • •Have not been or will not be treated with stereotactic radiosurgery (SRS) or surgical resection
  • •These treatment options are allowed only at relapse
  • •Patients who have brain metastases at initial presentation allowed and do not need to demonstrate 3 months of stable scans
  • •At least 1 week since open biopsy
  • •Karnofsky performance status 70-100%
  • •Fertile patients must use effective contraception
  • •Negative pregnancy test 2 weeks or less prior to study entry
  • •Patients must be English proficient, with patients who speak English as a second language eligible

排除标准

  • •Small cell lung cancer or germ cell malignancy
  • •Leptomeningeal metastases
  • •Non-small cell lung cancer-associated brain metastases with ≥ 2 organ sites of extracranial metastases
  • •Radiologic evidence of hydrocephalus
  • •Serum creatinine > 1.4 mg/dL within 30 days prior to study entry
  • •Pregnant or nursing
  • •Contraindication to MRI imaging such as implanted metal devices or foreign bodies or severe claustrophobia
  • •Severe, active co-morbidity including any of the following:
  • •Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months
  • •Transmural myocardial infarction within the past 6 months
  • •Acute bacterial or fungal infection requiring intravenous antibiotics
  • •Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
  • •Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy
  • •Uncontrolled, clinically significant cardiac arrhythmias
  • •Prior radiotherapy to the brain
  • •Plan for chemotherapy or targeted therapies during WBRT or during the subsequent 7 days

研究组 & 干预措施

WBRT with Hippocampal Avoidance

Other

Whole brain radiotherapy (WBRT) with hippocampal avoidance using intensity-modulated radiation therapy (IMRT)

干预措施: intensity-modulated radiation therapy (Radiation)

结局指标

主要结局

Percent Change in Delayed Recall at 4 Months as Measured by the Hopkins Verbal Learning Test-Revised (HVLT-R)

时间窗: Baseline and 4 months from start of treatment

Change in Hopkins Verbal Learning Test-Revised delayed recall (HVLT_R DR) score from baseline to 4 months after the start of treatment calculated as (baseline score - 4 month score)/ baseline score. A positive change indicates a decline in function. The HVLT-R assesses verbal learning and memory. It incorporates 6 different forms, helping to mitigate practice effects of repeated administrations. Each form includes 12 nouns (targets) with 4 words drawn from 3 semantic categories, which differ across the 6 forms. Delayed recall involves recalling a list of 12 targets after a 20-minute delay. The score is the sum of the number of targets correctly recalled. Percent change calculated as 100\*\[(baseline score - 4 month score)/ baseline score\]

次要结局

  • Quality of Life as Measured by the Functional Assessment of Cancer Therapy-Brain (FACT-Br)(Baseline and 4 months from start of treatment)
  • ApoE4 Genotype and Other Potentially Predictive Biomarkers of Cognitive Function(Baseline and 4 months from start of treatment)
  • Percent Change at 4 Months in Visual Learning Measured by Cogstate's One Card Learning Test (OCLT)(Baseline and 4 months from start of treatment)
  • Percent Change at 4 Months in Auditory Learning Measured by Cogstate's International Shopping List Test (ISLT)(Baseline and 4 months from start of treatment)
  • Progression-free Survival(Analysis occurs after all patients have been on study for at least 4 months. (Patients are followed from registration to death or study termination whichever occurs first.))
  • Quality of Life as Measured by the Barthel Index of Activities of Daily Living (ADL)(Baseline and 4 months from start of treatment)
  • Overall Survival(Analysis occurs after all patients have been on study for at least 4 months. (Patients are followed from registration to death or study termination whichever occurs first.))
  • The Frequency of Patients With Grade 3 and Higher Adverse Events (AE) Related to Treatment(From start of treatment to 12 months from start of treatment)

研究者

申办方类型
Network
责任方
Sponsor

研究点 (63)

Loading locations...

相似试验