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Sponsored by: |
University Health Network, Toronto |
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Information provided by: | University Health Network, Toronto |
ClinicalTrials.gov Identifier: | NCT00805103 |
Brain metastases occur in 20% to 40% of all patients with cancer , with an incidence 10 times higher than that of primary malignant brain tumors. Patients with brain metastases have a poor prognosis with a median survival of 1-2 months with corticosteroids and 5-7 months with whole brain radiotherapy (WBRT). Local control achieved with WBRT in patients with otherwise controlled systemic disease remains at issue. A single high dose of radiation delivered with high precision to the target lesion (Stereotactic radiosurgery (SRS)), is considered standard care in salvage of recurrent lesions after WBRT. SRS can destroy tumour with very little damage to surrounding tissue. Research suggests that delivering radiotherapy in a number of smaller doses is more beneficial than receiving all of the radiotherapy in a single dose. Brain metastases are well suited for SRS as they are often small, radiographically well-circumscribed, pseudospherical tumors that are noninfiltrative.
Condition | Intervention | Phase |
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Brain Metastases |
Radiation: Hypofractionated stereotactic radiotherapy |
Phase I |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study |
Official Title: | Hypofractionated and Adaptive Stereotactic Radiotherapy (HFA-SRT) for Large-Volume Brain Metastases |
Estimated Enrollment: | 48 |
Study Start Date: | December 2008 |
Estimated Study Completion Date: | November 2011 |
Estimated Primary Completion Date: | November 2011 (Final data collection date for primary outcome measure) |
With increasing volume of tumor, the dose of radiosurgery that can be safely delivered to recurrent oligo-metastases in the brain must be reduced. However, reducing the dose of radiosurgery also compromises local control. There is mounting evidence of a local control benefit to a hypofractionated approach in radiation delivery for brain metastases compared with single fraction radiosurgery. Here we propose a novel therapeutic strategy that builds on this concept whereby time between each delivered fraction will enable us to measure and adapt to response, with the objective of reducing irradiated volumes and improving outcomes. In general, the treatment of malignant tumors benefits from fractionation of the dose due to a number of radiobiological properties (redistribution, reoxygenation, repair) that distinguish, and select against, malignant lesions in the fractionation process. Hypofractionated stereotactic radiotherapy (HSRT) is a method of delivering a highly conformal dose distribution in a few treatment sessions using a relocatable stereotactic frame. HSRT may be an attractive alternative to SRS because it may 1) improve patient comfort by removing the invasive nature of SRS frames, 2) confer a radiobiologic advantage over single fraction treatment.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Cynthia Ménard, MD | 416 946 4501 ext 6513 | cynthia.menard@rmp.uhn.on.ca |
Canada, Ontario | |
University Health Network | Recruiting |
Toronto, Ontario, Canada, M5G 2M9 | |
Contact: Cynthia Ménard, MD 416-946-4501 ext 6513 cynthia.menard@rmp.uhn.on.ca | |
Principal Investigator: Cynthia Ménard, MD |
Principal Investigator: | Cynthia Ménard, MD | University Health Network, Princess Margaret Hospital |
Responsible Party: | University Health Network, Princess Margaret Hospital ( Dr. Cynthia Ménard, Staff Radiation Oncology, Clinician Scientist ) |
Study ID Numbers: | UHN REB 08-0602-C |
Study First Received: | December 8, 2008 |
Last Updated: | December 8, 2008 |
ClinicalTrials.gov Identifier: | NCT00805103 |
Health Authority: | Canada: Ethics Review Committee |
Brain Metastases Stereotactic radiosurgery (SRS) Hypofractionated stereotactic radiotherapy (HSRT) Recurrent Brain Metastases |
Brain Neoplasms Neoplasm Metastasis Central Nervous System Diseases Central Nervous System Neoplasms |
Brain Diseases Nervous System Neoplasms Recurrence |
Neoplasms Neoplastic Processes Neoplasms by Site Pathologic Processes Nervous System Diseases |