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Sponsors and Collaborators: |
North Central Cancer Treatment Group National Cancer Institute (NCI) |
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Information provided by: | National Cancer Institute (NCI) |
ClinicalTrials.gov Identifier: | NCT00540969 |
RATIONALE: Cryoablation kills cancer cells by freezing them. Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells. It is not yet known whether cryoablation is more effective than external-beam radiation therapy in treating painful bone metastases.
PURPOSE: This randomized phase III clinical trial is studying cryoablation to see how well it works compared with external-beam radiation therapy in treating patients with painful bone metastases.
Condition | Intervention | Phase |
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Kidney Cancer Melanoma (Skin) Metastatic Cancer Pain Unspecified Adult Solid Tumor, Protocol Specific |
Procedure: cryosurgery Radiation: radiation therapy |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Active Control |
Official Title: | A Phase III Randomized Trial of Cryoablation vs. Radiation for the Palliation of Painful Bone Metastases |
Estimated Enrollment: | 140 |
Study Start Date: | February 2008 |
Estimated Primary Completion Date: | March 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Arm I (percutaneous cryoablation): Experimental
Cryoprobes are inserted percutaneously under CT scan or ultrasound guidance, to the malignant soft tissue-bone interface. Patients undergo ablations using a freeze-thaw-freeze cycle lasting approximately 10-5-10 minutes, respectively.
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Procedure: cryosurgery
Patients undergo cryosurgery using guidance from CT scan or ultrasound
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Arm II (external-beam radiotherapy): Active Comparator
Patients undergo external-beam radiotherapy comprising either a single 8 Gy dose or 20 Gy/5 fractions administered over 1 week.
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Radiation: radiation therapy
Patients undergo radiotherapy for 1 week
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OBJECTIVES:
OUTLINE: This is a multicenter study. Patients are stratified according to size of the indexing lesion (≤ 5 cm vs > 5 cm), location of the target lesion (pelvis vs extremity vs vertebral body vs other), primary cancer type (melanoma or renal cell carcinoma vs other), and severity of pain (i.e., worst pain score in the last 24-hour period) (4-6 vs 7-10). Patients are randomized to 1 of 2 treatment arms.
Patients who fail to achieve a 2-point reduction in worst or average pain (in a 24-hour period) during weeks 6-20 after initial treatment and patients who report a return of pain (i.e., pain ≥ the worst pain in a 24-hour period reported at baseline) for 2 consecutive time points are offered the alternative treatment (radiotherapy or cryoablation, whichever the patient was not randomized to receive at initial treatment)*.
NOTE: *Patients who refuse to receive the alternative treatment are taken off study.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Inclusion criteria:
Histologically or cytologically confirmed solid tumor metastasis with index lesion involving or abutting bone
One primary painful metastatic site
Exclusion criteria:
Index lesion involves the skull
PATIENT CHARACTERISTICS:
PRIOR CONCURRENT THERAPY:
Inclusion criteria:
Exclusion criteria:
United States, Alabama | |
UAB Comprehensive Cancer Center | |
Birmingham, Alabama, United States, 35294 | |
United States, Arizona | |
Mayo Clinic Scottsdale | |
Scottsdale, Arizona, United States, 85259-5499 | |
United States, Florida | |
Mayo Clinic - Jacksonville | |
Jacksonville, Florida, United States, 32224 | |
United States, Michigan | |
Barbara Ann Karmanos Cancer Institute | |
Detroit, Michigan, United States, 48201-1379 | |
United States, Minnesota | |
Mayo Clinic Cancer Center | |
Rochester, Minnesota, United States, 55905 | |
United States, Wisconsin | |
Medical College of Wisconsin Cancer Center | |
Milwaukee, Wisconsin, United States, 53226 | |
Vince Lombardi Cancer Clinic at Aurora St. Luke's Medical Center | |
Milwaukee, Wisconsin, United States, 53215 |
Study Chair: | Matthew R. Callstrom, MD, PhD | Mayo Clinic |
Responsible Party: | North Central Cancer Treatment Group ( Charles L. Loprinzi ) |
Study ID Numbers: | CDR0000570788, NCCTG-N06C6 |
Study First Received: | October 5, 2007 |
Last Updated: | June 20, 2009 |
ClinicalTrials.gov Identifier: | NCT00540969 History of Changes |
Health Authority: | United States: Federal Government |
bone metastases pain unspecified adult solid tumor, protocol specific stage IV melanoma stage IV renal cell cancer |
Urinary Tract Neoplasm Kidney Cancer Pain Urogenital Neoplasms Urologic Neoplasms Melanoma Carcinoma Neuroendocrine Tumors Neuroectodermal Tumors Renal Cancer Urologic Diseases |
Kidney Neoplasms Nevus, Pigmented Neoplasms, Germ Cell and Embryonal Neoplasm Metastasis Carcinoma, Renal Cell Neuroepithelioma Nevus Kidney Diseases Adenocarcinoma Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Neoplasms, Nerve Tissue Urogenital Neoplasms Urologic Neoplasms Neuroendocrine Tumors Melanoma Carcinoma Neuroectodermal Tumors Neoplastic Processes Neoplasms Pathologic Processes |
Neoplasms by Site Urologic Diseases Kidney Neoplasms Neoplasms, Germ Cell and Embryonal Carcinoma, Renal Cell Neoplasm Metastasis Nevi and Melanomas Kidney Diseases Adenocarcinoma Neoplasms, Glandular and Epithelial |