Spinal met_radiosurgery/SBRT Study
Randomized Phase II Study of Image-Guided Radiosurgery / SBRT for Localized Spine Metastasis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Hong Kong, Hong Kong
- Department of Clinical Oncology, Prince of Wales Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- The patient must have localized spine metastasis from the C1 to L5 levels by a screening imaging study (bone scan, PET, CT, or MRI). A solitary spine metastasis; two separate spine levels; or up to 3 separate sites are permitted. Each of the separate sites may have a maximal involvement of 2 contiguous vertebral bodies. A paraspinal mass ≤ 5 cm is allowed.
- Zubrod Performance Status 0-2;
- Age ≥ 18;
- History/physical examination within 2 weeks prior to registration;
- No pregnancy for women of childbearing potential;
- MRI of the involved spine within 4 weeks prior to registration to determine the extent of the spine involvement. MRI is required as it is superior to a CT scan in delineating the spinal cord as well as identifying an epidural or paraspinal soft tissue component. If possible, an MRI with thin slice thickness (<1mm) with 3D reconstruction quality would be most preferable for treatment planning purpose.
- Numerical Rating Pain Scale within 1 week prior to registration. The patient must have a score on the Scale of ≥ 4 for at least one of the planned sites for spine radiosurgery. Patients taking medication for pain at the time of registration are eligible.
- Neurological examination within 1 week prior to registration to rule out rapid neurologic decline; see Appendix IV for the standardized neurological examination. Patients with mild to moderate neurological signs are eligible. These neurological signs include radiculopathy, dermatomal sensory change, and muscle strength of involved extremity 4/5 (lower extremity for ambulation or upper extremity for raising arms and/or arm function).
- Patients with epidural compression are eligible provided that there is no significant displacement or compression on the spinal cord itself.
- Patients with a paraspinal mass ≤ 5 cm in the greatest dimension and that is contiguous with spine metastasis are eligible.
- Patients must provide study specific informed consent prior to study entry.
Exclusion Criteria:
- Histologies of myeloma or lymphoma.
- Patients with any spine metastasis with a rating of < 4 on the Numerical Rating Pain Scale.
- Non-ambulatory patients.
- Spine instability due to a compression fracture.
- > 50% loss of vertebral body height.
- Significant spinal cord compression or displacement.
- Patients with rapid neurologic decline.
- Bony retropulsion causing neurologic abnormality.
- Prior radiation to the index spine.
- Patients for whom an MRI of the spine is medically contraindicated.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm A: SBRT
|
•24 Gy in 3 fractions to cover at least 90% of the defined target volume
|
|
Experimental: Arm B: Radiosurgery
|
16 Gy in 1 fraction to cover at least 90% of the defined target volume
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Pain control at 3 months post-treatment
Time Frame: 4 years
|
4 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Overall Survival
Time Frame: 4 years
|
4 years
|
|
Determine the time of onset of pain response of the responders at the treated site(s) using radiosurgery/SBRT
Time Frame: 4 years
|
4 years
|
|
Determine the duration of pain response at the treated site(s) using radiosurgery/SBRT
Time Frame: 4 years
|
4 years
|
|
Study the adverse events of radiosurgery/SBRT according to the criteria in the CTEP Active Version of the CTCAE
Time Frame: 4 years
|
4 years
|
|
Evaluate the radiological response of image-guided radiosurgery/SBRT by RECIST MRI
Time Frame: 4 years
|
4 years
|
|
2-year Tumor Control Rate
Time Frame: 4 years
|
4 years
|
|
Quality of life assessment
Time Frame: 4 years
|
4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Michael KM KAM, FRCP, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SYM008
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