- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00053872
Radiation Therapy Plus Combination Chemotherapy in Treating Children With Medulloblastoma
A Prospective Randomised Controlled Trial Of Hyperfractionated Versus Conventionally Fractionated Radiotherapy In Standard Risk Medulloblastoma
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving radiation therapy in different ways with combination chemotherapy may kill any remaining tumor cells following surgery. It is not yet known which radiation therapy regimen combined with combination chemotherapy is more effective in treating medulloblastoma.
PURPOSE: Randomized phase III trial to compare different radiation therapy regimens plus combination chemotherapy in treating children who have undergone surgery for medulloblastoma.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Compare the event-free survival rate in pediatric patients with standard-risk medulloblastoma treated with conventional vs hyperfractionated radiotherapy and vincristine followed by maintenance with cisplatin, lomustine, and vincristine.
- Compare the overall survival of patients treated with these regimens.
- Compare the pattern of relapse, especially local relapse (tumor bed or posterior fossa outside tumor bed), in patients treated with these regimens.
- Determine the toxicity of surgery and whether there are identifiable factors that correlate with toxicity in these patients.
- Determine the impact of any surgical complications on commencement of adjuvant therapy and event-free survival of these patients.
- Compare late sequelae, in terms of health status, endocrine deficiencies, and hearing loss, in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to country. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Within 28-40 days after surgical resection, patients undergo conventional fractionated radiotherapy once daily, 5 days a week, for 6-7 weeks. Patients also receive vincristine IV once weekly for 8 weeks.
- Arm II: Beginning as in arm I, patients undergo hyperfractionated radiotherapy twice daily, 5 days a week, for 6-7 weeks. Patients also receive vincristine as in arm I.
- Maintenance chemotherapy:Six weeks after completion of radiotherapy, all patients receive cisplatin IV over 6 hours and oral lomustine on day 1 and vincristine IV on days 1, 8, and 15. Treatment repeats every 6 weeks for 8 courses.
Patients are followed at least every 6 months for 3 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
PROJECTED ACCRUAL: A total of 316 patients (158 per treatment arm) will be accrued for this study within 4 years.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Leuven, Belgium, B-3000
- U.Z. Gasthuisberg
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Paris, France, 75248
- Institut Curie Hopital
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Wuerzburg, Germany, D-97080
- Universitaets - Kinderklinik Wuerzburg
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Turin, Italy, 10126
- Ospedale Infantile Regina Margherita
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Amsterdam, Netherlands, 1105 AZ
- Academisch Medisch Centrum at University of Amsterdam
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Vizcaya, Spain, 48
- Hospital de Cruces
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Gothenburg, Sweden, 41685
- Östra sjukhuset
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England
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Liverpool, England, United Kingdom, L12 2AP
- Royal Liverpool Children's Hospital, Alder Hey
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed medulloblastoma, including the following variants:
- Classic
- Nodular/desmoplastic
- Large cell
- Melanotic
- Medullomyoblastoma
Prior total or subtotal surgical removal of tumor within the past 28-40 days
- No more than 1.5 cm^2 residual tumor by early postoperative MRI or CT scan
- No brainstem or supratentorial primitive neuroectodermal tumor
- No atypical teratoid rhabdoid tumor
- No known predisposition to medulloblastoma (e.g., Gorlin's syndrome)
- No CNS metastasis (supratentorial, arachnoid of the posterior fossa, or craniospinal axis) by MRI
- No clinical evidence of metastasis outside the CNS
- No tumor cells in lumbar cerebrospinal fluid by cytospin
PATIENT CHARACTERISTICS:
Age
- 3 to 21
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Hematological function less than CTC grade 2
Hepatic
- Liver function less than CTC grade 2
Renal
- Renal function less than CTC grade 2
Other
- Not pregnant
- Fertile patients must use effective contraception
- Able to receive radiotherapy twice daily
- Vital functions within age-appropriate normal range
- Audiological function less than CTC grade 2
- No medical contraindication to radiotherapy or chemotherapy
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- Concurrent dexamethasone as an antiemetic allowed, provided all other therapies have failed
Radiotherapy
- No concurrent cobalt irradiation
Surgery
- See Disease Characteristics
Other
- No prior treatment for brain tumor or any other malignancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
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Comparison of event-free survival at 3 years
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Secondary Outcome Measures
Outcome Measure |
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Comparison of overall survival
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Comparison of the pattern of relapse (i.e., local relapse [tumor bed and posterior fossa outside tumor bed])
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Comparison of late sequelae, in terms of health status, quality of life, hearing loss, and endocrine deficiencies
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Toxicity of neurosurgery
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Brigitta Lannering, MD, PhD, Östra sjukhuset
Study record dates
Study Major Dates
Study Start
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nervous System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Glioma
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroectodermal Tumors, Primitive
- Nervous System Neoplasms
- Central Nervous System Neoplasms
- Medulloblastoma
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Antineoplastic Agents, Phytogenic
- Cisplatin
- Vincristine
- Lomustine
Other Study ID Numbers
- CDR0000269521
- SIOP-PNET-4
- EU-20244
- UKCCSG-CNS-2003-05
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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