- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01199978
Hearing Outcomes Using Fractionated Proton Radiation Therapy for Vestibular Schwannoma
March 22, 2024 updated by: Helen A. Shih, MD, Massachusetts General Hospital
In this research study we are looking at another type of radiation called proton radiation which is known to spare surrounding normal tissues from radiation.
The proton radiation will be delivered using fractionated stereotactic radiotherapy (FSRT) to improve localization of the small tumor target.
Proton radiation delivers minimal radiation beyond the area of the tumor.
This may reduce side effects that patients would normally experience with conventional radiation therapy.
In this research study, we are looking to determine the effects of fractionated proton radiotherapy on long-term hearing preservation and controlling tumor growth.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
- Proton radiation will be delivered daily for approximately 5.5 weeks. Participants will be assessed weekly for any side effects they may be experiencing.
- Participants will have a follow-up visit 6 months after their last proton radiation treatment and then every year from the time of treatment completion for 5 years. The following tests and procedures will be performed at these visits: medical history, physical exam, MRI scan, comprehensive hearing tests and a questionnaire.
Study Type
Interventional
Enrollment (Actual)
30
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- MRI confirmed unilateral vestibular schwannoma within 8 weeks prior to study entry
- Measurable disease, defined as a lesion that can be accurately measured in at least one dimension
- No prior radiotherapy with dose delivered to structures in proximity to the internal acoustic canal is allowable
- Participants must have baseline "useful hearing" defined at the discretion of the treating physician in the irradiated ear
- 18 years of age or older
- Life expectancy of greater than 60 months
- Karnofsky performance status 60 or greater
- Diagnosis of neurofibromatosis 2 (NF2) is permitted
- Women of child-bearing potential and men must agree to use adequate contraception during the interval of irradiation
- Able to tolerate the supine position as required for the radiation treatment unit and able to tolerate rotation needed for treatment delivery
- Able to tolerate the standard immobilization device that typically utilizes a dental impression mouth piece and thus requires breathing through the nasal passage.
- Willing and able to comply with comprehensive audiologic testing, at baseline prior to radiation therapy, at 6 months from treatment completion, and at annual timepoints for 5 years after completion
- Baseline Systolic Blood Pressure (BP) > 100mm Hg. This is based on the average of two values - separate seated, resting measurements taken five minutes apart. BP does not need to be checked in both arms unless a reading is below 110 mm Hg, in which case the other arm can be checked as well. If BP is checked in both arms, the higher value is deemed accurate for calculating the average.
Exclusion Criteria:
- Participants who have had prior radiotherapy, with dose delivered to structures in proximity to the internal acoustic canal (IAC).
- Participants with tumors (or residual tumor after surgery) measuring > 3cm in greatest dimension
- Participants may not be receiving any other study agents
- History of adverse reaction to radiotherapy
- Participants may not already be on losartan, other angiotensin II type I receptor blocker (ARB), or on an angiotensin-converting enzyme (ACE) inhibitor prior to enrollment of this study.
- Participants receiving any medications or substances that are known to cause ototoxicity are ineligible
- Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Pregnant women
- Individuals with a history of malignancy are ineligible except for the following circumstances. Individuals with a history of malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be a low risk for recurrence of that malignancy. Individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, and basal cell squamous cell carcinoma of the skin.
- HIV-positive individuals on combination antiretroviral therapy
- Patients with co-existing major ear disease, such as chronic otitis, Menieres disease, or otosclerosis
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Fractionated Proton Radiation
Single arm study, delivering fractionated radiation with a technique (proton therapy) that may be associated with reduced side effects
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Given daily for approximately 5.5 weeks
25mg or 50mg daily, oral administration, for approximately 6 months.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Characterization of long-term hearing effects
Time Frame: 5 years
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Characterization of long-term hearing effects of fractionated proton therapy in patients with vestibular schwannomas.
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5 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Local control rate after fractionated proton radiation
Time Frame: 5 years
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5 years
|
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Delineation of dosimetric parameters after fractionated proton radiation
Time Frame: 5 years
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The distribution of dosimetric parameters will be summarized, and their correlation to clinical outcomes, including hearing loss, will be explored.
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5 years
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Incidence of second tumors after fractionated proton radiation
Time Frame: 5 years
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5 years
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Toxicity profile of Losartan given concurrently with proton radiation
Time Frame: 5 years
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Toxicities associated with losartan before, during and after proton radiation will be summarized by grade according to CTCAE 4.0.
The losartan cohort of 10 participants will provide 90% confidence interval of maximal width +/-27% based on the exact binomial distribution.
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5 years
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Impact of Losartan on hearing preservation
Time Frame: 5 years
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5 years
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Impact of Losartan on circulating biomarkers
Time Frame: 5 years
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5 years
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Helen A. Shih, MD, Massachusetts General Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 8, 2011
Primary Completion (Estimated)
November 1, 2026
Study Completion (Estimated)
November 1, 2026
Study Registration Dates
First Submitted
September 9, 2010
First Submitted That Met QC Criteria
September 10, 2010
First Posted (Estimated)
September 13, 2010
Study Record Updates
Last Update Posted (Actual)
March 26, 2024
Last Update Submitted That Met QC Criteria
March 22, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nervous System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Otorhinolaryngologic Neoplasms
- Otorhinolaryngologic Diseases
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Ear Diseases
- Nervous System Neoplasms
- Cranial Nerve Diseases
- Neuroendocrine Tumors
- Nerve Sheath Neoplasms
- Peripheral Nervous System Neoplasms
- Cranial Nerve Neoplasms
- Vestibulocochlear Nerve Diseases
- Retrocochlear Diseases
- Neuroma
- Neurilemmoma
- Neuroma, Acoustic
- Molecular Mechanisms of Pharmacological Action
- Anti-Arrhythmia Agents
- Antihypertensive Agents
- Angiotensin II Type 1 Receptor Blockers
- Angiotensin Receptor Antagonists
- Losartan
Other Study ID Numbers
- 10-218
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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