- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01552239
Preoperative Radiotherapy for Sarcomas of the Extremities With Intensity-Modulation, Image-Guidance and Small Safety-margins (PREMISS)
Phase II Study of Preoperative Radiotherapy for Sarcomas of the Extremities With Intensity-Modulation, Image-Guidance, Small Safety-margins and Brachytherapy Conditioned by Resection Margin
RATIONALE: Modern radiotherapy techniques in a neoadjuvant setting have the potential to minimize morbidity and maximize efficacy. An additional boost dose can be provided locally by HDR-brachytherapy in patients with positive margins after tumor resection.
PURPOSE: This phase II trial is studying the safety and efficacy of a combination of modern radiotherapy elements applied to the tumor and small volumes of surrounding normal tissue (IMRT, IGRT; brachytherapy in case of positive resection margin) and see how well it works in treating patients with High-Risk Soft Tissue Sarcoma of the Extremities.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Munich, Germany, 81675
- Recruiting
- Klinikum rechts der Isar
-
Contact:
- Barbara Röper, MD
- Phone Number: 4502 49-89-4140
- Email: barbara.roeper@lrz.tu-muenchen.de
-
Sub-Investigator:
- Michael Molls, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histologic and radiographic proof of localized high-risk soft tissue sarcoma meeting the following criteria:
Lesion originates in extremity
- upper extremity lesions may occur from the medial border of the scapula to tumors as far distal as the finger tips
- lower extremity regions include hip girdle tumors commencing at the iliac crest, excluding lesions arising from within the pelvis, and extends to include lesions as far distal as the toes
- AJCC Stage II or III disease (except T1a-tumors or N1)
- Primary presentation or local recurrence
- after biopsy or inadequate surgery resulting in residual tumor in cross-sectional imaging
- Tumors must be considered resectable according to cross sectional imaging, or potentially resectable after preoperative radiotherapy
- ECOG Performance Status 0-2
- Informed Consent
Exclusion Criteria:
Diagnosis of the following:
- Primitive neuroectodermal tumor
- Soft tissue Ewing's sarcoma
- Extraskeletal osteo- or chondrosarcoma
- Aggressive fibromatosis (desmoid tumors)
- Dermatofibrosarcoma protuberans
- Regional nodal disease or unequivocal distant metastasis
- Life expectancy < 1 year
- Pregnancy
- Major medical illness that would preclude study treatment
- History of major wound complication or recurrent skin infection
- Known HIV positivity
- < 2 weeks elapsed from prior surgery or cytotoxic chemotherapy
- persisting acute toxicities > grade 1 in tumor-bearing limb resulting from prior treatment with anti-cancer modalities
- Cytotoxic chemotherapy, targeted therapy or investigational agents concurrent to study treatment
- Prior radiotherapy to the site of present STS.
- Chronic requirement for treatment with immuno¬suppressive agents or steroids.
Study Plan
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 |
---|---|
Experimental: 1 Arm
Stratum A: R0, primary wound closure Stratum B: R0, secondary wound closure Stratum C: R1, tertiary wound closure |
All: Preoperative IMRT with small safety margins (GTV according to MRT plus 1.5cm laterally / 3cm proximodistally) to 50Gy total dose, 2 Gy single dose, 5 fractions per week, daily IGRT with in-room CT (Tomotherapy) Tumor resection after 4-6 weeks Stratum C: Interstitial Brachytherapy to tumor bed with 15 Gy total dose, 3 Gy single dose b.i.d. in second week after tumor resection |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Wound Complication Rate
Time Frame: 3 months
|
Wound Complication Rate up to 3 months after tumor resection
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy
Time Frame: 2 years
|
Efficacy: Rate of margin-free resection Local control rate (LC) Metastasis-Free Survival (MFS) Disease-Free Survival (DFS) Disease-Specific Survival, Overall Survival (OS) Limb Preservation Rate (LP) |
2 years
|
Safety
Time Frame: 2 years
|
Acute toxicity as measured by CTCAE v. 4.03 Late toxicity (skin, soft tissue, joint, bone, neural toxicity) as measured by CTCAE v. 4.03
|
2 years
|
Limb Functionality
Time Frame: 2 years
|
as measured by the Musculoskeletal Tumor Society (MSTS) rating scale and the Toronto Extremity Salvage Score (TESS)
|
2 years
|
Quality of Life
Time Frame: 2 years
|
as measured by QLQ C30
|
2 years
|
Translational
Time Frame: 2 years
|
2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Barbara Röper, MD, Klinik für Strahlentherapie und Radiologische Onkologie
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRE-1205-ROE-0050-I
- No. 2009.906.1 (Other Grant/Funding Number: Wilhelm-Sander-Stiftung)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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