- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02163226
A Randomized Trial Evaluating Rapid Delivery of Dose Escalated Hypofractionated Radiotherapy for Patients Diagnosed With Bone Metastases for Effective Palliation of Symptoms
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Groups:
If you are found to be eligible to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 study groups. This is done because no one knows if one study group is better, the same, or worse than the other group. You will have an equal chance of being assigned to either group.
If you are in Group 1, you will receive 1 radiation treatment a day for 10 days in a row (not counting weekends or holidays). You will receive a higher total dose of radiation than Group 2.
If you are in Group 2, you will receive 1 radiation treatment given on 1 day.
Radiation Therapy:
You will lie on a table for the radiation treatment(s). Each treatment will last about 30 minutes.
Length of Treatment:
You may receive 1 or 10 radiation treatments, depending on which group you are in. You will no longer be able to receive radiation therapy if intolerable side effects occur or if you are unable to follow study directions.
Your participation on the study will be over after the follow-up visits.
Follow-Up Visits:
At Months 3, 6, 9, 12 and every 3 to 6 months after the start of radiation therapy, you will have x-rays, a bone scan, CT scan, or MRI to check the status of the disease.
At Months 3, 4, and 6 and then every 3 months after that for at least 3 years, you will complete the questionnaires about the pain, your pain relief, and your quality of life. The questionnaires can be filled out at a clinic visit or sent back in the mail.
This is an investigational study. Radiation therapy is delivered using FDA-approved and commercially available methods. It is investigational to compare the number and size of radiation doses.
Up to 300 participants will take part in this multicenter study. Up to 300 participants will be enrolled at MD Anderson.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
-
-
Arizona
-
Gilbert, Arizona, United States, 85234
- Banner MD Anderson Cancer Center
-
-
New Jersey
-
Voorhees, New Jersey, United States, 08043
- MD Anderson Cancer Center at Cooper
-
-
Texas
-
Houston, Texas, United States, 77030
- University of Texas MD Anderson Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a pathologic diagnosis of malignancy
- Patients with any radiographic evidence of bone metastases, including plain x-ray, bone scan, computed tomography (CT) scan, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan
- Patients with pain or dysaesthesia
- Patients with a life expectancy of more than 3 months
- Patients able to complete pain assessment and quality of life surveys
- Patients with multiple osseous sites are eligible; however should not treat more than 3 separate radiation treatment fields concurrently.
- Patients with surgery for osseous metastases are allowed.
Exclusion Criteria:
- Patients with prior radiation therapy to the treatment site
- Patients with a current, untreated spinal cord compression
- Patients with a radiographic or pathologic fracture to the treatment site
- Patients with painful metastases to hands and feet that need to be radiated on protocol
- Patients previously treated with radioactive isotope (e.g. Sr89) within 30 days of randomization
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Hypofractionated Radiation Therapy
Participants receive standard hypofractionated regimen of 3 Gy x 10 fractions, 1 radiation treatment a day for 5 days in a row.
Questionnaire completion at months 1, 2, 3, 4, and 6 and then every 3 months after that for at least 3 years.
Questionnaires ask about pain, pain relief, and quality of life.
|
Participants receive standard hypofractionated regimen of 3 Gy x 10 fractions, 1 radiation treatment a day for 5 days in a row.
Other Names:
Questionnaire completion at months 1, 2, 3, 4, and 6 and then every 3 months after that for at least 3 years.
Questionnaires ask about pain, pain relief, and quality of life.
Other Names:
|
Active Comparator: One Radiation Therapy Treatment
12 Gy x 1 fraction or 16 Gy x 1 fractions adaptively depending on the size of the metastases or gross tumor volume (GTV).
Questionnaire completion at months 1, 2, 3, 4, and 6 and then every 3 months after that for at least 3 years.
Questionnaires ask about pain, pain relief, and quality of life.
|
Questionnaire completion at months 1, 2, 3, 4, and 6 and then every 3 months after that for at least 3 years.
Questionnaires ask about pain, pain relief, and quality of life.
Other Names:
12 Gy x 1 fraction or 16 Gy x 1 fractions adaptively depending on the size of the metastases or gross tumor volume (GTV).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Intent- to- Treat Patients With Pain Response by Treatment
Time Frame: From date of registration until the date of first documented Pain failure or death from any cause, or lost to follow up, whichever came first, assessed up to 9 months
|
Evaluate single fraction stereotactic regimen for pain response in terms of time to failure.
Pain response was defined by international consensus criteria as a combination of pain score and analgesic use (daily morphine-equivalent dose).
Pain failure (ie, lack of response) was defined as worsening pain score (2 points on a 0-to-10 scale), an increase in morphine-equivalent opioid dose of 50% or more, reirradiation, or pathologic fracture.
Time to failure was defined as the first occurrence of any of the following events: worsening in pain score by at least 2 categories by MDASI survey.
Statistical tests in treatment group were based on the Wilcoxon rank sum test to compare changes in pain scores and analgesic use at each assessment point relative to baseline.
Increases or decreases of 2 or more points on a scale of 0 to 10 indicated improving or worsening pain.
Fisher exact tests were used to compare the distribution of pain responders (CR + PR) and nonresponders (PP + IR).
|
From date of registration until the date of first documented Pain failure or death from any cause, or lost to follow up, whichever came first, assessed up to 9 months
|
Number of Evaluable Participants With Pain Response by Treatment
Time Frame: From date of registration until the date of first documented Pain failure or death from any cause, or lost to follow up, whichever came first, assessed up to 9 months
|
Evaluate single fraction stereotactic regimen for pain response in terms of time to failure.
Pain response was defined by international consensus criteria as a combination of pain score and analgesic use (daily morphine-equivalent dose).
Pain failure (ie, lack of response) was defined as worsening pain score (2 points on a 0-to-10 scale), an increase in morphine-equivalent opioid dose of 50% or more, reirradiation, or pathologic fracture.
Time to failure was defined as the first occurrence of any of the following events: worsening in pain score by at least 2 categories by MDASI survey.
Complete response (CR) is a pain score of 0 at the treated site and no increase in analgesic.
Partial response (PR): reduction in pain score of 2 or more points above baseline with no increase in analgesic.
Pain progression (PP): Increases of 2 or more points on a scale of 0 to 10 or worsening pain.
indeterminate response (IR): were all other responses.
|
From date of registration until the date of first documented Pain failure or death from any cause, or lost to follow up, whichever came first, assessed up to 9 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Toxicity Associated With Treatment
Time Frame: From date of registration until the date of documented death from any cause, or lost to follow up, whichever came first, assessed up to 2 years.
|
Report grade 3 acute (skin, fatigue, flare reaction) and long term (sclerosis, bone ossification, bone fracture rate) toxicity associated with treatment.
During radiotherapy, the patient will be examined weekly and acute reactions recorded and toxicity occurring after 3 months of radiation therapy.
|
From date of registration until the date of documented death from any cause, or lost to follow up, whichever came first, assessed up to 2 years.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Quynh-nhu Nguyen, MD, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- 2013-0640
- NCI-2014-01482 (Registry Identifier: NCI CTRP)
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.
Clinical Trials on Bone Metastases
-
University of CalgaryNot yet recruitingBone Metastases | Spine Metastases | Bone LesionCanada
-
Suzhou Suncadia Biopharmaceuticals Co., Ltd.Not yet recruitingPatients With Bone MetastasesChina
-
Luye Pharma Group Ltd.RecruitingBone Metastases From Solid TumorsChina
-
Shanghai JMT-Bio Inc.CompletedBone Metastases From Solid TumorsChina
-
Varian, a Siemens Healthineers CompanyRecruitingBone Metastases in the ThoraxUnited States
-
Ottawa Hospital Research InstituteWithdrawn
-
UMC UtrechtCompletedBone Metastases | Spinal MetastasesNetherlands
-
University of Roma La SapienzaCompletedBone Metastases | Secondary Bone CancerItaly
-
Shanghai JMT-Bio Inc.Not yet recruitingImaging Examination Shows at Least One Site With Bone Metastases From Soild Tumors
-
Heidelberg UniversityCompletedVertebral Bony MetastasesGermany
Clinical Trials on Hypofractionated Radiation Treatment
-
AHS Cancer Control AlbertaUnknownHigh-risk Prostate CancerCanada
-
University of UtahNational Cancer Institute (NCI)RecruitingCervical Carcinoma | Endometrial CarcinomaUnited States
-
University of UtahActive, not recruitingStage 0 Breast Cancer | Stage I Breast Cancer | Stage II Breast Cancer | Invasive Breast Carcinoma | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIA Breast Cancer | Stage IIB Breast Cancer | Ductal Breast Carcinoma In SituUnited States
-
Ruijin HospitalRecruiting
-
Mayo ClinicNational Cancer Institute (NCI)Active, not recruitingAnatomic Stage I Breast Cancer AJCC v8 | Anatomic Stage IA Breast Cancer AJCC v8 | Anatomic Stage IB Breast Cancer AJCC v8 | Anatomic Stage IIA Breast Cancer AJCC v8 | Prognostic Stage I Breast Cancer AJCC v8 | Prognostic Stage IA Breast Cancer AJCC v8 | Prognostic Stage IB Breast Cancer AJCC v8 | Prognostic Stage IIA Breast Cancer AJCC...United States
-
University of Colorado, DenverActive, not recruitingBreast CancerUnited States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)TerminatedNonsmall Cell Lung Cancer Stage III | Nonsmall Cell Lung Cancer, Stage IIUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RecruitingStage I Prostate Cancer AJCC v8 | Stage II Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IVA Prostate Cancer AJCC v8United States
-
Samsung Medical CenterRecruitingRadiotherapy Side EffectKorea, Republic of
-
Postgraduate Institute of Medical Education and...Completed