- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05109819
Esophagus-sparing Radiotherapy for Metastatic Spinal Cord Compression. (ESO-SPARE)
ESO-SPARE: Esophagus Sparring Radiotherapy for Thoracic and Cervical Metastatic Spinal Cord Compression. A Randomized Phase III Study.
Metastatic spinal cord compression (MSCC) is a serious complication to metastatic cancer and when diagnosed life expectancy is short. Treatment is palliative radiotherapy (RT). Early esophageal toxicity is underreported but can seriously impact quality of life (QoL).
The aim of the ESO-SPARE trial is to investigate if esophagus sparing RT can decrease patient reported esophageal toxicity without compromising ambulatory function or increase other toxicities.
200 patients with MSCC in the thoracic or cervical spine referred for RT will be randomized to either standard or esophagus/pharynx sparing RT. Subsequently participants will be followed with PROM (Patient Reported Outcome Measures) for 9 weeks. PROM-CTCAE questionnaires on upper GI toxicity and pain will be collected daily for 5 weeks and weekly for 4 weeks. Questionnaires evaluating QoL and physical function will be collected weekly for 9 weeks.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Anna M Nielsen, MD
- Phone Number: 00 45 26718136
- Email: anna.mann.nielsen@regionh.dk
Study Contact Backup
- Name: Gitte Persson, MD, Ph.d.
- Phone Number: 00 45 38689299
- Email: Gitte.Persson@regionh.dk
Study Locations
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-
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Copenhagen, Denmark, 2100
- Recruiting
- Rigshospitalet
-
Contact:
- Morten H Suppli, MD, PhD.
- Phone Number: 00 45 35459698
- Email: morten.hiul.suppli@regionh.dk
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Contact:
- Ivan R Vogelius, Dr. med, clinical proffesor
- Phone Number: 00 45 35459885
- Email: ivan.richter.vogelius@regionh.dk
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Herlev, Denmark, 2730
- Recruiting
- Herlev Hospatal
-
Contact:
- Anna M Nielsen
- Phone Number: +4526718136
- Email: anna.mann.nielsen@regionh.dk
-
Contact:
- Gitte Persson
- Phone Number: +4538689299
- Email: Gitte.Persson@regionh.dk
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histology or cytology proven cancer
Referred for palliative radiotherapy of the cervical or thoracic vertebra for
- epidural ingrowth
- metastatic spinal cord compression
- metastatic spinal nerve root compression
- post-operative radiotherapy after decompressive surgery for spinal cord or nerve root compression
- Ability to understand and the willingness to sign a written informed consent document
- Referred for the following dose prescriptions 5 Gy x 5, 5 Gy x 4, 3 Gy x 10, 10 Gy x 1, 8 Gy x 1.
- ≥ 18 years old.
Exclusion Criteria:
- Referred for > 10 fractions
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Arm A: standard radiotherapy treatment
Patients in arm A will receive standard radiotherapy treatment for metastatic spinal cord compression.
|
|
Experimental: Arm B: esophagus sparring radiotherapy treatment
Patients in arm B will receive esophagus sparring radiotherapy treatment.
|
A radiotherapy plan for metastatic spinal cord compression is conducted with specific constrains sparring the esophagus.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Early patient reported gastro-oesophageal toxicity
Time Frame: Measured within the first 5 weeks after treatment start
|
Measured as a peak score using CTCAE Patient Reported Outcome Measures
|
Measured within the first 5 weeks after treatment start
|
Ambulatory function
Time Frame: Measured 9 weeks after treatment start
|
Preserved ability to walk will be evaluated using the European Quality of Life - 5 Dimensions questionnaire (EQ-5D-5L) mobility dimension.
The EQ-5D includes one question for each of the five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each dimension has five response levels: no problems (Level 1); slight; moderate; severe; and extreme problems (Level 5).
|
Measured 9 weeks after treatment start
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duration of gastro-oesophageal toxicity
Time Frame: Assessed 9 weeks after treatment start
|
Measured as the time from an increase in gastro-oesophageal symptom score to a return to baseline
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Assessed 9 weeks after treatment start
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Reirradiation rate - Overall survival (OS)
Time Frame: Assessed 6 months after inclusion of the last patient.
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Defined as fraction of patients getting reirradiation, where the same spine levels are included in the irradiated volume
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Assessed 6 months after inclusion of the last patient.
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Patient reported physical function
Time Frame: Assessed Weekly over a period of 9 weeks
|
Patient reported physical function will be assessed using answers from the EORTC QLQ-C30 questionnaire.
Questions regarding physical function are measured on a four-point scale (1= not at all, 2 = a little, 3 = quite a bit, 4 = very much).
All EORTC QLQ-C30 answers will be scored according to the EORTC QLQ-C30 Scoring Manual.
|
Assessed Weekly over a period of 9 weeks
|
Health related Quality of life (QoL)
Time Frame: Assessed Weekly over a period of 9 weeks
|
Health related quality of life measured with EQ-5D-5L European Quality of Life - 5 Dimensions questionnaire (EQ-5D-5L). The EQ-5D includes one question for each of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has five response levels: no problems (Level 1); slight; moderate; severe; and extreme problems (Level 5). Health state scores are defined by combining one level from each dimension, ranging from 11111 (full health) to 55555 (worst health). A visual analogue scale indicating the respondent's own assessment of their health status from 0-100 is also included (100 = the best health you can imagine and 0 = the worst health you can imagine). |
Assessed Weekly over a period of 9 weeks
|
Health related Quality of life (QoL)
Time Frame: Assessed Weekly over a period of 9 weeks
|
Health related quality of life assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire - Cancer (QLQ-C30).
The EORTC QLQ-C30 consists of 30 questions assessing quality of life issues using a four-point scale (1= not at all, 2 = a little, 3 = quite a bit, 4 = very much) except from the last two questions which are measured between 1 (Very Poor) to 7 (Excellent).
The EORTC QLQ-C30 will be scored according to the EORTC QLQ-C30 Scoring Manual.
|
Assessed Weekly over a period of 9 weeks
|
Weight
Time Frame: Assessed Weekly over a period of 9 weeks
|
Assessed Weekly over a period of 9 weeks
|
Assessed Weekly over a period of 9 weeks
|
Analgesic consumption
Time Frame: Assessed Weekly over a period of 9 weeks
|
Assessed Weekly over a period of 9 weeks
|
Assessed Weekly over a period of 9 weeks
|
Pain (MSCC site)
Time Frame: Assessed daily for 5 weeks and subsequently weekly for 4 weeks.
|
Evaluated by "Numeric Pain Rating Scale (NPRS)" The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). |
Assessed daily for 5 weeks and subsequently weekly for 4 weeks.
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Pain assessment (MTS site)
Time Frame: Best response during 9 weeks of follow-up
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Assessment will be performed using International Consensus Pain Response Endpoints (ICPRE).
Analysis of pain reduction will only include patients with NPRS ≥ 1 registered at baseline. We intend to report the best response during follow-up. |
Best response during 9 weeks of follow-up
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001 Jul;33(5):337-43. doi: 10.3109/07853890109002087.
- Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76. doi: 10.1093/jnci/85.5.365.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- AA 2112 ESO-SPARE
- H-20069184 (Registry Identifier: Regional Committee on Health Research Ethics, Capital Region, Denmark)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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