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Radiation Therapy Plus Combination Chemotherapy in Treating Children With Medulloblastoma

23 giugno 2014 aggiornato da: University of Leicester

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.

Panoramica dello studio

Stato

Sconosciuto

Condizioni

Tumori cerebrali e del sistema nervoso centrale

Intervento / Trattamento

Descrizione dettagliata

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.

Tipo di studio

Interventistico

Iscrizione (Anticipato)

316

Fase

Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

Belgio
- - Leuven, Belgio, B-3000
    - U.Z. Gasthuisberg
Francia
- - Paris, Francia, 75248
    - Institut Curie Hopital
Germania
- - Wuerzburg, Germania, D-97080
    - Universitaets - Kinderklinik Wuerzburg
Italia
- - Turin, Italia, 10126
    - Ospedale Infantile Regina Margherita
Olanda
- - Amsterdam, Olanda, 1105 AZ
    - Academisch Medisch Centrum at University of Amsterdam
Regno Unito
- England
  - Liverpool, England, Regno Unito, L12 2AP
    - Royal Liverpool Children's Hospital, Alder Hey
Spagna
- - Vizcaya, Spagna, 48
    - Hospital De Cruces
Svezia
- - Gothenburg, Svezia, 41685
    - Ostra Sjukhuset

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 3 anni a 21 anni (Bambino, Adulto)

Accetta volontari sani

Sessi ammissibili allo studio

Tutto

Descrizione

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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Scopo principale: Trattamento
Assegnazione: Randomizzato

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Comparison of event-free survival at 3 years

Misure di risultato secondarie

Misura del risultato
Comparison of overall survival
Comparison of the pattern of relapse (i.e., local relapse [tumor bed and posterior fossa outside tumor bed])
Comparison of late sequelae, in terms of health status, quality of life, hearing loss, and endocrine deficiencies
Toxicity of neurosurgery

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

University of Leicester

Investigatori

Cattedra di studio: Brigitta Lannering, MD, PhD, Ostra Sjukhuset

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 febbraio 2003

Date di iscrizione allo studio

Primo inviato

5 febbraio 2003

Primo inviato che soddisfa i criteri di controllo qualità