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- Klinische proef NCT00053872
Radiation Therapy Plus Combination Chemotherapy in Treating Children With Medulloblastoma
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.
Studie Overzicht
Toestand
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Verwacht)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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Leuven, België, B-3000
- U.Z. Gasthuisberg
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Wuerzburg, Duitsland, D-97080
- Universitaets - Kinderklinik Wuerzburg
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Paris, Frankrijk, 75248
- Institut Curie Hopital
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Turin, Italië, 10126
- Ospedale Infantile Regina Margherita
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Amsterdam, Nederland, 1105 AZ
- Academisch Medisch Centrum at University of Amsterdam
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Vizcaya, Spanje, 48
- Hospital De Cruces
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England
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Liverpool, England, Verenigd Koninkrijk, L12 2AP
- Royal Liverpool Children's Hospital, Alder Hey
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Gothenburg, Zweden, 41685
- Ostra Sjukhuset
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
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Comparison of event-free survival at 3 years
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Secundaire uitkomstmaten
Uitkomstmaat |
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Comparison of overall survival
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Comparison of the pattern of relapse (i.e., local relapse [tumor bed and posterior fossa outside tumor bed])
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Comparison of late sequelae, in terms of health status, quality of life, hearing loss, and endocrine deficiencies
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Toxicity of neurosurgery
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie stoel: Brigitta Lannering, MD, PhD, Ostra Sjukhuset
Studie record data
Bestudeer belangrijke data
Studie start
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Ziekten van het zenuwstelsel
- Neoplasmata per histologisch type
- Neoplasmata
- Neoplasmata per site
- Neoplasmata, glandulair en epitheel
- Glioom
- Neoplasmata, neuro-epitheliaal
- Neuro-ectodermale tumoren
- Neoplasmata, kiemcellen en embryonaal
- Neoplasmata, zenuwweefsel
- Neuro-ectodermale tumoren, primitief
- Neoplasmata van het zenuwstelsel
- Neoplasmata van het centrale zenuwstelsel
- Medulloblastoom
- Moleculaire mechanismen van farmacologische werking
- Antineoplastische middelen
- Tubuline-modulatoren
- Antimitotische middelen
- Mitose modulatoren
- Antineoplastische middelen, alkylering
- Alkyleringsmiddelen
- Antineoplastische middelen, fytogeen
- Cisplatine
- Vincristine
- Lomustine
Andere studie-ID-nummers
- CDR0000269521
- SIOP-PNET-4
- EU-20244
- UKCCSG-CNS-2003-05
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