- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07605546
RAD ONC FREEDOM Oncology Pain (FREEDOM)
Functional Radiosurgery for Easing or Eliminating Debilitating Oncologic Morbidity (FREEDOM)
Przegląd badań
Szczegółowy opis
Refractory pain is one of the most debilitating challenges in oncology patients, particularly at the end of life. Over 60% of cancer patients experience pain, with 30% of these patients becoming refractory to opioid pain medication. Interventional techniques such as nerve blocks and pain pumps only transiently relieve pain and are often not viable for advanced cancer patients. In patients with diffuse metastatic disease with less than 3-6 months survival, there is a pressing need for a rapid and thorough relief of pain sensation.
Recently, using highly focused radiation delivered to very unique targets in the brain, patients can have marked reduction in perceived pain. There are centers in the brain dubbed as gateways of pain, including the pituitary hypophysis1 and the centromedian and parafascicular complexes2, with some preliminary data also involving the anterior cingulum. Ablation or neuromodulation of these targets with focused high doses of radiation have been shown in small series to provide pain relief in ~3.5 days with a 50% reduction of perceived pain.
The investigators propose to conduct a study in medically refractory cancer pain patients utilizing radiosurgery to ablate the pituitary hypophysis, as well as neuromodulate the centromedian and parafascicular complexes within the thalami - the so-called “triple target.†3 This involves treating the pituitary hypophysis and thalamus to a dose of 90 Gy. These patients will have previously failed to achieve adequate pain control with opioid pain regimens and interventional approaches. This trial will involve a multidisciplinary approach involving radiation oncology, neurosurgery, palliative care, and medical oncology colleagues across UCLA.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: CHRISTY PALODICHUK
- Numer telefonu: +1 310-794-2971
- E-mail: cpalodichuk@mednet.ucla.edu
Kopia zapasowa kontaktu do badania
- Nazwa: William Delery
- Numer telefonu: 310-825-5111
- E-mail: WDelery@mednet.ucla.edu
Lokalizacje studiów
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California
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Los Angeles, California, Stany Zjednoczone, 90095
- Rekrutacyjny
- UCLA / Jonsson Comprehensive Cancer Center
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Kontakt:
- CHRISTY PALODICHUK
- Numer telefonu: +1 310-794-2971
- E-mail: cpalodichuk@mednet.ucla.edu
-
Kontakt:
- William Delery
- Numer telefonu: 310-825-5111
- E-mail: WDelery@mednet.ucla.edu
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-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Male or female ≥ 18 years of age on day of SRS treatment.
- Documentation of insufficiently controlled mixed, complex cancer pain based on Brief Pain Inventory (BPI) >8/10 despite optimization of opioid regimen
- Not eligible for or willing to undergo further pain-relieving interventions
- Written informed consent (and assent when applicable) obtained from patient or patient's legal representative and ability for patient to comply with the study requirements and agree to undergo the study's SRS treatment plan.
Exclusion Criteria:
- Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study.
- Claustrophobia or inability to life flat
- Inability to undergo routine imaging studies
- Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
- Current history of intracranial malignancy or brain metastasis
- Any prior intracranial irradiation
- Previous history of craniotomy, deep brain stimulation (DBS) or laser interstitial themal therapy (LITT).
- Presence of intracranial hardware such as leads for DBS or any other material that may interfere with safe treatment.
- Any comorbidity or condition which would limit full compliance with the protocol
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie podtrzymujące
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Eksperymentalny: Treatment
intracranial functional stereotactic radiosurgery (FnSRS) to the centromedian-parafasciular complex bilaterally, and the hypophysis.
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intracranial functional stereotactic radiosurgery (FnSRS) to the triple target: centromedian-parafasciular complex bilaterally, and the hypophysis
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Pain Inventory
Ramy czasowe: - Baseline: Daily measurements on three separate days prior to treatment (Day -7 +/- 3 days, Day -3 +/- 1 day, Day -2 +/- 1 day)- Post-baseline: Days +1, 2, 3, 4, 7, 14, 21, 28
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For each patient, investigator will measure the Brief Pain Inventory (BPI) (score range: 0-10) at the following days.
Higher score indicates greater pain perception.
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- Baseline: Daily measurements on three separate days prior to treatment (Day -7 +/- 3 days, Day -3 +/- 1 day, Day -2 +/- 1 day)- Post-baseline: Days +1, 2, 3, 4, 7, 14, 21, 28
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Opioid Usage Quantification
Ramy czasowe: o Pre-study (screening visit) and Baseline (Day-7, Day-3, & Day-2)o Days +1, 2, 3, 4, 7, 14, 21, 28
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(1) To describe opioid daily consumption pre- and post-treatment
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o Pre-study (screening visit) and Baseline (Day-7, Day-3, & Day-2)o Days +1, 2, 3, 4, 7, 14, 21, 28
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functional stereotactic radiosurgery (FnSRS) treatment side effects
Ramy czasowe: 28 days post treatment
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To characterize the side effect profile of FnSRS for treatment of intracranial triple targets
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28 days post treatment
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Pain anxiety symptom scale (PASS-20)
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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To evaluate the changes in neuropsychiatric metrics, quality of life and executive function after FnSRS for modulation of intracranial triple targets.
Assesses fear, avoidance, and anxiety related to pain.
(0-5, 0=Never, 5=Always); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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17-item Hamilton Depression Rating Scale:
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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Evaluates the severity of depressive symptoms.
(0-4, 0=Absent, 4=Very Severe); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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Hamilton Anxiety Rating Scale
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
|
Measures the severity of anxiety symptoms.
(0-4, 0=Not Present, 4=Very Severe); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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Pittsburgh Sleep Quality Index
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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Assesses sleep quality and disturbances over a one-month period.
(0-3, 0=Not During the past month, 3=Three or more times a week); higher scores indicate a worse assessment.
|
Baseline visit (Day -7) Day +28 after treatment.
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Social disability screening schedule/WHO disability assessment schedule
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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Measures social functioning and disability in various life domains.
(0-4, 0=None, 4=Extreme or Cannot Do); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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Activity of Daily Living Scale
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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Evaluates the ability to perform basic self-care and everyday activities.
(0-3 or NA, 0=Appropriate, 3=Cannot do by self alone at all; Not Applicable); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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36-item Short Form-Health Survey/RAND-36
Ramy czasowe: Baseline visit (Day -7) Day +28 after treatment.
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Assesses health-related quality of life across multiple dimensions, including physical, mental, and social well-being.
(0=2, 0=No, not limited at all; 2=Yes, Limited a lot); higher scores indicate a worse assessment.
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Baseline visit (Day -7) Day +28 after treatment.
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Współpracownicy i badacze
Współpracownicy
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- 25-0116
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
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