Bone Metastasis Clinical Trial
— OPTIMALOfficial title:
The OPTIMAL Study - A Prospective Cohort of Patients With Bone Metastases of the Long Bones
Rationale: Bone metastases arise in 50% of all patients dying from carcinoma, increasing up
to 70% in patients with breast and prostate cancer. The lesions can cause pain and
fractures, leading to diminished quality of life and poorer survival. Current knowledge
concerning adequate, personalized treatment of metastatic lesions of the long bones in
patients with disseminated cancer is insufficient and inconclusive due to lack of large,
prospective series with patient reported outcome measures.
Objective: The OPTIMAL cohort aims to describe the quality of life and pain perception of
patients after local treatment (radiotherapy and/or surgery) of metastases of the long
bones, for both the entire cohort as well as for specific treatments separately. With this a
more personalized treatment for metastases in the long bones based on expected survival and
impending fracture risk can be provided in order to improve functioning and the quality of
life for the remaining lifetime in patients with disseminated cancer.
Study design: Observational, prospective, multicentre cohort study.
Study population: All patients with metastases of the long bones visiting a radiation
oncologist or orthopaedic surgeon.
Main study parameters/endpoints: Primary endpoints are patient reported quality of life
(including functioning) and pain levels. Complications and survival are secondary endpoints.
Nature and extent of the burden and risks associated with participation, benefit and group
relatedness: Patients in the OPTIMAL cohort will perhaps not directly benefit from their
participation. Participation will contribute to deriving patient-specific treatment
modalities for future patients with bone metastases of the long bones. Risks associated with
participation in the prospective cohort are considered negligible due to the observational
nature of the study. The burden for the patients lies in completion of questionnaires, which
is considered to be in proportion with the potential value of this research.
Status | Recruiting |
Enrollment | 900 |
Est. completion date | January 2021 |
Est. primary completion date | January 2018 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Aged 18 or older - Radiographic or histologic proof of metastatic bone disease - Histologic diagnosis of the primary tumour or - if the diagnosis is unknown - at least adequate diagnostic investigations into the origin of the metastasis (e.g. dissemination imaging, histology, biopsy) - Bone metastasis deriving from the bones of the extremities Exclusion Criteria: - Primary bone tumours (benign and/or malignant) - No informed consent signed - Communication with patient is hampered (e.g. language barrier, severe cognitive impairment, dementia) |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
Netherlands | Leiden University Medical Center | Leiden |
Lead Sponsor | Collaborator |
---|---|
Leiden University Medical Center |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in quality of life before and after treatment as measured by EQ-5D, EORTC BM-22, and EORTC PAL-15. | The influence on the quality of life of a treatment will be measured by several patient reported outcome scores (EQ-5D, EORTC BM-22, and EORTC PAL-15) at several time points after treatment. These will be used to calculate the changes shortly and longer after treatment. | 4 weeks, 8 weeks, 3 months, 6 months, 12 months, 18 months, 24 months after treatment | No |
Primary | Change in pain before and after treatment as measured by an 11-point numeric rating scale (NRS) | The influence of a treatment on the pain will be measured by a reported outcome score (NRS) at several time points after treatment. These will be used to calculate the changes shortly and longer after treatment. | 4 weeks, 8 weeks, 3 months, 6 months, 12 months, 18 months, 24 months after treatment | No |
Primary | Change in function before and after treatment as measured by the Toronto Extremity Salvage Score (TESS). | The influence of a treatment on the function will be measured by a patient reported outcome scores (TESS) at several time points after treatment. These will be used to calculate the changes shortly and longer after treatment. | 4 weeks, 8 weeks, 3 months, 6 months, 12 months, 18 months, 24 months after treatment | No |
Secondary | Proportion of participants with overall survival at 6 months | 6 months | No | |
Secondary | Proportion of participants with overall survival at 1 year | 1 year | No | |
Secondary | Proportion of participants with overall survival at 2 years | 2 years | No | |
Secondary | Number of patients with complications as reported by physicians | For complication rate, the Henderson classification of complications will be applied. This classification identifies five primary modes of endoprosthetic failure: soft tissue failure (type 1), aseptic loosening (type 2), structural failure (type 3), infection (type 4), and tumour progression (type 5). Wound complications with clinical consequences will be registered separately. Re-operations due to complications will be registered as such in the treatment field as a new operation. | 8 weeks | Yes |
Secondary | Number of patients with complications as reported by physicians | For complication rate, the Henderson classification of complications will be applied. This classification identifies five primary modes of endoprosthetic failure: soft tissue failure (type 1), aseptic loosening (type 2), structural failure (type 3), infection (type 4), and tumour progression (type 5). Wound complications with clinical consequences will be registered separately. Re-operations due to complications will be registered as such in the treatment field as a new operation. | 6 months | Yes |
Secondary | Number of patients with complications as reported by physicians | For complication rate, the Henderson classification of complications will be applied. This classification identifies five primary modes of endoprosthetic failure: soft tissue failure (type 1), aseptic loosening (type 2), structural failure (type 3), infection (type 4), and tumour progression (type 5). Wound complications with clinical consequences will be registered separately. Re-operations due to complications will be registered as such in the treatment field as a new operation. | 1 year | Yes |
Secondary | Number of patients with complications as reported by physicians | For complication rate, the Henderson classification of complications will be applied. This classification identifies five primary modes of endoprosthetic failure: soft tissue failure (type 1), aseptic loosening (type 2), structural failure (type 3), infection (type 4), and tumour progression (type 5). Wound complications with clinical consequences will be registered separately. Re-operations due to complications will be registered as such in the treatment field as a new operation. | 2 years | Yes |
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