Brain and Central Nervous System Tumors Clinical Trial
Official title:
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.
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.
;
Allocation: Randomized, Primary Purpose: Treatment
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