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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02323295
Other study ID # 14-208
Secondary ID C06CA059267
Status Completed
Phase N/A
First received
Last updated
Start date July 2015
Est. completion date July 2019

Study information

Verified date November 2021
Source Massachusetts General Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study is designed to characterize the effects of high energy radiation on bone breakdown, with a specific interest in reducing the rate of sacral fractures. Although radiation is very important in managing tumors, it is related to complications such as bone fractures. In this research study, the investigators are looking to determine changes in blood markers, bone density, and bone structure following radiation and to better understand the reason for these changes.


Description:

Participants in the Surgical Arm of the study will be treated according to the schedule outlined in protocol for a combined treatment with surgery and adjuvant high dose radiotherapy. Patients in the non surgical arm of the the study will be treated according to the protocol being treated with radiotherapy alone.


Recruitment information / eligibility

Status Completed
Enrollment 12
Est. completion date July 2019
Est. primary completion date July 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - All laboratory tests that are a part of the eligibility criteria must be completed within 14 days prior to the date of registration. Diagnostic tests that are a part of the eligibility criteria must be performed within 30 days of the date of registration. Participants must meet the following criteria on screening examination to be eligible to participate in the study: - Study participants must have histologically confirmed primary malignant bone tumor in the sacrum for which surgery and radiation or radiation alone are planned. - Age 18 years or older. In children under the age of 8, tetracycline derivatives have been reported to stain tooth enamel yellow color. These considerations lead us to exclude young persons under the age of 18 from the study. - Participants must have normal organ and marrow function as defined below: - Total bilirubin within normal institutional limits - Aspartaataminotransferase (AST) (SGOT)/ Alanine-aminotransferase (ALT) (SGPT) < 2.5 X institutional upper limit of normal - Creatinine within normal institutional limits or creatinine clearance > 60 mL/min/1.73 m2 for subjects with creatinine levels about institutional normal limit - The effects of tetracyclines and radiation used in computer tomography on the developing human fetus are known to be detrimental. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. - Participants must be able to read and understand English language and have the ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Participants who exhibit any of the following conditions at screening will not be eligible for admission into the study. - Participants who have had surgery, chemotherapy, or radiotherapy of the sacrum prior to entering the study - History of allergic reactions attributed to compounds of similar chemical or biologic composition to tetracyclines. - Pregnant or nursing - Uncontrolled inter current illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

Study Design


Related Conditions & MeSH terms


Intervention

Radiation:
Radiation (Surgical Arm)
For surgical candidates, the standard treatment includes pre-operative radiation of 50.4 Gy, followed by a recovery period of approximately 4 to 5 weeks. After this surgery will take place. After approximately 6 weeks of recovery, to allow the surgical incision to heal, the patient is treated with another 19.8 Gy up to 27 Gy of radiation postoperatively depending on the final margin status (higher for gross residual disease)
Radiation (Non-surgical Arm)
Non-surgical candidates receive 72 up to 77.14 Gy of radiation depending on the histology (72 Gy for osteosarcoma and chondrosarcoma and 77.4 Gy for chordoma)
Procedure:
Malignant Tumor Surgery
Surgery involves removing the malignant tumor in the sacrum in one piece, preferably with a cuff of normal tissue around the tumor

Locations

Country Name City State
United States Massachusetts General Hospital Boston Massachusetts

Sponsors (2)

Lead Sponsor Collaborator
Massachusetts General Hospital National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Bone Mineral Density (Tb. BMD) Trabecular bone mineral density will be measured in mg/cm3 using volumetric Quantitative Computed Tomography (QCT) of L1, L2 and the vertebrae adjacent to the tumor. Non-surgical arm: baseline, 3 months Surgical arm: baseline, 9 weeks
Secondary Serum N-Telopeptide (NTX) Indicator for Bone Formation, units reported in nmol NTX/mmol creatinine Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Serum Tartrate-resistant Acid Phosphatase 5b (TRAP5b) Indicator for Bone Formation, units reported in U/L Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Serum Osteocalcin (OC) Indicator for Bone Formation, units reported in ng/mL Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Serum Type 1 Procollagen N-terminal (P1NP) Indicator for systemic metabolism that can affect bone health, units reported in pg/mL Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Serum Phosphate (P) Indicators for systemic metabolism that can affect bone health, units reported in mg/dL Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Serum 25-hydroxycalciferol Vit D (25-OH VitD) Indicators for systemic metabolism that can affect bone health, units reported in nmol/L Non-surgical arm: baseline, 3.5 weeks, 7 weeks, ~5 months, ~8 months Surgical arm: baseline, 5.5 weeks, 18.5 weeks, ~7 months, ~10 months
Secondary Mineral Apposition Rate (MAR) Tetracycline quadruple labeling method will be used and the unit of measure will be um/day Only surgical arm: The months after biopsies are taken during surgery (surgery is during week 4 and 5). These measurements will be done in batches so timeframe isn't clear.
Secondary Bone Formation Rate (BFR/BS) Tetracycline quadruple labeling method will be used and the unit of measure will be mm3/mm2/year Only surgical arm: The months after biopsies are taken during surgery (surgery is during week 4 and 5). These measurements will be done in batches so timeframe isn't clear.
Secondary Mineralization Lag Time (Mlt) Tetracycline quadruple labeling method will be used and the unit of measure will be days Only surgical arm: The months after biopsies are taken during surgery (surgery is during week 4 and 5). These measurements will be done in batches so timeframe isn't clear.
Secondary Osteoblast Number (N.Ob/BPm) Immunohistochemistry staining methods will be used and the unit of measure will be mm^-1 Only surgical arm: The weeks after biopsies are taken during surgery (surgery is during week 4 and 5).
Secondary Osteoblast Surface (Ob. S/BS) Immunohistochemistry staining methods will be used and the unit of measure will be mm^-1 Only surgical arm: The weeks after biopsies are taken during surgery (surgery is during week 4 and 5).
Secondary Osteoclast Number (N.Oc/BPm) Immunohistochemistry staining methods will be used and the unit of measure will be mm^-1 Only surgical arm: The weeks after biopsies are taken during surgery (surgery is during week 4 and 5).
Secondary Osteoclast Surface (Oc.S/BS) Immunohistochemistry staining methods will be used and the unit of measure will be mm^-1 Only surgical arm: The weeks after biopsies are taken during surgery (surgery is during week 4 and 5).