Metastatic Brain Cancer Clinical Trial
Official title:
Investigating the Efficacy of Scalp Sparing Radiotherapy Treatment to the Whole Brain: Examining the Effect of Hair Loss and Re-growth
To investigate the use of a scalp sparing technique of radiotherapy treatment designed to
treat the whole brain. Current treatment methods to treat the whole brain with radiotherapy
result in complete alopecia as a side effect. Hair loss is usually patchy and uneven and
re-growth similar and slow.
It is hoped that reducing the radiation dose to the hair bearing follicle on the scalp will
reduce hair loss and increase the speed and evenness of re-growth.
Rationale for conducting the SPARE study:
The purpose of this study is to evaluate the effect of delivering WBRT via the VMAT method on
hair loss and subsequent re-growth. Hair loss has been found to have a negative impact on QoL
and can be particularly stressful for patients with a very short life expectancy, this is
already well documented. Trying to minimise this treatment side effect, as previously stated
in the literature, is a worthwhile investigation. This study is not looking at any prescribed
dose changes to the established, evidence based and well documented prescriptions for WBRT.
SPARE is an observational study of hair loss and re-growth during and after a patient's
prescribed clinical treatment.
Aims and Objectives;
1) To observe hair loss and re-growth in patients undergoing Whole Brain Radiotherapy using
the Volumetric Modulated Arc Therapy method of delivery.
As complete alopecia is expected in 100% of patients receiving conventionally delivered WBRT
it will be considered a positive result if complete hair loss does not happen when using VMAT
in this group of patients.
Assessment of hair loss and re-growth.
The assessment of hair loss and subsequent re-growth will be conducted using both objective
and subjective assessments:
1. Objective assessment: Photographic
2. Subjective assessment: Patient interviews \ completion of a hair record sheet.
Photographic assessment:
Initial baseline photographs will be taken before any radiotherapy treatment is delivered on
day one of the treatment schedule. Four photographs in total of the head, two laterals (left
and right sides), the top (superior) and back (posterior). Subsequent serial photographs will
be taken at two weeks, one, two, three, and four months after radiotherapy treatment.
Subjective assessment:
Patients will be asked to give their own opinion on their hair loss \ gain and this will be
recorded on the hair record forms and completed by a member of the study team. This will be
conducted at the same time intervals as the scalp photographs being taken.
Scalp photos will also be assessed by 2 independent members of the research team and scored
using the same scales as the participant. Subsequent follow-up scalp pictures will be
assessed against baseline (day 1) photos or complete alopecia images to assess re-growth.
Planning and Dosimetry:
Treatment plans will be generated using a 2 arc VMAT technique generated on Varian's Eclipse
treatment planning system using 10 MV photons delivered on a Varian Clinac equipped with a
Millennium Multileaf Collimator. Plans will be optimized selecting a maximum dose rate of 600
MU/min.
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