Neoplasm Metastasis Clinical Trial
Official title:
A Phase II Trial Evaluating the Role of Posterior Fossa Irradiation (PFI) Plus Stereotactic Radiosurgery (SRS) for Cerebellar Metastases
The aggregate of data pertaining to brain metastases suggests that optimal results are
achievable with a 2-pronged approach that addresses both the specific focus (with surgery or
radiosurgery) and the surrounding brain parenchymal tissue that may harbor micrometastases.
Patterns of failure following treatment of metastases that arise in the posterior fossa have
not been reliably defined. Although most would agree that radiosurgery alone is not
sufficient treatment for focal metastases in the cerebellum, it may be possible to deliver
less than WBI as an "expanded port" beyond the SRS volume.
The current study acknowledges that at least two therapeutic modalities are requisite for
patients with cerebellar metastases but hypothesizes that it is unnecessary to extend the
treatment of ostensibly uninvolved brain tissue beyond the limits of the posterior fossa. In
so doing, it is hoped that the putative advantage derived from foregoing whole brain
irradiation (e.g., reduction in neurocognitive impairment) will not be at the expense of
excessive surpratentorial failure.
SCHEMA:
- Posterior Fossa Irradiation as defined by diagnostic MRI and CT simulation.
- 37.5 Gy in 2.5 Gy fractions administered via conformal beams.
- Radiosurgical boost (with dose titrated to parameters of RTOG 9005).
- Contrast enhanced MRI will be obtained at baseline and then at 3, 6, and 12 months
following completion of posterior fossa irradiation.
- The Mini Mental Status Examination will be used to evaluate global cognitive function
at baseline and then at 3, 6, and 12 months following completion of posterior fossa
irradiation.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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