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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00267033
Other study ID # P040426
Secondary ID AOM04013
Status Completed
Phase Phase 3
First received December 19, 2005
Last updated December 1, 2008
Start date November 2005
Est. completion date August 2008

Study information

Verified date March 2007
Source Assistance Publique - Hôpitaux de Paris
Contact n/a
Is FDA regulated No
Health authority France: Ministry of Health
Study type Interventional

Clinical Trial Summary

A randomized phase III study of palliative external beam radiotherapy (RTOG 97-14) has shown that 8 Gy in a single fraction is very effective in providing pain relief, with complete or partial improvement in pain seen in 66% of patients with bone metastases. Percutaneous vertebroplasty (PV) is a technique designed to consolidate pathologic vertebral bodies through the injection of orthopaedic cement under fluoroscopic guidance. Consolidation provides rapid pain relief to painful vertebral body lesions secondary to osteoporosis, haemangiomas, myeloma and metastatic diseases, with complete or partial improvement in pain seen in 70-85% of patients. To date, no randomized trial has tested the association of vertebroplasty and radiotherapy to enhance pain relief for patients with painful osseous spine metastases.

A randomized trial has been designed to determine whether vertebroplasty and radiotherapy (8 Gy in a single fraction) provide enhancement pain and narcotic relief compared to radiotherapy alone for patients with painful osseous spine metastases


Description:

Patients with 1 to 4 painful osseous spine metastases are randomized to 1 of 2 treatment arms:

- Arm 1: 8 Gy in a single fraction

- Arm 2: 8 Gy in a single fraction followed by vertebroplasty of the vertebral bodies, within 14 days after radiotherapy


Recruitment information / eligibility

Status Completed
Enrollment 186
Est. completion date August 2008
Est. primary completion date February 2008
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Osseous spine metastases from squamous cell carcinoma or adenocarcinoma

- One to four painful metastases located between the second cervical vertebra and the fifth lumbar vertebra

- Moderate to severe pain

- No spinal cord compression

- Karnofsky performance status > 40

Exclusion Criteria:

- Previous radiotherapy or surgery

- Vertebral fracture or any other formal indication of stabilization of the rachis by surgery or vertebroplasty

- Spinal cord compression

- Known anomaly of the haemostasis, or needed anticoagulant treatment

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Procedure:
injection of orthopaedic cement into vertebral bodies
injection of orthopaedic cement into vertebral bodies

Locations

Country Name City State
France CHU Pitié-Salpétrière Paris

Sponsors (1)

Lead Sponsor Collaborator
Assistance Publique - Hôpitaux de Paris

Country where clinical trial is conducted

France, 

References & Publications (2)

Hartsell WF, Scott CB, Bruner DW, Scarantino CW, Ivker RA, Roach M 3rd, Suh JH, Demas WF, Movsas B, Petersen IA, Konski AA, Cleeland CS, Janjan NA, DeSilvio M. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst. 2005 Jun 1;97(11):798-804. — View Citation

Weill A, Chiras J, Simon JM, Rose M, Sola-Martinez T, Enkaoua E. Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology. 1996 Apr;199(1):241-7. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Evaluation of pain relief with the Brief Pain Index (BPI), by a blind arm trial algologist, 3 months after radiotherapy. 3 months after radiotherapy Yes
Primary Response will be scored as complete (no pain), partial (improvement of < 2 points in BPI), stable (+/- 1 point change in BPI) or progressive (> 2 point worsening of BPI). during the study Yes
Primary Complete and partial responses will be considered treatment success, and stable and progressive responses will be considered treatment failures during the study Yes
Secondary Evaluation of pain relief one month after radiotherapy one month after radiotherapy Yes
Secondary BPI-SF and EORTC QLQ-C30 will be used to assess general cancer quality of life. during the study Yes
Secondary The incidence of vertebral pathologic fracture will be registered. one month after radiotherapy No

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