Sarcoma Clinical Trial
Official title:
A Phase II Trial of Image Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity
Verified date | June 2018 |
Source | Radiation Therapy Oncology Group |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
RATIONALE: Image-guided radiation therapy uses high-energy x-rays to kill tumor cells.
Specialized radiation therapy that delivers a lower dose of radiation directly to the tumor
may kill more tumor cells and cause less damage to normal tissue.
PURPOSE: This phase II trial is studying the side effects and how well image-guided radiation
therapy works in treating patients with primary soft tissue sarcoma of the shoulder, arm,
hip, or leg.
Status | Completed |
Enrollment | 98 |
Est. completion date | May 21, 2018 |
Est. primary completion date | December 2012 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
DISEASE CHARACTERISTICS: - Histologically confirmed primary soft tissue sarcoma of the upper extremity (including shoulder) or lower extremity (including hip) - Incisional or core biopsy required within the past 8 weeks - No histopathological diagnosis of any of the following: - Rhabdomyosarcoma - Extraosseous primitive neuroectodermal tumor (PNET) - Soft tissue Ewing sarcoma - Osteosarcoma - Kaposi sarcoma - Angiosarcoma - Aggressive fibromatosis (desmoid tumor) - Dermatofibrosarcoma protuberans - Chondrosarcoma - Extraskeletal myxoid chondrosarcoma allowed - Tumor must be surgically resectable, as determined by a surgeon within the past 8 weeks - Limb-preservation surgery alone would not provide adequate local control, as determined by the surgeon - No sarcoma of the hand, foot, head, neck, or intra-abdominal or retroperitoneal region or body wall - No sarcoma = 32 cm in any direction - No lymph node or distant metastases, according to the following within the past 8 weeks: - History/physical examination, including a detailed description of the location, size, and stage of the sarcoma - MRI with contrast of the primary tumor - The maximum dimension of the primary tumor is measured in MRI images - CT scan of the chest - Multiple pulmonary nodules < 8 mm without a histological diagnosis detected incidentally on a non-screening CT scan may be allowed - CT scan with contrast of the abdomen and pelvis in patients with intermediate- or high-grade sarcoma of the upper thigh - No recurrent tumor after prior potentially curative therapy PATIENT CHARACTERISTICS: - Zubrod performance status 0-1 - Absolute neutrophil count = 1,500/mm^3 - Platelet count = 100,000/mm^3 - Hemoglobin = 8.0 g/dL (transfusion or other intervention allowed) - Bilirubin = 1.5 mg/dL* - Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) = 2 times upper limit of normal* - Serum creatinine = 1.6 mg/dL OR creatinine clearance = 55 mL/min* - Left ventricular ejection fraction (LVEF) = 50% by multiple gated acquisition scan (MUGA) or echocardiogram* - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - No other invasive malignancy within the past 3 years, except nonmelanomatous skin cancer or carcinoma in situ of the breast, oral cavity, or cervix - No severe, active co-morbidity, including any of the following*: - Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months - Transmural myocardial infarction within the past 6 months - Acute bacterial infection or fungal infection requiring intravenous antibiotics - Acquired Immune Deficiency Syndrome (AIDS) or immunocompromised patients - HIV testing not required - No NCI CTCAE v 3.0 grade 3-4 electrolyte abnormalities, including any of the following*: - Calcium < 7 mg/dL or > 12.5 mg/dL - Glucose < 40 mg/dL or > 250 mg/dL - Magnesium < 0.9 mg/dL or > 3 mg/dL - Potassium < 3mmol/L or > 6 mmol/L - Sodium < 130 mmol/L or > 155 mmol/L NOTE: *Applies to group 1 only, which was closed to accrual as of 01/08/10) PRIOR CONCURRENT THERAPY: - See Disease Characteristics - No prior excisional biopsy in which the majority of the tumor (= 50%) is removed - No prior radiotherapy to the region of the study cancer that would result in overlap of radiotherapy fields - No other concurrent investigational agents |
Country | Name | City | State |
---|---|---|---|
Canada | Cross Cancer Institute at University of Alberta | Edmonton | Alberta |
Canada | London Regional Cancer Program at London Health Sciences Centre | London | Ontario |
Canada | McGill Cancer Centre at McGill University | Montreal | Quebec |
United States | Massachusetts General Hospital | Boston | Massachusetts |
United States | Roswell Park Cancer Institute | Buffalo | New York |
United States | University of Florida Shands Cancer Center | Gainesville | Florida |
United States | Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center | Hershey | Pennsylvania |
United States | Mayo Clinic - Jacksonville | Jacksonville | Florida |
United States | Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center | Lebanon | New Hampshire |
United States | Norton Suburban Hospital | Louisville | Kentucky |
United States | University of Miami Sylvester Comprehensive Cancer Center - Miami | Miami | Florida |
United States | Medical College of Wisconsin Cancer Center | Milwaukee | Wisconsin |
United States | CCOP - Christiana Care Health Services | Newark | Delaware |
United States | Mayo Clinic Cancer Center | Rochester | Minnesota |
United States | William Beaumont Hospital - Royal Oak Campus | Royal Oak | Michigan |
United States | Norris Cotton Cancer Center - North | Saint Johnsbury | Vermont |
United States | H. Lee Moffitt Cancer Center and Research Institute at University of South Florida | Tampa | Florida |
Lead Sponsor | Collaborator |
---|---|
Radiation Therapy Oncology Group | National Cancer Institute (NCI), NRG Oncology |
United States, Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Correlation of Late Radiation Morbidity at 2 Years With the 3 Quality of Life Assessments [Functional Assessment of Cancer Therapy-General (FACTG), Toronto Extremity Salvage Score (TESS), and Sexual Adjustment Questionnaire (SAQ)] | 2 years after start of treatment (+/- 3 months) | ||
Other | Comparison of TESS and the MSTS Scores at 2 Years Between Cohort B Patients and the Preoperative Radiotherapy Patients in the NCIC CTG Trial [National Cancer Institute of Canada Clinical Trials Group] | 2 years after start of treatment (+/- 3 months) | ||
Other | Comparison of SAQ Scores at 2 Years for Cohort A Patients With Cohort B Patients | 2 years after start of treatment (+/- 3 months) | ||
Primary | Rate of Late Radiation Morbidity (= Grade 2 Lymphedema, Subcutaneous Fibrosis, or Joint Stiffness) at 2 Years From the Start of Radiotherapy as Measured by EORTC/RTOG Criteria | The rate of patients with late radiation morbidity (= grade 2 lymphedema, subcutaneous fibrosis, or joint stiffness) at 2 years from the start of radiotherapy as measured by EORTC(European Organisation for Research and Treatment of Cancer)/RTOG (Radiation Therapy Oncology Group) criteria. Grade refers to the severity of the morbidity. The RTOG/EORTC Late Radiation Morbidity Scoring Schema assigns Grades 1 through 5 with unique clinical descriptions of severity for each morbidity based on this general guideline: Grade 1 Mild , Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to morbidity. | 2 years after start of treatment (+/- 3 months) | |
Secondary | Local Failure Rate at Two Years | Local failure is defined as the time from registration to date of failure (local progression) or death or last follow-up. Two year rate and 95% confidence interval were estimated by the cumulative incidence method. | From registration to date of failure (local progression) or death or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Regional Failure Rate at Two Years | Regional failure is defined as the time from registration to date of failure (regional progression) or death or last follow-up. Two year rate and 95% confidence interval were estimated by the cumulative incidence method. | From registration to date of failure (regional progression) or death or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Distant Failure Rate at Two Years | Distant failure is defined as the time from registration to date of failure (distant progression) or death or last follow-up. Two year rate and 95% confidence interval were estimated by the cumulative incidence method. | From registration to date of failure (distant progression) or death or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Distant Disease-free Survival Rate at Two Years | Distant disease-free survival is defined as the time from registration to date of failure (distant progression or death) or last follow-up. Two year rate and 95% confidence interval were estimated by the Kaplan-Meier method. | From registration to date of failure (distant progression or death) or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Disease-free Survival Rate at Two Years | Disease-free survival is defined as the time from registration to date of failure (local, regional, or distant progression or death) or last follow-up. Two year rate and 95% confidence interval were estimated by the Kaplan-Meier method. | From registration to date of failure (local, regional or distant progression or death) or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Overall Survival Rate at Two Years | Overall survival is defined as the time from registration to date of death or last follow-up. Two year survival rate and 95% confidence interval were estimated by the Kaplan-Meier method. | From registration to date of death or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Second Primary Tumor Rate at Two Years | Second primary tumor is defined as the time from registration to date of failure (second primary tumor) or death or last follow-up. Two year rate and 95% confidence interval were estimated by the cumulative incidence method. | From registration to date of failure (second primary tumor) or death or last follow-up. Report at time of primary outcome measure analysis. | |
Secondary | Late Radiation Morbidity Rate (= Grade 2 Lymphedema, Subcutaneous Fibrosis or Joint Stiffness) at 2 Years From the Start of Radiotherapy as Measured by CTCAE v3.0 | Adverse events are graded using CTCAE v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild AE, Grade 2 Moderate AE, Grade 3 Severe AE, Grade 4 Life-threatening or disabling AE, Grade 5 Death related to AE. | 2 years after start of treatment (+/- 3 months) | |
Secondary | Percentage of Patients With Wound Complications | Estimate rate of patients with acute wound complications with 95% confidence interval assuming binomial distribution. | From date of surgery to 4 months post-surgery | |
Secondary | Pattern of First Failure | Pattern of first failure including local failure (in-field, marginal, and outside-field failure), regional failure, distant failure, and death without disease progression. | From registration to date of local, regional or distant progression. Report at time of primary outcome measure analysis. | |
Secondary | Mean Musculoskeletal Tumor Rating Scale (MSTS) by Late Radiation Morbidity at Two Years | The Musculoskeletal Tumor Rating Scale (MSTS) is a measure of physical function across 7 items, completed by the physician (preferably by the Orthopedic Surgeon or Surgical Oncologist) or the physician's designated staff. The 7 items are: pain, range of motion, strength, joint stability, joint deformity, emotional, acceptance, and overall function. Each item is scored from 0-5 (worst possible to best possible condition). The item scores are summed to get the total score which ranges from 0-35. Late radiation morbidity is defined as = grade 2 lymphedema, subcutaneous fibrosis, or joint stiffness. Adverse events are graded using CTCAE v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild AE, Grade 2 Moderate AE, Grade 3 Severe AE, Grade 4 Life-threatening or disabling AE, Grade 5 Death related to AE. |
From start of treatment to 2 years. | |
Secondary | Percentage of Patients With Other CTCAE, v.3.0 Grade 3-5 Adverse Events | Adverse events are graded using CTCAE v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild AE, Grade 2 Moderate AE, Grade 3 Severe AE, Grade 4 Life-threatening or disabling AE, Grade 5 Death related to AE. | From start of treatment to last follow-up. Analysis can occur at or after time of primary outcome measure analysis. |
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