Patients with metastatic cancer are usually treated with systemic therapy (treating the entire body) with the assumption that any localized treatment of clinically apparent metastases would not impact survival. In the setting of increasingly effective systemic therapy and limited metastatic disease, aggressive treatment to clinically active sites of disease (alone or in addition to systemic therapy) may improve survival.
Up to recently it has been assumed that in the setting of metastatic solid tumors, locoregional control of clinically apparent metastases does not substantially impact survival due to undetectable micrometastic (clinically not visualized) disease that ultimately lead to treatment failure/progression. However, as more advanced systemic therapy continue to improve control of micrometastatic disease, failures at the original sites of disease remain common. Furthermore, some studies have shown locoregional treatment of limited clinical metastases to actually improve survival. Therefore, the investigators hypothesize that aggressive treatment to clinically active sites of disease (alone or in addition to systemic therapy) may improve survival or alter the course of the disease in some patients with limited metastatic disease.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
110
Rocky Mountain Cancer Centers - Aurora
Aurora, Colorado, United States
RECRUITINGRocky Mountain Cancer Centers - Boulder
Boulder, Colorado, United States
RECRUITINGRocky Mountain Cancer Centers - Littleton
Littleton, Colorado, United States
Survival
Overall and disease-specific survival, to be assessed at 1, 3, and 5 years.
Time frame: 5 years
Progression free survival (PFS)
Time to first progression of disease (regardless of location)
Time frame: 5 years
Locoregional disease control
Time to first progression within definitively treated areas
Time frame: 5 years
Toxicity
Including grade 2+ toxicity attributable to localized study treatment as well as to systemic therapy
Time frame: 5 years
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Residual tumor or close/positive margins should be followed by ablative radiation doses (by either stereotactic radiosurgery or convential EBRT) to constitute definitive locoregional treatment
radioembolization of the liver with Y-90 microspheres or other site-appropriate techniques
Rocky Mountain Cancer Centers - Thornton
Thornton, Colorado, United States
RECRUITING