The main purpose of this study is to determine the safety (defined as number of participants experiencing ≥ 5% toxicity at 12 months post treatment) of stereotactic ablative fractionated radiotherapy versus radiosurgery for oligometastatic neoplasia to the lung.
Stereotactic Ablative Body Radiotherapy (SABR) is an exciting novel radiotherapy technique that is delivered over very few sessions. In the case of limited pulmonary 'oligometastases', SABR can result in long-term survival. It is non-invasive and associated with high rates of tumour control and relatively low toxicity. Additionally, the large doses of precision radiotherapy involved may evoke a strong immune response to recognise and attack any remaining tumour cells. In the future, SABR may be an attractive alternative to invasive surgery. There are two SABR techniques emerging in Australia; fractionated and single fraction treatments. We aim to conduct the first clinical trial of SABR in patients with limited pulmonary metastases testing fractionated versus single fraction treatments. The primary aim of this study is to evaluate the toxicity, Quality of Life, clinical efficacy and cost effectiveness of single fraction SABR compared to multi-fraction SABR in patients with oligometastases to the lung. The secondary aim of this study is to assess the immune response evoked by both fractionated and single fraction SABR and its prognostic implications for patient outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
Multi-fraction SABR; 48Gy delivered in 4 fractions, delivered over 2 weeks, with each fraction delivered 48 hours apart.
Single fraction SABR; 28Gy delivered in 1 fraction
Liverpool Hospital
Liverpool, New South Wales, Australia
Calvary Mater Hospital
Newcastle, New South Wales, Australia
Prince of Wales Hospital
Randwick, New South Wales, Australia
Northern Sydney Cancer Centre (RNS)
Toxicity
The primary outcome is safety, defined as number of participants experiencing less than or equal to 5% toxicity at 12 months post treatment (toxicity as measured by CTCAE V4).
Time frame: 12 months
Quality of Life
To compare quality of life outcomes between techniques assessed using EQ-5DL and MDASI-LC questionnaires.
Time frame: 24 months
Time to local failure
Local progression free survival assesed by CT scan and clinical assessment
Time frame: 24 months
Overall survival
Overall survival assesed by clinical assessment
Time frame: 24 months
Time to distant failure
Time to distant failure assessed by CT scan and clinical assessment
Time frame: 24 months
Resources use and costs associated with treatment
Resources use and costs associated with treatment assessed by EQ5DL and accessing Medicare data
Time frame: 24 months
Disease Free Survival
Disease free survival will be measured from the date of randomisation to the date of a local recurrence, regional or distant metastasis, or death from any cause, whichever occurs first.
Time frame: 24 months
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St Leonards, New South Wales, Australia
Cambelltown Hospital
Sydney, New South Wales, Australia
Princess Alexandra Hospital
Woolloongabba, Queensland, Australia
Royal Adelaide Hospital
Adelaide, South Australia, Australia
Peter MacCallum Cancer Center
Melbourne, Victoria, Australia
Sir Charles Gairdner Hospital
Nedlands, Western Australia, Australia