This phase II trial studies how well single-fraction stereotactic body radiation therapy (SBRT) works when compared to standard radiation therapy in treating patients with cancer that has spread to other places in the body (metastatic). Stereotactic body radiation therapy uses special equipment to position a patient and deliver radiation to tumors with high precision. This method can kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue.
PRIMARY OBJECTIVES: I. To assess patient-reported pain response and quality of life (QoL) in patients randomized to either single-fraction stereotactic body radiation therapy (SBRT) or non-SBRT palliative radiation therapy for metastatic disease. SECONDARY OBJECTIVES: I. Compare overall survival for patients undergoing single fraction SBRT versus non-SBRT palliative radiation therapy. EXPLORATORY OBJECTIVES: I. Assess for changes in immune markers. II. Assess toxicity related to radiation treatment. III. Assess change in frailty index and cognitive function over time in patients undergoing treatment for metastatic cancer. IV. Evaluate the effect of circadian rhythm and radiation treatment time on outcomes. V. Assess the utility of the Pain Catastrophizing Index in patients undergoing radiation treatment for metastatic cancer. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients undergo 1, 3-5, 5-6, or 10 fractions of palliative radiation therapy (RT) deemed appropriate by the treating physician. ARM II: Patients undergo single fraction SBRT. After completion of study treatment, patients may be followed up at 5 and 12 weeks.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
1,500
Undergo palliative RT
Ancillary studies
Ancillary studies
Undergo SBRT
Roswell Park Cancer Institute
Buffalo, New York, United States
RECRUITINGThe Cancer Institute at St. Francis Hospital
East Hills, New York, United States
RECRUITINGGood Samaritan Hospital
West Islip, New York, United States
RECRUITINGPain responses
Will be quantified using the pain scales from the Brief Pain Inventory (BPI). Will be an analysis-of-covariance.
Time frame: Baseline up to 12 weeks
Change in Quality of life
Will be measured with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Will be an analysis-of-covariance.
Time frame: Baseline up to 12 weeks
Overall survival
Will be assessed by chart review. Will be carried out using a Cox proportional hazards regression model.
Time frame: Up to date of last follow-up or date of death, at the time of study analysis, assessed up to 12 weeks
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