Brain metastases (BM) are a common systemic cancer manifestation which incidence increases. Therapeutic options include whole-brain radiotherapy (WBRT), surgery, and stereotactic radiosurgery (SRS). The concept of "oligometastatic" cerebral disease (oligoBM) has emerged and led to consider alternative approaches. The main challenge is to preserve neurological function and independence the longest as possible. Stereotactic radiotherapy (SRT) has emerged as an alternative treatment modality for selected oligoBM patients. It allows to achieve the balance of tumour destruction and normal tissue preservation by precisely and accurately delivering a very high dose of radiation in one (SRS) or a few (HSRT) fractions to a limited, well-defined volume. However, no standard exists for decision-making between SRS and HSRT and this important question is being discussed in the recent literature. HSRT appears particularly interesting, assuming the patient convenience of few fractions, the normal tissue sparing achieved through focal irradiation, and the improved normal tissue tolerance of high dose radiation through fractionation. Common adverse effects of SRT are rare but can occasionally be serious, notably radionecrosis that may induce neurological deficits in patients. Although SRS is often less well-tolerated, it remains the mainstay of treatment. To investigators knowledge, SRS and HSRT have not been prospectively compared.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
504
3\*10Gy over 1 week
20 to 25Gy/1 fraction
CHU
Bordeaux, France
NOT_YET_RECRUITINGInstitut Bergonié
Bordeaux, France
NOT_YET_RECRUITINGCHU
Brest, France
RECRUITINGCentre François Baclesse
Caen, France
RECRUITINGCHU
Grenoble, France
NOT_YET_RECRUITINGCentre Guillaume le Conquérant
Le Havre, France
RECRUITINGGroupe hospitalier Bretagne Sud
Lorient, France
RECRUITINGCentre Antoine Lacassagne
Nice, France
NOT_YET_RECRUITINGLa Pitié Salpétrière
Paris, France
NOT_YET_RECRUITINGCentre hospitalier Lyon Sud
Pierre-Bénite, France
NOT_YET_RECRUITING...and 5 more locations
Efficacy: Local control assessed by RANO-BM criteria
Time frame: 12 months
Brain acute and late toxicities assessed by NCI CTCAE v5.0
Time frame: 12 months
Radionecrosis by RANO-BM criteria
Time frame: 12 months
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