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CompletedNCT00968643Updated Dec 31, 2014

Spinal Cord Compression. ICORG 05-03, V6

A Phase 3 interventional study of radiation therapy in Spinal Cord Compression and Unspecified Adult Solid Tumor, Protocol Specific, sponsored by Cancer Trials Ireland. Completed at 4 sites in Ireland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2014-12-31.

Sponsored by Cancer Trials Ireland · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
126
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known which radiation therapy schedule is more effective in treating patients with malignant spinal cord compression.

PURPOSE: This randomized phase III trial is studying two different radiation therapy schedules to compare their side effects and how well they work in treating patients with malignant spinal cord compression.

Read the detailed description

OBJECTIVES:

Primary

  • To compare the response in patients with malignant spinal cord compression treated with single fraction (10 Gy) radiotherapy vs standard multiple fraction (20 Gy) radiotherapy.
  • To compare the toxicity of these treatment regimens in these patients.

Secondary

  • Examine the safety, practicability, and efficacy of treatment with a single 10 Gy fraction of radiotherapy in these patients.
  • Analyze the initial neurological status, document the response to treatment, and calculate median survival of these patients.
  • Perform an economic impact analysis comparing the two treatment arms.

OUTLINE: This is a multicenter study. Patients are stratified according to participating center. Patients are randomized to 1 of 2 treatment arms.

  • Arm I (control): Patients undergo radiotherapy to the area of spinal cord compression once daily for 5 days (total of 20 Gy).
  • Arm II: Patients undergo a single fraction of radiotherapy to the area of spinal cord compression (total of 10 Gy).

Patients complete the EORTC QLQ-C30 quality-of-life questionnaire at baseline, at 5 weeks, and then every 3 months thereafter.

After completion of study treatment, patients are followed up at 1 and 5 weeks, at 3 months, and then every 3 months thereafter.

02

Conditions studied

  • Spinal Cord Compression
  • Unspecified Adult Solid Tumor, Protocol Specific

Keywords

  • spinal cord compression
  • unspecified adult solid tumor, protocol specific
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed malignancy, excluding the following:

    • Leukemia
    • Myeloma
    • Germ cell tumor
    • Primary tumor of the spine or vertebral column
  • Diagnosis of malignant spinal cord compression confirmed by MRI of the entire spine
  • Deemed inoperable or unsuitable for neurosurgical intervention at the time of initial assessment
  • No single bone metastasis with controlled primary site

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 30-100%
  • No medical or psychiatric condition that, in the opinion of the investigator or research team, would contraindicate study participation

PRIOR CONCURRENT THERAPY:

  • No prior radiotherapy to the involved area of the spinal cord such that further treatment exceeds spinal cord tolerance
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
126 participants (estimated)

Study arms

  • Active comparator
    Arm I (control)

    Patients undergo radiotherapy to the area of spinal cord compression once daily for 5 days (total of 20 Gy).

    Radiation: radiation therapy

  • Experimental
    Arm II

    Patients undergo a single fraction of radiotherapy to the area of spinal cord compression (total of 10 Gy).

    Radiation: radiation therapy

Interventions

  • Radiationradiation therapy

    Given in multiple fractions or as a single fraction

05

What researchers measure

Primary outcomes

  1. Mobility status: measured by the change in mobility status between baseline and 5 weeks, as measured by the in-house mobility scale

    Time frame: 5 weeks from date of randomisation

Secondary outcomes

  1. Quality of life as assessed by the EORTC QLQ-C30 version 3 quality-of-life questionnaire

    Time frame: 5 weeks from date of randomisation

  2. Toxicity: assessed at first follow-up, evaluated as per standard RTOG acute and long-term toxicity scale

    Time frame: 1 week after completion of therapy

  3. Pain control: assessed using a Visual Analogue Scale

    Time frame: Until death

  4. Overall survival: the survival duration will be calculated from time of randomisation to death whatever cause

    Time frame: Until death

  5. Sphincter function: assessed using an 'In-House' Bladder Function Scale

    Time frame: Until death

06

Study locations

4 sites
  • Cork University Hospital
    Cork, Ireland
  • Saint Luke's Radiation Oncology Network (SLRON)
    Dublin, 6, Ireland
  • Galway University Hospital
    Galway, Ireland
  • Whitfield Cancer Centre at Whitfield Clinic
    Waterford, Ireland
07

References and documents

Publications

  • Thirion PG, Dunne MT, Kelly PJ, Flavin A, O'Sullivan JM, Hacking D, Sasiadek W, Small C, Pomeroy MM, Martin J, McArdle O, Parker I, O'Sullivan LS, Shannon AM, Clayton-Lea A, Collins CD, Stevenson MR, Alvarez-Iglesias A, Armstrong JG, Moriarty M. Non-inferiority randomised phase 3 trial comparing two radiation schedules (single vs. five fractions) in malignant spinal cord compression. Br J Cancer. 2020 Apr;122(9):1315-1323. doi: 10.1038/s41416-020-0768-z. Epub 2020 Mar 11. PubMed 32157242 ↗
08

Registry details

Key details

Study ID
NCT00968643
Lead sponsor
Cancer Trials Ireland
Responsible party
Sponsor
First posted
Aug 31, 2009
Start date
Jan 2006
Primary completion
May 2014
Last update
Dec 31, 2014

Study contacts

Pierre Thirion
principal investigator · St Luke's Radiation Oncology Network

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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