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TerminatedNCT03312868Updated Apr 6, 2022

Stereotactic Body Radiotherapy for the Treatment of Solitary Bone Plasmacytoma

A Phase 2 interventional study of SBRT in Plasmacytoma, sponsored by Instituto do Cancer do Estado de São Paulo. Terminated at 1 site in Brazil. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2022-04-06.

Sponsored by Instituto do Cancer do Estado de São Paulo · Phase 2, Interventional, and Treatment

Why this study was terminated
Burocracy and funding
Phase
Phase 2
Study type
Interventional
Enrollment
10
Allocation
Not applicable
Ages
18 Years to 85 Years
Sex
All
01

Study summary

This project aims to propose a new approach in the treatment of solitary plasmacytoma: hypofractionated irradiation alone with stereotactic technique that may contribute to the successful treatment of this disease.

This work aims to apply this new technique with the primary objective of reducing the progression-free survival for multiple myeloma of patients treated for solitary plasmacytoma, as well as quantify overall survival, local control, toxicities and quality of life in a phase I trial / II.

Read the detailed description

Solitary plasmacytoma is a rare disease whose treatment has not evolved much in the last decades. The role of radiotherapy in the curative treatment of this entity was defined in a major publication in the 1980s and has since been proven to be the best practice in several other comparative trials, mostly retrospective. The radiotherapy dose of curative intent has also been described over the same period and remains unchanged to this day. Thus, local control, disease cure rate, and rate and progression time for multiple myeloma have been unaffected for almost 30 years.

Radiobiology of plasmacytoma cells is also not widely studied. The alpha / beta ratio, which defines the pattern of response of this disease to radiotherapy fractions and its response time, is also not well described. However, it is believed to be smaller in comparison to other hematological malignancies due to reports of cases of intrinsic radioresistance and late recurrence and reports of success with hypofractionated dose in isolated cases where stereotactic techniques were used such as base of skull and spine.

02

Conditions studied

  • Plasmacytoma

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Keywords

  • Stereotactic Body Radiotherapy
03

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Biopsy proven plasmacytic for the index lesion;
  • Age between 18 and 85 years;
  • ECOG scale performance of 0 to 2

Exclusion criteria

Exclusion Criteria:

  • Refuse to sign or inability to understand the term of free and informed commitment (TCLE);
  • Technical limitations for treatment with SBRT among which is cited, but not limited to, weight greater than 115 Kg, inability to abduct limb to be treated in appendicular bone plasmocytomas, intolerable pain to remain in treatment position;
  • Criteria for multiple myeloma at diagnosis: more than 10% of plasma cells in bone marrow biopsy, hypercalcemia greater than 11.5 mg/dL, serum creatinine greater than 2mg/dL, creatinine clearance less than 40mL/min , Hemoglobin less than 10g/dL.
  • Previous cancer diagnosis and treatments;
  • Previous bone events such as fractures and osteomyelitis in the bone in which the index lesion is found;
  • Prior autoimmune diseases, even if controlled;
  • Extra-medullary plasmacytoma requiring elective treatment of lymph node drainage;
  • Current pregnancy
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
10 participants (actual)

Study arms

  • Experimental
    Prospective Arm

    Prospective arm with patients being treated with SBRT

    Radiation: SBRT

Interventions

  • RadiationSBRT

    Stereotactic Body Radiotherapy

05

What researchers measure

Primary outcomes

  1. Progression-free survival for multiple myeloma

    Progression-free survival for multiple myeloma at 5 years evaluation in patients undergoing SBRT for solitary plasmacytoma compared to a retrospective cohort of patients

    Time frame: 5 years

Secondary outcomes

  1. Local control rate

    Local progression-free survival

    Time frame: 5 years

  2. Overall survival

    Overall survival

    Time frame: 5 years

  3. Survival free of bone events

    Those are described as fractures, osteomyelitis, necessity of surgery, deformation of bone or ironic bone pain

    Time frame: 5 Years

  4. Toxicities

    Toxicities in the scale of common criteria of toxicity by the National Cancer Institute CTCAE v4

    Time frame: 5 Years

  5. Quality of Life

    Quality of life of patients in the prospective cohort using the EORTC QLQ-30 questionnaire

    Time frame: 5 years

  6. Quality of Life

    Quality of life of patients in the prospective cohort using the Short Form Health Survey 36 v.2 (SF-36) questionnaire

    Time frame: 5 years

Other outcomes

  1. Dosimetric prognostic factors

    Describe and explore dosimetric factors for local control and toxicities

    Time frame: 5 years

06

Study locations

1 site
  • Sao Paulo Cancer Institute
    São Paulo, Sao Paulo 01246-000, Brazil
07

References and documents

Publications

  • Mill WB, Griffith R. The role of radiation therapy in the management of plasma cell tumors. Cancer. 1980 Feb 15;45(4):647-52. doi: 10.1002/1097-0142(19800215)45:43.0.co;2-e. PubMed 6153562 ↗
  • Li QW, Niu SQ, Wang HY, Wen G, Li YY, Xia YF, Zhang YJ. Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma. Asian Pac J Cancer Prev. 2015;16(9):3741-5. doi: 10.7314/apjcp.2015.16.9.3741. PubMed 25987031 ↗
  • Mendenhall CM, Thar TL, Million RR. Solitary plasmacytoma of bone and soft tissue. Int J Radiat Oncol Biol Phys. 1980 Nov;6(11):1497-501. doi: 10.1016/0360-3016(80)90006-1. No abstract available. PubMed 6780494 ↗
  • Ozsahin M, Tsang RW, Poortmans P, Belkacemi Y, Bolla M, Dincbas FO, Landmann C, Castelain B, Buijsen J, Curschmann J, Kadish SP, Kowalczyk A, Anacak Y, Hammer J, Nguyen TD, Studer G, Cooper R, Sengoz M, Scandolaro L, Zouhair A. Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. Int J Radiat Oncol Biol Phys. 2006 Jan 1;64(1):210-7. doi: 10.1016/j.ijrobp.2005.06.039. Epub 2005 Oct 17. PubMed 16229966 ↗
  • Wong ET, Lu XQ, Devulapalli J, Mahadevan A. Cyberknife radiosurgery for basal skull plasmacytoma. J Neuroimaging. 2006 Oct;16(4):361-3. doi: 10.1111/j.1552-6569.2006.00062.x. PubMed 17032388 ↗
  • Chang UK, Lee DH, Kim MS. Stereotactic radiosurgery for primary malignant spinal tumors. Neurol Res. 2014 Jun;36(6):597-606. doi: 10.1179/1743132814Y.0000000381. Epub 2014 Apr 28. PubMed 24773479 ↗
  • Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol. 2008 Oct;18(4):215-22. doi: 10.1016/j.semradonc.2008.04.001. No abstract available. PubMed 18725106 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03312868
Lead sponsor
Instituto do Cancer do Estado de São Paulo
Responsible party
Geovanne Pedro Mauro (MD, Instituto do Cancer do Estado de São Paulo) — Principal investigator
First posted
Oct 18, 2017
Start date
Oct 1, 2017
Primary completion
Mar 28, 2022
Completion
Mar 28, 2022
Last update
Apr 6, 2022

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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