Radiation Therapy With or Without Radiosurgery in Treating Patients With Brain Metastases
Metastatic Cancer
About this trial
This is an interventional treatment trial for Metastatic Cancer focused on measuring tumors metastatic to brain
Eligibility Criteria
DISEASE CHARACTERISTICS: No more than 1 unresected or subtotally resected brain metastasis lesion from histologically confirmed systemic malignancy Eligible only if surgical resection refused by patient or resection deemed inappropriate by patient's physician 1 intraparenchymal metastasis clearly defined on contrast enhanced MRI Maximum diameter of lesion no greater than 4.0 cm No leukemia or lymphoma Extracranial sites of primary metastatic disease allowed if no clinical or radiographic evidence of progression within 1 month prior to entry No metastasis to brainstem, midbrain, pons, or medulla No leptomeningeal metastasis by MRI or CSF evaluation No metastasis within 10 mm of optic nerves and chiasm (area must be excluded from high dose stereotactic radiosurgery boost field) PATIENT CHARACTERISTICS: Age: 18 and over Performance status: 70-100% Karnofsky Hematopoietic: Absolute neutrophil count at least 1,000/mm3 Platelet count at least 50,000/mm3 Hemoglobin at least 8 g/dL Hepatic: Not specified Renal: Not specified Other: Neurologic status 0-2 No major medical or psychiatric contraindication to protocol entry Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No concurrent chemotherapy for systemic cancer Endocrine therapy: Concurrent hormonal therapy, including tamoxifen, allowed Radiotherapy: No prior cranial radiotherapy Surgery: Prior subtotal resection allowed Other: No other concurrent treatment for brain metastasis until recurrence
Sites / Locations
- University of Alabama Comprehensive Cancer Center
- Comprehensive Cancer Institute of Huntsville
- Huntsville Hospital System
- Mobile Infirmary Medical Center
- Urology Associates - Mobile AL
- MBCCOP - Gulf Coast
- Alabama Oncology, LLC
- Radiation Oncology Associates of West Alabama
- Providence Cancer Therapy Center
- Arizona Cancer Center
- Mount Diablo Medical Center
- California Cancer Center
- Saint Agnes Cancer Center
- Glendale Memorial Hospital and Health Center
- Sutter Health Western Division Cancer Research Group
- University of California San Diego Cancer Center
- Loma Linda University Medical Center
- Veterans Affairs Medical Center - Long Beach
- Kaiser Permanente Medical Center - Los Angeles
- USC/Norris Comprehensive Cancer Center
- Jonsson Comprehensive Cancer Center, UCLA
- Beckman Research Institute, City of Hope
- CCOP - Bay Area Tumor Institute
- Cancer Care Center
- Radiation Oncology Center - Sacramento
- Radiation Medical Group, Inc.
- UCSF Cancer Center and Cancer Research Institute
- O'Connor Hospital
- CCOP - Santa Rosa Memorial Hospital
- Stanford University
- Memorial Hospital Cancer Center
- University of Colorado Cancer Center
- Bridgeport Hospital
- Whittingham Cancer Center
- CCOP - Christiana Care Health Services
- Walter Reed Army Medical Center
- Lykes Center for Radiation Therapy
- Halifax Medical Center
- Radiation Therapy Associates - Fort Myers
- University of Florida Health Science Center
- Health First Holmes Regional Medical Center
- CCOP - Mount Sinai Medical Center
- Veterans Affairs Medical Center - Miami
- Sylvester Cancer Center, University of Miami
- Baptist Hospital of Miami
- Florida Radiation Oncology Group
- MD Anderson Cancer Center Orlando
- Bay Medical Center
- Gulf Coast Cancer Treatment Center
- West Florida Cancer Institute - Pensacola
- Bayfront Medical Center
- Sarasota Radiation and Medical Oncology Center
- Tallahassee Memorial Healthcare
- H. Lee Moffitt Cancer Center and Research Institute
- Emory University Hospital - Atlanta
- CCOP - Atlanta Regional
- Medical Center/John B. Amos Community Cancer Center
- InterCommunity Cancer Center at Rome
- Northwest Community Hospital
- Northwestern Memorial Hospital
- University of Chicago Cancer Research Center
- CCOP - Central Illinois
- Provena St. Joseph Hospital- Regional Cancer Care Center
- Ingalls Memorial Hospital
- Loyola University Medical Center
- Lutheran General Cancer Care Center
- Methodist Medical Center of Illinois
- St. John's Medical Center
- Veterans Affairs Medical Center - Indianapolis (Roudebush)
- Clarion Health Partners Inc.
- Community Hospitals of Indianapolis - Regional Cancer Center
- Ball Memorial Hospital
- Memorial Hospital of South Bend
- St. Joseph's Radiation Oncology Center
- Wendt Regional Cancer Center of Finley Hospital
- University of Iowa Hospitals and Clinics
- Veterans Affairs Medical Center - Lexington
- Albert B. Chandler Medical Center, University of Kentucky
- James Graham Brown Cancer Center
- Louisville Radiation Oncology
- Merle M. Mahr Cancer Center
- Western Baptist Hospital
- Mary Bird Perkins Cancer Center
- Romagosa Radiation Oncology Center
- MBCCOP - LSU Medical Center
- Tulane University School of Medicine
- CCOP - Ochsner
- Maine Medical Center
- Anne Arundel Oncology Center
- Greater Baltimore Medical Center and Cancer Center
- Harbor Hospital Center
- Sinai Hospital of Baltimore
- Johns Hopkins Oncology Center
- Radiation Oncology Affiliates of Maryland, P.A.
- Peninsula Regional Medical Center
- Cape Cod Hospital
- Veterans Affairs Medical Center - Boston (Jamaica Plain)
- CCOP - Ann Arbor Regional
- University of Michigan Comprehensive Cancer Center
- Barbara Ann Karmanos Cancer Institute
- Henry Ford Hospital
- McLaren Regional Cancer Center
- Hurley Medical Center
- CCOP - Kalamazoo
- Sparrow Regional Cancer Center
- Marquette General Hospital
- MidMichigan Medical Center - Midland
- William Beaumont Hospital
- St. Mary's Medical Center
- Mayo Clinic Cancer Center
- CCOP - Metro-Minnesota
- North Mississippi Medical Center/Cancer Center
- Ellis Fischel Cancer Center - Columbia
- CCOP - Kansas City
- St. Louis University Health Sciences Center
- Mallinckrodt Institute of Radiology
- Cancer Research for the Ozarks
- CCOP - Cancer Research for the Ozarks
- CCOP - Montana Cancer Consortium
- Methodist Cancer Center - Omaha
- Nebraska Health System
- CCOP - Southern Nevada Cancer Research Foundation
- Norris Cotton Cancer Center
- Elliot Regional Cancer Center
- Cooper Cancer Institute
- Veterans Affairs Medical Center - East Orange
- John F. Kennedy Medical Center
- Trinitas Hospital - Jersey Street Campus
- Monmouth Medical Center
- South Jersey Hospital - Millville
- Fox Chase Cancer Center at Virtua Memorial Hospital Burlington County
- Cancer Institute of New Jersey
- Newark Beth Israel Medical Center
- Atlantic City Medical Center
- Community Medical Center
- St. Francis Medical Center
- Associated Radiologists, P.A.
- Saint Joseph Medical Center
- Cancer Center of Albany Medical Center
- Albert Einstein Comprehensive Cancer Center
- State University of New York Health Science Center at Brooklyn
- New York Methodist Hospital
- Roswell Park Cancer Institute
- Finger Lakes Radiation Oncology, P.C.
- CCOP - North Shore University Hospital
- Beth Israel Medical Center
- NYU School of Medicine's Kaplan Comprehensive Cancer Center
- Memorial Sloan-Kettering Cancer Center
- Herbert Irving Comprehensive Cancer Center
- Champlain Valley Physicians Hospital Medical Center
- Vassar Brothers Hospital
- University of Rochester Cancer Center
- New York Medical College
- Lineberger Comprehensive Cancer Center, UNC
- Northeast Medical Center
- East Carolina University School of Medicine
- Catawba Memorial Hospital
- CCOP - Southeast Cancer Control Consortium
- Comprehensive Cancer Center of Wake Forest University Baptist Medical Center
- Meritcare Roger Maris Cancer Center
- UNIMED Medical Center
- Akron General Medical Center
- Akron City Hospital
- Christ Hospital
- Ireland Cancer Center
- University Hospitals of Cleveland
- CCOP - Columbus
- Arthur G. James Cancer Hospital - Ohio State University
- CCOP - Dayton
- CCOP - Toledo Community Hospital Oncology Program
- St. Anthony Hospital
- St. John Medical Center
- CCOP - Columbia River Program
- Lehigh Valley Hospital
- St. Luke's Hospital Regional Cancer Center
- Geisinger Medical Center
- Mercy Catholic Medical Center, Mercy Fitzgerald Divison
- Delaware County Memorial Hospital
- Penn State Geisinger Cancer Center
- Hahnemann University Hospital
- University of Pennsylvania Cancer Center
- Veterans Affairs Medical Center - Philadelphia
- Kimmel Cancer Center of Thomas Jefferson University - Philadelphia
- Fox Chase Cancer Center
- Albert Einstein Cancer Center
- University of Pittsburgh Cancer Institute
- Mercy Hospital of Pittsburgh
- Western Pennsylvania Hospital
- Reading Hospital and Medical Center
- Mercy Hospital Cancer Center - Scranton
- Wilkes Barre General Hospital
- CCOP - MainLine Health
- York Hospital
- Roger Williams Medical Center/BUSM
- Medical University of South Carolina
- CCOP - Greenville
- CCOP - Upstate Carolina
- Rapid City Regional Hospital
- Jackson-Madison County General Hospital
- Baptist Regional Cancer Center - Knoxville
- University of Tennessee, Memphis Cancer Center
- CCOP - Baptist Cancer Institute
- Vanderbilt-Ingram Cancer Center
- Harrington Cancer Center
- Julie and Ben Rogers Cancer Institute
- University of Texas Medical Branch
- University of Texas - MD Anderson Cancer Center
- Wilford Hall - 59th Medical Wing
- Joe Arrington Cancer Research and Treatment Center
- Bayshore Medical Center
- East Texas Medical Center - Cancer Institute
- Dixie Regional Medical Center
- University of Utah Health Sciences Center
- LDS Hospital
- CCOP - Southwestern Vermont Regional Cancer Center
- Vermont Cancer Center
- Green Mountain Oncology Group
- Martha Jefferson Hospital
- Cancer Center, University of Virginia HSC
- RMH Regional Canter Center
- Virginia Baptist Hospital
- Naval Medical Center, Portsmouth
- Swedish Cancer Institute
- Virginia Mason Medical Center
- Deaconess Medical Center
- Yakima Valley Memorial Hospital
- Schiffler Cancer Center
- St. Vincent Hospital
- Gundersen Lutheran Medical Foundation
- Southern Wisconsin Radiotherapy Center
- University of Wisconsin Comprehensive Cancer Center
- Marshfield Clinic
- Community Memorial Hospital
- St. Joseph's Hospital
- Columbia Hospital
- St. Luke's Medical Center
- Medical College of Wisconsin
- Veterans Affairs Medical Center - Milwaukee (Zablocki)
- Southeastern Wisconsin Regional Cancer Center
- Waukesha Memorial Hospital
- Tom Baker Cancer Center - Calgary
- Cross Cancer Institute
- BC Cancer Agency
- Doctor Leon Richard Oncology Centre
- Saint John Regional Hospital
- Newfoundland Cancer Treatment and Research Foundation
- Nova Scotia Cancer Centre
- Cancer Care Ontario-Hamilton Regional Cancer Centre
- Kingston Regional Cancer Centre
- Cancer Care Ontario-London Regional Cancer Centre
- Ottawa Regional Cancer Centre - General Campus
- Northeastern Ontario Regional Cancer Centre, Sudbury
- Northwestern Ontario Regional Cancer Centre, Thunder Bay
- Toronto Sunnybrook Regional Cancer Centre
- Princess Margaret Hospital
- Centre Universitaire de Sante de l'Estrie - Site Fleurimont
- McGill University Department of Oncology
- Saskatoon Cancer Centre
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm 1
Arm 2
Whole brain radiation therapy (WBRT) to 37.5 Gy/15 fractions/2.5 Gy once daily, 5 days/week followed by radiosurgery to all metastases
WBRT to 37.5 Gy/15 fractions/2.5 Gy once daily, 5 days/week