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Preoperative Proton Radiotherapy for Retroperitoneal Sarcoma (SA03)

Primary Purpose

Retroperitoneal Sarcoma

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Preoperative proton therapy
Surgery
Sponsored by
University of Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retroperitoneal Sarcoma focused on measuring Sarcoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients must have histologically-confirmed intermediate or high grade retroperitoneal sarcomas of any histologic subtype.
  • Primary or recurrent disease isolated to a single intra-abdominal or retroperitoneal region is allowed.
  • Tumor must be considered potentially completely resectable as defined by cross sectional imaging (no 360o encasement of the superior mesenteric artery, aorta, inferior vena cava, iliac arteries or iliac veins and no extension of tumor into the vertebral column).
  • At least 2 weeks must have elapsed from any prior surgery or hormonal therapy. Patients must have ≤ grade 1 acute toxicities of any prior treatment with anti-cancer modalities (returned to baseline status as noted before most recent treatment). Patients with persisting, stable chronic toxicities from prior treatment ≤ grade 1 are eligible.
  • Age ≥18 years at time of consent.
  • Life expectancy of greater than 3 months. Physician documented.
  • Women of child-producing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and the subsequent 6 months. Patients must have a negative serum pregnancy test within 2 weeks prior to beginning treatment on this trial. Sexually active men must also use appropriate contraception method and should not father a child while receiving therapy during this study.
  • Ability to understand and the willingness to sign a written Institutional Review Board(IRB) stamped study specific informed consent document before undergoing research related procedures or study treatment.
  • Biopsy is required with pathologic confirmation of intermediate or high grade sarcoma with pathology review at the University of Florida.
  • Agree to allow their tissue to be used for current study.

Exclusion Criteria:

  • Receiving any investigational agents.
  • Evidence of metastatic disease.
  • Uncontrolled intercurrent illness and/or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant and nursing women are excluded from this study because the radiotherapy may have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued if the mother is treated.
  • All herbal and/or alternative medications should be discontinued while on study, including, but not limited to: Hydrastis canadensis (goldenseal), Uncaria tomentosa (cat's claw) or Echinacea angustifolia.
  • Requirement for treatment with immunosuppressive agents or chronic steroids.
  • Previous intra-abdominal or retroperitoneal radiotherapy.
  • Treatment with cytotoxic agents and/or treatment with biologic agents within the 4 weeks prior to beginning treatment on this study.

Sites / Locations

  • University of Florida Proton Therapy Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Preoperative Proton Therapy

Surgery

Arm Description

28 daily fractions of 1.8 cobalt gray equivalent(CGE)/fx for total of 50.4 CGE over 5.5 weeks.

Standard of care surgery will be performed 4-6 weeks after the completion of radiation.

Outcomes

Primary Outcome Measures

To assess treatment feasibility of preoperative proton therapy for resectable intermediate or high grade retroperitoneal sarcoma.

Secondary Outcome Measures

To evaluate the acute and late toxicity of preoperative proton therapy for resectable intermediate or high grade retroperitoneal sarcoma
To determine the incidence of margin negative resection in patients compared to historic controls treated with photon therapy.
To determine the percent tumor necrosis and percent apoptosis compared to historic controls treated with photon therapy.
To assess the predictive value of CT and MRI in evaluating pathologic tumor response and margin negative resection following proton radiotherapy.
To compare the dose distribution to tumor and surrounding normal structures using dose volume histograms (DVHs) generated from the proton plan used to treat the patient and a theoretical photon plan generated for comparison purposes.

Full Information

First Posted
May 13, 2009
Last Updated
February 9, 2017
Sponsor
University of Florida
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1. Study Identification

Unique Protocol Identification Number
NCT00901836
Brief Title
Preoperative Proton Radiotherapy for Retroperitoneal Sarcoma
Acronym
SA03
Official Title
A Pilot Study Investigating Preoperative Proton Radiotherapy for Retroperitoneal Sarcoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Terminated
Why Stopped
Study closed due to feasability
Study Start Date
May 2009 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
November 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Florida

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this study is to evaluate radiation treatment intended to increase the chance of curing your sarcoma and decrease the side effects of proton therapy. This study will also look at the tumor tissue that was removed during your initial biopsy and your final surgery for information that may help to treat retroperitoneal sarcoma in the future.
Detailed Description
Data collection will be obtained from the patient's medical records including initial evaluation, pathology report, dosimetry information, radiotherapy completion records and follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retroperitoneal Sarcoma
Keywords
Sarcoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Preoperative Proton Therapy
Arm Type
Experimental
Arm Description
28 daily fractions of 1.8 cobalt gray equivalent(CGE)/fx for total of 50.4 CGE over 5.5 weeks.
Arm Title
Surgery
Arm Type
Active Comparator
Arm Description
Standard of care surgery will be performed 4-6 weeks after the completion of radiation.
Intervention Type
Radiation
Intervention Name(s)
Preoperative proton therapy
Intervention Description
28 daily fractions of 1.8 cobalt gray equivalent(CGE)/fx for total of 50.4 CGE over 5.5 weeks.
Intervention Type
Procedure
Intervention Name(s)
Surgery
Intervention Description
Standard of care surgery will be performed 4-6 weeks after completion of radiation.
Primary Outcome Measure Information:
Title
To assess treatment feasibility of preoperative proton therapy for resectable intermediate or high grade retroperitoneal sarcoma.
Time Frame
4-6 weeks post treatment
Secondary Outcome Measure Information:
Title
To evaluate the acute and late toxicity of preoperative proton therapy for resectable intermediate or high grade retroperitoneal sarcoma
Time Frame
Weekly during treatment, then every 3 months for 1 year, then every 6 months for 4 years.
Title
To determine the incidence of margin negative resection in patients compared to historic controls treated with photon therapy.
Time Frame
4-6 weeks post treatment
Title
To determine the percent tumor necrosis and percent apoptosis compared to historic controls treated with photon therapy.
Time Frame
4-6 weeks post treatment
Title
To assess the predictive value of CT and MRI in evaluating pathologic tumor response and margin negative resection following proton radiotherapy.
Time Frame
4-6 weeks post treatment
Title
To compare the dose distribution to tumor and surrounding normal structures using dose volume histograms (DVHs) generated from the proton plan used to treat the patient and a theoretical photon plan generated for comparison purposes.
Time Frame
4-6 weeks post treatment

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically-confirmed intermediate or high grade retroperitoneal sarcomas of any histologic subtype. Primary or recurrent disease isolated to a single intra-abdominal or retroperitoneal region is allowed. Tumor must be considered potentially completely resectable as defined by cross sectional imaging (no 360o encasement of the superior mesenteric artery, aorta, inferior vena cava, iliac arteries or iliac veins and no extension of tumor into the vertebral column). At least 2 weeks must have elapsed from any prior surgery or hormonal therapy. Patients must have ≤ grade 1 acute toxicities of any prior treatment with anti-cancer modalities (returned to baseline status as noted before most recent treatment). Patients with persisting, stable chronic toxicities from prior treatment ≤ grade 1 are eligible. Age ≥18 years at time of consent. Life expectancy of greater than 3 months. Physician documented. Women of child-producing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation and the subsequent 6 months. Patients must have a negative serum pregnancy test within 2 weeks prior to beginning treatment on this trial. Sexually active men must also use appropriate contraception method and should not father a child while receiving therapy during this study. Ability to understand and the willingness to sign a written Institutional Review Board(IRB) stamped study specific informed consent document before undergoing research related procedures or study treatment. Biopsy is required with pathologic confirmation of intermediate or high grade sarcoma with pathology review at the University of Florida. Agree to allow their tissue to be used for current study. Exclusion Criteria: Receiving any investigational agents. Evidence of metastatic disease. Uncontrolled intercurrent illness and/or psychiatric illness/social situations that would limit compliance with study requirements. Pregnant and nursing women are excluded from this study because the radiotherapy may have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued if the mother is treated. All herbal and/or alternative medications should be discontinued while on study, including, but not limited to: Hydrastis canadensis (goldenseal), Uncaria tomentosa (cat's claw) or Echinacea angustifolia. Requirement for treatment with immunosuppressive agents or chronic steroids. Previous intra-abdominal or retroperitoneal radiotherapy. Treatment with cytotoxic agents and/or treatment with biologic agents within the 4 weeks prior to beginning treatment on this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel J Indelicato, MD
Organizational Affiliation
University of Florida Proton Therapy Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Florida Proton Therapy Institute
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32206
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
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2363604
Citation
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Preoperative Proton Radiotherapy for Retroperitoneal Sarcoma

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