Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation in Patients With 5-20 Brain Metastases: A Phase III, Randomized Trial
Brain Metastases
About this trial
This is an interventional treatment trial for Brain Metastases focused on measuring Brain metastases, Brain metastasis, Lung cancer, Melanoma, Breast cancer, Kidney cancer, Renal cell carcinoma, Stereotactic radiation, Stereotactic radiosurgery, SRS, Stereotactic, Whole brain radiation, WBRT, Hippocampal avoidance, Hippocampal sparing, Hippocampal, Hippocampus, Radiation, Quality of Life, Neurocognitive, Neurocognition, Survival, Salvage, MDASI, Chemotherapy, Recurrence
Eligibility Criteria
Inclusion Criteria:
- Participants must have a biopsy proven solid malignancy with untreated (by radiation) intracranial lesions radiographically consistent with or pathologically proven to be brain metastases. Patients who have undergone prior systemic therapy are eligible
- Five-twenty intracranial lesions must be present on MRI of the brain
- Age 18-80 years at diagnosis of brain metastases
- Karnofsky performance status of at least 70
Exclusion Criteria:
- Participants who have undergone prior radiation for brain metastases.
- Patients who have undergone resection of one or more brain metastases but who have not yet started adjuvant radiotherapy are eligible for the study
- Participants who cannot undergo a brain MRI
- Participants who cannot receive gadolinium (MRI contrast)
- Participants with stage IV-V chronic kidney disease or end stage renal disease
- Participants with widespread, definitive leptomeningeal disease
- Participants with small cell lung cancer, lymphoma, or myeloma
- Participants with a maximum tumor diameter exceeding 5 cm (if not resected)
Sites / Locations
- Brigham and Women's HospitalRecruiting
- Dana Farber Cancer InstituteRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Whole Brain Radiation
Stereotactic Radiation (SRS)
MRI will be performed prior to radiation is administered A hippocampal sparing approach will be used when possible Dose will be 30 Gy in 10 fractions
MRI will be performed prior to radiation is administered Radiation will be given in 1-5 fractions (dose depends on the size of the tumor that will be treated)