|
1
|
Siva S, Kron T, Bressel M, Haas M, Mai T, Vinod S, Sasso G, Wong W, Le H, Eade T, Hardcastle N, Chesson B, Pham D, Høyer M, Montgomery R, Ball D. A randomised phase II trial of Stereotactic Ablative Fractionated radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the lung (TROG 13.01 SAFRON II). BMC Cancer 2016; 16:183. [PMID: 26944262 PMCID: PMC4778366 DOI: 10.1186/s12885-016-2227-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/28/2016] [Indexed: 12/15/2022] Open
Abstract
Background Stereotactic ablative body radiotherapy (SABR) is emerging as a non-invasive method for precision irradiation of lung tumours. However, the ideal dose/fractionation schedule is not yet known. The primary purpose of this study is to assess safety and efficacy profile of single and multi-fraction SABR in the context of pulmonary oligometastases. Methods/Design The TROG 13.01/ALTG 13.001 clinical trial is a multicentre unblinded randomised phase II study. Eligible patients have up to three metastases to the lung from any non-haematological malignancy, each < 5 cm in size, non-central targets, and have all primary and extrathoracic disease controlled with local therapies. Patients are randomised 1:1 to a single fraction of 28Gy versus 48Gy in four fractions of SABR. The primary objective is to assess the safety of each treatment arm, with secondary objectives including assessment of quality of life, local efficacy, resource use and costs, overall and disease free survival and time to distant failure. Outcomes will be stratified by number of metastases and origin of the primary disease (colorectal versus non-colorectal primary). Planned substudies include an assessment of the impact of online e-Learning platforms for lung SABR and assessment of the effect of SABR fractionation on the immune responses. A total of 84 patients are required to complete the study. Discussion Fractionation schedules have not yet been investigated in a randomised fashion in the setting of oligometastatic disease. Assuming the likelihood of similar clinical efficacy in both arms, the present study design allows for exploration of the hypothesis that cost implications of managing potentially increased toxicities from single fraction SABR will be outweighed by costs associated with delivering multiple-fraction SABR. Trials registration ACTRN12613001157763, registered 17th October 2013
Collapse
Affiliation(s)
- Shankar Siva
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia. .,University of Melbourne, Royal Parade, Parkville, 8006, Australia.
| | - Tomas Kron
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia. .,University of Melbourne, Royal Parade, Parkville, 8006, Australia.
| | - Mathias Bressel
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia.
| | - Marion Haas
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway Sydney, 2007, Australia.
| | - Tao Mai
- Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Qld, 4102, Australia.
| | - Shalini Vinod
- Cancer Therapy Centre, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.
| | - Giuseppe Sasso
- Radiation Oncology Department, Auckland City Hospital, Auckland, New Zealand.
| | - Wenchang Wong
- Department of Radiation Oncology, Prince of Wales Hospital, Barker St, Randwick, NSW, 2031, Australia.
| | - Hien Le
- Department of Radiation Oncology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.
| | - Thomas Eade
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, 2065, NSW, Australia.
| | - Nicholas Hardcastle
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, 2065, NSW, Australia.
| | - Brent Chesson
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia.
| | - Daniel Pham
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia.
| | - Morten Høyer
- Department of Oncology, Aarhus University Hospital, Aarhus, 8000, Denmark.
| | - Rebecca Montgomery
- Trans Tasman Radiation Oncology Group (TROG), PO Box 88, Waratah, 2298, Australia.
| | - David Ball
- Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, 3002, Australia. .,University of Melbourne, Royal Parade, Parkville, 8006, Australia.
| |
Collapse
|