Evaluation of Low-dose Irinotecan and Cyberknife® SBRT to Treat Colorectal Cancer With Limited Liver Metastasis
Study Details
Study Description
Brief Summary
The purpose of this study is to determine the effects of CyberKnife stereotactic body radiotherapy in combination with irinotecan chemotherapy in patients with colon or rectal cancer that has spread to the liver.
Conventional radiation therapy has a limited role in the treatment of patients with liver metastases because the radiation doses are limited by liver toxicity. The CyberKnife system is a type of radiation machine that precisely focuses large doses of x-rays on the tumor, so that injury from radiation to the nearby normal tissue will be minimal. It is approved by the U.S. Food and Drug Administration to treat tumors, lesions and conditions anywhere in the body when radiation therapy is required. While the device is no longer classified as "investigational", the best treatment dose and times are still being evaluated.
Chemotherapy delivered with radiation therapy can increase the effectiveness of treatment, and may allow for a lower dose of radiation therapy to be utilized, thereby limiting negative side effects.
In this study, patients will receive Cyberknife radiosurgery directed to liver metastasis for 3-5 treatments, given every other day. Irinotecan 40mg/m2 will be administered intravenously daily for 3-5 days (5 treatments within 10 elapsed days), and prior to radiation therapy. Patients will have follow-up visits at months 1,2,4,6,9,12,15,18, 24, 30, 36, and every 6 months thereafter for 3 years.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Low-Dose Irinotecan & CyberKnife SBRT Irinotecan 40mg/m2 x 3-5 days + CyberKnife SBRT 45-60Gy x 3-5 fractions |
Drug: Irinotecan
40mg/m2 x 3-5 days
Other Names:
Radiation: CyberKnife
45-60 Gy for 3-5 days CyberKnife SBRT to liver metastasis within 10 elapsed days. Irinotecan will be administered on the same day, prior to SBRT.
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Number of participants with adverse events related to toxicities from concurrent SBRT and irinotecan [3 years]
Secondary Outcome Measures
- Tumor response rate [3 years]
- Progression free survival [3 years]
- Overall survival [3 years]
Eligibility Criteria
Criteria
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Age>18 years
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Histologically confirmed primary colorectal cancer
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Stage IV colorectal cancer with </= 3 metastases, up to 5cm in size.
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CT scan or MRI of the abdomen with contrast, 60days prior to enrollment
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If patient is allergic to contrast, imaging without contrast is acceptable
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Positron-Emission Tomography 60 days prior to enrollment
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No additional sites of metastasis at the time of protocol enrollment. History of other sites of metastasis that are currently controlled are acceptable.
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No malignant ascites
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At least 4 weeks from any chemotherapy
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No prior liver radiation therapy
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ECOG performance status 0-1
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Life expectancy>3months
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Laboratory evaluations completed 60 days prior to treatment including CMP, CBC with differential, liver function test, and prothrombin time.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Advocate Lutheran General Hospital | Park Ridge | Illinois | United States | 60068 |
Sponsors and Collaborators
- Advocate Health Care
Investigators
- Study Chair: Arica Hirsch, MD, Advocate Lutheran General Hospital
- Study Chair: James Ruffer, MD, Advocate Lutheran General Hospital
- Study Chair: Jacob Bitran, MD, Advocate Lutheran General Hospital
- Study Chair: Edward S James, M.D., Advocate Lutheran General Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 5443