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Randomised trial of adjuvant versus delayed stereotactic radiotherapy to resection cavity of brain metastases and quality of life outcomes
Other Non-Commercial Sponsor
William Buckland Radiotherapy Centre
The study aims to address whether the timing of stereotactic radiotherapy (SRT) after surgical removal of brain metastases impacts on quality of life; that is, whether treatment on local recurrence (disease returning at the surgical cavity) impacts on quality of life more than upfront SRT following resection of brain metastases.
Who is it for?
You may be eligible to participate in this study if you are aged 18 years or above and have had 1-3 brain metastases surgically removed.
After surgical removal of brain metastases, in the absence of further treatment, about half of patients will develop a recurrence (disease returning) within the surgical cavity(s), while about half will not.
For patients who had 1-3 brain metastases surgically removed, SRT targeting the surgical cavity(s) has been shown to provide local control rates of 70-90% at 1 year. Nevertheless, approximately 50% of patients are destined to never recur at the surgical cavity(s); hence close observation, with radiotherapy at the first sign of recurrence is also often practised. This approach spares treatment in potentially half of patients. By using regular 3-monthly MRIs of the brain, most recurrences should be detected while they are small and before symptoms develop.
The study aims to address whether the timing of SRT after surgical removal of brain metastases impacts on quality of life. We are also studying the effect of treatment on patientâ€™s neurocognitive function (memory, thinking processes). It is hypothesized that delivering SRT on local recurrence is no worse than upfront SRT to resection cavity in terms of patientâ€™s quality of life.