About this trial
Stereotactic radiosurgery (SRS) is a commonly used treatment for brain tumors. It is a one-day (or in some cases two day), out-patient procedure during which a high dose of radiation is delivered to small spots in the brain while excluding the surrounding normal brain.
Whole brain radiation therapy with hippocampal avoidance (HA-WBRT) is when radiation therapy is given to the whole brain, while trying to decrease the amount of radiation that is delivered to the area of the hippocampus. The hippocampus is a brain structure that is important for memory. Memantine is a drug that is given to help relieve symptoms that can be caused by WBRT, including problems with memory and other mental symptoms.
Health Canada, the regulatory body that oversees the use of drugs in Canada, has not approved the sale or use of memantine in combination with WBRT to treat this kind of cancer, although they have allowed its use in this study.
Eligibility criteria
Qualifiers
Patients must have 5 or more brain metastases as counted on a T1 contrast enhanced MRI obtained ≤ 30 days from randomization (maximum 15 brain metastases).
Patients must have a pathological diagnosis (cytological or histological) of a non-hematopoietic malignancy.
The largest brain metastasis must measure <2.5 cm in maximal diameter.
Centre must have the ability to treat patients with either a Gamma Knife, Cyberknife, or a linear accelerator-based radiosurgery system.
Disqualifiers
Pregnant or nursing women.
Men or women of childbearing potential who are unwilling to employ adequate contraception.
Inability to complete a brain MRI.
Known allergy to gadolinium.
Trial design
Treatments tested in this trial
- Memantine
- Hippocampal-avoidant (HA-WBRT) Radiotherapy
- Stereotactic Radiosurgery (SRS)
Treatment groups
Sponsors and collaborators
Canadian Cancer Trials Group
Lead sponsor
Alliance for Clinical Trials in Oncology
Collaborator
NRG Oncology
Collaborator