Preoperative stereotactic radiosurgery for brain metastases

Phase II Study to Assess Preoperative Hypofractionated Stereotactic Radiotherapy of Brain Metastases

Phase 2 Interventional Centre Jean Perrin · NCT04503772

This study is testing if a special type of targeted radiation therapy before surgery can help control brain tumors in patients with certain cancers like breast, digestive, or lung cancer.

Quick facts

PhasePhase 2
Study typeInterventional
Enrollment70 (estimated)
Ages18 Years and up
SexAll
SponsorCentre Jean Perrin Academic / other
Locations8 sites (Clermont-Ferrand, Puy-de-Dôme and 7 other locations)
Trial IDNCT04503772 on ClinicalTrials.gov

What this trial studies

This phase II study evaluates the effectiveness of preoperative stereotactic radiosurgery (SRS) in achieving local control of brain metastases over a six-month period. It is a multicenter, prospective, non-randomized trial involving patients with up to four distinct brain metastases, one of which requires surgical intervention. The study aims to assess the impact of SRS on patients diagnosed with specific types of cancer, including breast, digestive, or non-small cell lung cancer.

Who should consider this trial

Good fit: Ideal candidates include adults with up to four brain metastases from specific cancers who are eligible for both surgery and stereotactic radiotherapy.

Not a fit: Patients with certain types of cancers such as lymphoma, leukemia, or small-cell lung cancer will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could improve local control of brain metastases and potentially enhance overall survival rates for patients.

How similar studies have performed: Other studies have shown promise with similar approaches, indicating potential for success in this novel application.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* ≤ 4 distinct brain metastases, one with surgical indication
* Diagnosis of primary histologically proven breast, digestive or non-small cells lung cancer
* ≤ 5 cm larger diameter
* Karnofsky performance status ≥ 70
* No contraindication for MRI
* Possibility for the patient to be treat with both surgery and stereotactic radiotherapy
* ≥ 18 years old
* Estimated overall survival ≥ 6 months according to diagnosis specific - graded prognostic assessment (DS GPA)
* Written inform consent signed
* Affiliation to the French social security system
* For women of childbearing age including those on luteinizing hormone-releasing hormone (LH-RH) agonists for ovarian suppression: inclusion negative serum pregnancy test (≤ 7 days prior to the start of preoperative stereotactic radiosurgery (SRS).

Exclusion Criteria:

* Lymphoma, leukaemia, multiple myeloma, germinal tumours or cerebral primary cancer
* Metastases from small-cells lung cancer, kidney cancer, melanoma or sarcoma
* Mass effect with deflection ≥ 5 mm from median line or hydrocephaly or compression 4th ventricle, patient neurologically unstable, need for emergency decompressive surgery
* \> 4 brain metastases
* Contraindication to anaesthesia, MRI or gadolinium injection
* Proximity of the tumour with organs at risk which do not allow the prescribed dose to be reached in the envelope
* Pregnant or breastfeeding woman
* Anti vascular endothelial growth factor (VEGF) within 6 weeks before treatment
* Documented leptomeningeal injury
* History of irradiation of the encephalon in toto
* History of stereotactic radiotherapy on metastasis to be operated on
* Non-candidate patient for surgery
* Surgical delay \> 3 days compared to stereotactic radiotherapy
* Estimated survival \< 6 months by DS GPA
* Patient under guardianship or curators
* Psychological disorder (cognitive disorders, mental alertness, etc.) or social (deprivation of liberty by judicial or administrative decision) or geographical reasons that may compromise medical monitoring of the trial or compliance with treatment
* Woman of childbearing age without effective contraception
* Patient participating in another intervention study within 4 weeks prior to inclusion

Where this trial is running

Clermont-Ferrand, Puy-de-Dôme and 7 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Brain Metastasesbrain metastasespreoperative stereotactic radiosurgerylocal controlradionecrosisoverall survival
Last reviewed 2026-06-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.