Neoplasms

All Conditions

Rare Diseases

Glioblastoma

Astrocytoma

Glioma

Neoplasms, Neuroepithelial

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Glandular and Epithelial

Neoplasms, Nerve Tissue

Neuroepithelioma

Antineoplastic Agents

All Drugs and Chemicals

Temozolomide

ABT-414

Antineoplastic Agents, Alkylating

Alkylating Agents

Immunoconjugates

Immunologic Factors

ABT-414 in combination with radiation and temozolomide

ABT-414 will be administered by intravenous infusion

Temozolomide will be administered per label and local prescribing regulations.

Whole Brain radiation will be administered in 30 fractions.

Whole Brain Radiation

Earle Bain, MD

This study is evaluating the safety and pharmacokinetics of ABT-414 in subjects with glioblastoma multiforme.

Evaluating the Safety and Pharmacokinetics of ABT-414 for Subjects With Glioblastoma Multiforme

A Phase 1 Study Evaluating the Safety and Pharmacokinetics of ABT-414 for Subjects With Glioblastoma Multiforme

Measurement by clinical lab results, vital signs, physical exam, and electrocardiogram (ECG)

Measurement of the maximum concentration of ABT- 414 in the blood

Measurement of the minimum concentration of ABT-414 in the blood

Assessment of tumor biomarkers that may correlate with efficacy.

Progression Free Survival per RANO criteria is the length of time during and after the treatment of a disease, that the participant lives with the disease but does not get worse.

The overall response rate will be evaluated every 8 weeks at each assessment of disease according to RANO criteria, up to 28 months

AbbVie

Nervous System Diseases

Skin and Connective Tissue Diseases

Symptoms and General Pathology

Brain Neoplasms

Alopecia

Alopecia Areata

Hypotrichosis

Hair Diseases

Skin Diseases

Pathological Conditions, Anatomical

Patients undergoing Radiation therapy to brain

OSL placed over the scalp for initial 5 fractions for patients undergoing partial/ whole brain radiation therapy

radiation therapy to brain

Meena Mishra, M.D.

Study will be conducted on patients receiving Whole brain(WB) / Partial Brain(PB) radiotherapy using volumetric modulated arc therapy or intensity modulated radiotherapy at Department of Radiation Oncology, Fortis Memorial Research Insititute, Gurgaon, Haryana with end points. 1) Primary - To observe degree of alopecia at conclusion of radiotherapy compared to pre- radiotherapy status using scalp sparing radiotherapy technique. 2) Secondary 1)Recording the temporal dose levels causing radiation associated alopecia and dose range acceptable for reversible radiation-induced alopecia and determine dose volume threshold for the same 2)Recording of scalp doses by in vivo dosimetry and correlation with radiation induced alopecia Methods: Study includes 50 patients of partial / whole brain radiation therapy to be followed consecutively for radiation- induced alopecia. Contouring: For WB radiation entire scalp will be contoured. For PB irradiation contouring of partial scalp to be done by drawing 2-3 cm beyond the PTV edge in all directions. Planning: The treatment planning and delivery to be done as per existing practice in department. Contouring at Monaco / Brain Lab Contouring stations and planning on Monaco Treatment planning system (TPS) Version 5.11.01. Duration: 18 months for patient accrual; in this observational study patients undergoing radiation therapy to brain will be evaluated clinically and objectively for degree of alopecia. Photographic and Clinical record of four views of scalp- Right lateral, Left lateral, top and rear to be taken at intervals- a)Pre-Radiotherapy (RT) b) RT Conclusion c) First follow-up at 1 month. Hair loss quantified using Severity of Alopecia Tool (SALT) Score. Dosimetric measurements having subcomponents - measurement of surface dose uses optically stimulated luminescence dosimeters to be placed over scalp for first 5 fractions in case of conventional or fractionated SRT, for the entire duration of short course treatments and for first 5 fractions in case of palliative whole brain radiation given over 10 fractions. TPS measurements: Average, maximum dose and dose per unit volume will be reported for whole and partial scalp. Outcomes 1. Quantify the degree of alopecia at the conclusion of radiotherapy as compared to pre- radiotherapy status. 2. To record the radiation dose levels causing alopecia. 3. Obtain in vivo dosimetry values for scalp doses in modern radiotherapy treatment

Patients with primary or metastatic cancers to the brain need to undergo partial or whole brain radiotherapy. Alopecia is an inadvertent side effect of Radiation therapy to the brain. Much of this alopecia occurs in patches and is often associated with permanent loss of hair. Irradiation-induced epilation is due to high susceptibility of anagen follicles to radiation. Loss of hair can be stressful and distressing for cancer patients.

Various studies have tried to address the issue of threshold dose for radiotherapy induced alopecia. The severity and type of skin response and consequent alopecia to radiation is decided by multitude of factors - total dose and dose fractionation, quality of radiation, area or volume of tissue irradiated, anatomic site and vascular response. Studies have shown that 3Gy produces complete, reversible anagen alopecia and permanent alopecia begins to occur at 5Gy.

At higher dose rates the susceptibility of hair melanocytes is much more than epidermal melanocytes. Freysz et al in a retrospective analysis of 18 patients deduced that a cumulative dose as high as 12Gy results in alopecia that is reversible.Temporary alopecia is seen in most patients receiving WBRT with conventional fractionation. Most of these studies are either small reports or were done before the advent of modern technology. The advent of precision radiotherapy techniques has made it possible to utilize techniques that reduce the dose to the scalp in an attempt to minimize the chances of radiation- induced alopecia.

In a first, a phase II dosimetric and clinical study by De Puysseleyr et al concluded that Volumetric Modulated Arc Therapy (VMAT)- WBRT delivers lower scalp doses as compared to conventional parallel opposed fields but the study was closed prematurely as it failed to show any clinical benefit in terms of preventing alopecia. They however, concluded that the threshold Treatment Planning System (TPS) dose for temporary alopecia is around 10Gy in 5 fractions.

In a study by Ting et al alopecia was observed in half of the patients undergoing Whole Brain Radiotherapy (WBRT) to a dose of 30Gy/10 fractions did not have significant alopecia. The remaining half had mild alopecia. In the study by Mahadevan A et al, hippocampus sparing WBRT also spares hair follicle bearing regions of the scalp while maintaining strict compliance to hippocampus avoidance zone. There is no consensus regarding the threshold TPS dose for alopecia as the study of dose received by hair follicles during intensity modulated radiotherapy for whole brain is limited by lack of knowledge of dose-effect relation of temporary alopecia.

Rivero M et al have reported zero incidence of alopecia in the departmental protocol that they have developed for patients undergoing WBRT using 20Gy/5#s using SIB (40Gy/5#s) by VMAT. The different dose weightage and dose volumes practiced in their department have yielded excellent cosmetic outcomes.

The objective alopecia scoring scales have their own issues of inter-observer variability. EORTC BN20 questionnaire though a validated tool, is largely subjective. Since the expectation of a patient being treated by VMAT despite adequate counseling may be disproportionate to the reality of treatment outcomes, there may be marked deviation of scores to extremes. Severity of Alopecia Tool (SALT Score) is more objective with again the limitation of inter-observer variability. In order to minimize subjectivity, we will use SALT scoring system to analyze the degree of alopecia. SALT Score of 0 indicates no alopecia whereas score of 100 indicates complete baldness.

The investigators have been been using scalp contouring and scalp sparing radiotherapy technique to decrease the dose to the scalp with the aim to reduce alopecia.

This study aims to prospectively study the extent of alopecia by modern treatment techniques and assess the factors affecting the same.

Aims and Objectives:

This study will be conducted on patients receiving Whole brain radiotherapy (WBRT)/ Partial Brain RT using volumetric modulated arc therapy (VMAT) or intensity modulated radiotherapy (IMRT) at Radiation Oncology Department of FMRI, Gurgaon, Haryana with the following end points

Materials and Methods The study will include 50 patients undergoing partial / whole brain radiation therapy who will be assessed prospectively for radiation- induced alopecia.

Contouring: For whole brain radiation only, the whole scalp will be contoured. For partial brain irradiation contouring of lateral lesions partial scalp will be done. Partial scalp contouring shall be done by drawing 2-3 cm beyond the PTV edge in all directions. Partial scalp shall be considered as an organ at risk (OAR).

Planning: The treatment planning and treatment delivery of patients shall be done as per existing routine in the department. All contouring will be done at Monaco / BrainLab Contouring stations and planning will be done on Monaco Treatment planning system Version 5.11.01 using full or partial arc Volumetric modulated arc therapy (VMAT) technique. Patients treated by other techniques such as IMRT and 3-D CRT will also be included in this study and analysed. During radiotherapy planning dose constraints will be given without affecting the PTV coverage.

Following measurements shall be done -

1. Objective, Clinical and photographic analysis- Photographic and Clinical review record of the scalp(excluding the face of the patient) will include four views- Right lateral, Left lateral, top view and rear view of the scalp. These shall be done at following intervals- a) Before starting RT b) RT Conclusion c) First follow-up at 1 month. Hair loss will be quantified using the SALT Score. (14)
2. Dosimetric measurements: This shall have two subcomponents

   1. A measurement of surface dose uses optically stimulated luminescence (OSL) dosimeters that shall be placed over the scalp for first 5 fractions in case of conventional or fractionated Stereotactic Radiotherapy (SRT), for the entire duration of short course treatments and for first 5 fractions in case of palliative whole brain radiation given over 10 fractions. OSL will be placed on the scalp at the centre of arc span of the beams lateral and AP-PA views at the beam entry points. For reproducibility, OSL position will be marked on the Thermoplastic mask. Dose to OSL will be calculated after taking measurements during delivery of therapeutic dose.
   2. Treatment Planning system (TPS) measurements: In the TPS, the average, maximum dose and dose per unit volume will be reported for the whole scalp and partial scalp. In addition the routing measurements of dosimetry related to planning target volume(PTV) and organs at risk (OAR) shall be done as per existing norms

Statistical Methods Mean dose to the point of the OSL will be calculated from the Treatment planning system (TPS), and further the statistical co-relation between the measured and calculated dose will be evaluated by student t test using a 95% confidence interval. Mean scalp dose will be evaluated from the TPS. Further mean TPS calculated dose, measured dose and clinical outcome (degree of alopecia using SALT score) will be co-related using paired sample t test.

Radiation- Induced Alopecia in Patients Undergoing Radiation Therapy to the Brain

Radiation- Induced Alopecia in Patients Undergoing Radiation Therapy to the Brain: A Prospective Clinical and Dosimetric Study of Primary and Metastatic Brain Tumour Patients

To measure the alopecia at pre- RT, post RT completion and 1st follow up after 1 month of RT completion objectively using the SALT score.

to identify dose range levels that causes alopecia for every case

to correlate the dose values of OSL with treatment planning system and assess the congruence between the two along with the dose range causing alopecia

Fortis Memorial Research Institute

Attending Consultant, Department of Radiation Oncology

Respiratory Tract (Lung and Bronchial) Diseases

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Behaviors and Mental Disorders

Lung Neoplasms

Carcinoma

Neoplasm Metastasis

Breast Neoplasms

Recurrence

Melanoma

Carcinoma, Renal Cell

Kidney Neoplasms

Neoplasms, Second Primary

Neoplastic Processes

Central Nervous System Neoplasms

Nervous System Neoplasms

Brain Diseases

Central Nervous System Diseases

Quality of Life

Renal Cell Carcinoma

Clear Cell Renal Cell Carcinoma

* MRI will be performed prior to radiation is administered
* A hippocampal sparing approach will be used when possible
* Dose will be 30 Gy in 10 fractions

* MRI will be performed prior to radiation is administered
* Radiation will be given in 1-5 fractions (dose depends on the size of the tumor that will be treated)

Treatment of the whole brain with radiation. When possible the hippocampus will be spared from radiation.

Whole brain radiation

Focused radiation to each individual brain metastasis without treatment of the remainder of the brain.

Stereotactic radiation (SRS)

Ayal Aizer, MD

Ivy Ricca, BA

Ayal Aizer, MD MHS

This research study is studying two different types of radiation as treatment for brain metastases (tumors in the brain that spread from a cancer that originated elsewhere in the body)

This research study is a Phase III clinical trial. Phase III clinical trials examine the safety and effectiveness of a treatment, often comparing it to another known treatment. In this case, the investigators are specifically looking at differences between two forms of radiation treatment in terms of subsequent quality of life.

In this research study, the investigators are comparing stereotactic (focused, pinpoint) radiation (in which each tumor is narrowly targeted) against whole brain radiation (radiation targeting the entire brain) in the treatment of brain metastases. Currently whole brain radiation is the standard option for patients with 5-20 brain metastases. Stereotactic radiation is the standard option for patients with 1-4 brain metastases. Among patients with 1-4 brain metastases, recently published studies suggest that stereotactic radiation results in fewer neurologic side effects than whole brain radiation. It also yields better quality of life in this population. It remains unknown whether stereotactic radiation improves quality of life in patients with 5-20 brain metastases relative to whole brain radiation. In this study, the investigators seek to determine which of the two methods of study treatment results in a better subsequent quality of life for patients with 5-20 brain metastases.

Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation in Patients With 5-20 Brain Metastases: A Phase III, Randomized Trial

Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation (SRS) in Patients With 5-20 Brain Metastases: A Phase III, Randomized Clinical Trial

Questionnaire - MD Anderson Symptom Inventory - Brain Tumor (MDASI-BT)

Clinical parameter to be assessed via review of study visits and medical records indicating cause of death (neurologic versus systemic)

Radiographic assessment of first appearance of new brain metastases

Radiographic assessment of first local recurrence in the 5-20 brain metastases that were initially treated with radiation

Radiographic assessment of first appearance of radiation necrosis

Radiographic assessment of first appearance of leptomeningeal disease

Clinical assessment of first use of neurosurgical resection as salvage therapy

Clinical assessment of first use of salvage brain-directed radiation

Clinical assessment of first post-treatment seizure as assessed during routine study visits and via medical record review

Questionnaire - Karnofsky performance status

Brigham and Women's Hospital

Dana-Farber Cancer Institute

Principal Investigator

Breast Diseases

Amino Acids

Trastuzumab

Lapatinib

Antineoplastic Agents, Immunological

Tyrosine Kinase Inhibitors

Protein Kinase Inhibitors

Enzyme Inhibitors

Tyrosine

Lapatinib before and during Whole Brain Radiation Therapy (WBRT), then Herceptin 4mg/kg IV weekly

Herceptin 4mg/kg loading dose then 2 mg/kg IV once weekly, then once every three weeks after cycle 3.

Herceptin

Nancy Lin, MD

The purpose of this research study is to determine the safety of combining lapatinib plus radiation in patients with breast cancer that has spread to the brain. Depending upon the participants cancer, they may also have stereotactic radiosurgery (SRS). Lapatinib s a compound that may stop cancer cells from growing abnormally. It is thought that lapatinib might also make cancer cells more sensitive to radiation. This drug has been used in other research studies in women with breast cancer, and information from those other research studies suggests that lapatinib may help to shrink or stabilize breast tumors both inside the brain and outside the brain.

* Participant's will be given a study medication-dosing calendar for each treatment cycle. Each treatment cycle lasts four weeks. On the first day of the treatment cycle, participants will take 1 lapatinib orally twice per day, 12 hours apart. After the first day, lapatinib will be taken once a day in the morning.
* Whole brain radiation treatments will begin approximately 1-8 days after the first dose of lapatinib. The radiation treatments will follow standard guidelines and will be supervised by a radiation oncologist. Radiation will be given in 15 treatments over a period of three weeks.
* Some participants will also undergo stereotactic radiosurgery (SRS). SRS is a highly focused and intense form of radiation treatment generally done as an outpatient procedure in a single treatment.
* After whole brain radiation treatments are completed, lapatinib will be continued at the same dose for one more week. After that, the lapatinib dose may change. In addition at the same time, Herceptin will be started. Participants will continue with both lapatinib and herceptin together as long as there is evidence that they are benefitting from it.
* During all treatment cycles participants will have a physical exam and be asked general questions about their health. Photographs will be taken of the tumor, if visible, to assess the response of the tumor to the treatment. An assessment of the tumor by CT scan of the body, and MRI imaging of the brain will be performed every two months. An assessment of heart function by MUGA scan or echocardiogram will be performed every 8 weeks. The participant will also be asked to complete a brief questionnaire measuring quality of life and asking about symptoms related to the cancer at baseline, 6 months, and one year. Blood tests will be performed every 4 weeks.

Lapatinib in Combination With Radiation Therapy in Patients With Brain Metastases From HER2-Positive Breast Cancer

A Phase I Study of Lapatinib in Combination With Radiation Therapy in Patients With Brain Metastases From HER2-Positive Breast Cancer

The maximum tolerated dose is defined as :The highest dose of a drug or treatment that does not cause unacceptable side effects.

Progression Free Survival is the time from date of start of treatment to the date of the first documented progression or death due to any cause. If a patient has not progressed or died, progression free survival is censored at the time of last tumor assessment. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0), as a 20 % increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Objective Response Rate was defined using volumetric response as the following: Complete Response (CR) is the disappearance of all target lesions, stable/responsive non-target lesions, and no new lesions. Partial response (PR) is at least a 50% reduction in the sum of the target lesions, stable/responsive non-target lesions, and no new lesions. Stable Disease (SD) is neither CR PR or Progressive Disease (PD). And Progressive Disease (PD) is at least 40% increase in sum of target lesionsor the appearance of any new lesion \>=6mm in the longest dimension. If a patient progressed in a non-central nervous system(CNS) site first, died, or withdrew from the study for any reason after the first dose of drug was administered, and before a CR or PR in the central nervous system was determined, she was considered a CNS non-responder.

Overall average length of participant survival after protocol initiation

Breast Cancer Research Foundation

GlaxoSmithKline

Serious Adverse Events include all Participants N=35. Non-serious Adverse Events also include all participants N=35.

n=27 participants Maximum Tolerated Dose 1250 mg lapatinib daily

Dose Level 2

Dose Level 1

Dose Level 3

Lapatinib,Whole Brain Radiation,Herceptin

Between 30 and 78

Age, Customized

Sex: Female, Male

United States

Region of Enrollment

The Maximum Tolerated Dose of Lapatinib When Combined With Cranial Radiation in Patients With CNS Metastases From HER2-positive Breast Cancer.

Progression Free Survival

28 participants had measurable disease out of the 35 participants enrolled.

Objective Response Rate in Central Nervous System Sites

Percentage of Participants Having Central Nervous System as the Site of the First Progression

Percentage of Participants Having Non-Central Nervous System Sites as the Site of First Progression

Overall Survival

Participants received lapatinib, orally, 750mg twice on day one followed by 1000mg, 1250mg, or 1500mg once daily. Whole Brain Radiation therapy (WBRT) (37.5 Gy, 15 fractions) began 1-8 days after starting lapatinib. Lapatinib was continued through WBRT. Following WBRT, patients received trastuzumab intravenously 2mg/kg weekly and lapatinib 1000mg orally once daily.

Overall Study

Cohort A - WBRT dose = 25 Gy, SIB dose = 42 Gy, # of daily fractions = 10, SIB dose in EQD2 = 49.7 Gy

Cohort A

Cohort B - WBRT dose = 20 Gy, SIB dose = 40 Gy, # of daily fractions = 8, SIB dose in EQD2 = 50.0 Gy

Cohort B

Kevin R. Shiue, MD

This trial is a pilot, Phase 2, sequential two-cohort study designed to test two de-escalated whole brain radiation therapy (WBRT) dose levels and assess their ability to maintain acceptable in-brain distant control. The WBRT dose would decrease as the study moves forward, both in terms of absolute value and equivalent dose in 2 Gray fractions (EQD2) (as determined by the linear quadratic radiobiological model). The absolute value of the simultaneous integrated boost (SIB) dose will change with each dose level because the number of fractions delivered will depend on the WBRT dose. As such, the SIB dose will be manipulated such that the EQD2 will remain essentially equivalent despite the difference in the number of fractions delivered. This design will ensure that the only variable is the change in WBRT dose.

The concept is that WBRT with SIB would be expected to maximize both local and in-brain distant control as has already been shown in studies exploring WBRT with SRS boost. However, by itself WBRT with SIB does not address the concern over neurocognitive outcomes. Therefore, investigators hypothesize that there is a lower WBRT dose threshold that will maintain acceptable in-brain distant control, particularly in the setting of a SIB to gross lesions to maintain treated lesion control. In addition, lower overall brain dose (including lower hippocampal dose without specific hippocampal avoidance) may potentially improve neurocognitive function. Investigators are also interested in evaluating treated lesion control, overall survival, neurocognitive sequelae of therapy, quality of life, performance status, and adverse effects of therapy. Biomarker identification for potential correlative circulating tumor DNA and microRNA is an exploratory endpoint to generate data for future prospective evaluation.

Primary Objective Evaluate two de-escalated whole brain radiation dose levels (in the setting of simultaneous integrated boost to gross lesions) with respect to in-brain distant control for brain metastases, defined as an in-brain failure rate outside of the planning target volume at 6 months of \< 20%.

Secondary Objectives

1. Evaluate treated lesion control at 6 months for brain metastases in the setting of a predetermined total biologically effective SIB dose as determined by radiographic progression within the planning target volume with fusion and overlay of follow-up MRIs.
2. Evaluate overall survival at 6 months for brain metastases in the setting of WBRT with SIB.
3. Evaluate changes in neurocognitive function after WBRT with SIB in the following domains: verbal learning and memory as assessed by the Hopkins Verbal Learning Test - Revised (HVLT-R).
4. Evaluate changes in health-related quality of life as assessed by the Functional Assessment of Cancer Therapy with Brain Subscale (FACT-Br) after WBRT-SIB for brain metastases.
5. Evaluate changes in performance status as assessed by the Karnofsky Performance Status tool after WBRT-SIB for brain metastases.
6. Evaluate adverse events after WBRT-SIB for brain metastases according to current CTCAE criteria.

Pilot Phase 2 Study Whole Brain Radiation Therapy With Simultaneous Integrated Boost for Patients With Brain Metastases

A Pilot Phase 2 Study Evaluating Dose De-escalation in Whole Brain Radiation Therapy With Simultaneous Integrated Boost for Patients With Brain Metastases

An actuarial 6-month rate of new parenchymal lesions seen outside the planning target volume of any lesion that received SIB on any post-treatment MRI (in all 3 planes)

An actuarial 6-month rate of any new, recurrent, or progressing (as defined by Response Assessment in Neuro-Oncology Brain Metastases criteria) tumor within the planning target volume on any post-treatment MRI

An actuarial 6-month rate of patients still alive regardless of disease status

Total change in score of neurocognitive tests (Hopkins Verbal Learning Test - Revised, Groton Maze, and Two or One Back Test)

Total change in score of health-related quality of life test (Functional Assessment of Cancer Therapy with Brain Subscale)

Total change in performance status score (Karnofsky)

Adverse effects will be defined per CTCAE

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Evaluating the Safety and Pharmacokinetics of ABT-414 for Subjects With Glioblastoma Multiforme	NCT01800695	Glioblastoma Mu...	ABT-414 Temozolomide Whole Brain Rad...	18 Years - 99 Years	AbbVie
Radiation- Induced Alopecia in Patients Undergoing Radiation Therapy to the Brain	NCT03543020	Alopecia; X-Ray...	radiation thera...	-	Fortis Memorial Research Institute
Hippocampal Sparing Whole Brain Radiation Versus Stereotactic Radiation in Patients With 5-20 Brain Metastases: A Phase III, Randomized Trial	NCT03075072	Brain Metastase...	Whole brain rad... Stereotactic ra...	18 Years - 80 Years	Dana-Farber Cancer Institute
Evaluating the Safety and Pharmacokinetics of ABT-414 for Subjects With Glioblastoma Multiforme	NCT01800695	Glioblastoma Mu...	ABT-414 Temozolomide Whole Brain Rad...	18 Years - 99 Years	AbbVie
Lapatinib in Combination With Radiation Therapy in Patients With Brain Metastases From HER2-Positive Breast Cancer	NCT00470847	Breast Cancer Brain Metastase...	Lapatinib Whole Brain Rad... Herceptin	18 Years -	Dana-Farber Cancer Institute
Pilot Phase 2 Study Whole Brain Radiation Therapy With Simultaneous Integrated Boost for Patients With Brain Metastases	NCT03189381	Brain Metastase...	Cohort A Cohort B	18 Years -	Indiana University

Spots Global Cancer Trial Database for whole brain radiation