Functional Radiosurgery for Easing or Eliminating Debilitating Oncologic Morbidity (FREEDOM)
Jonsson Comprehensive Cancer Center
Summary
The investigators propose to conduct a study in medically refractory cancer pain patients utilizing radiosurgery to ablate the pituitary hypophysis, as well as neuromodulate the centromedian and parafascicular complexes within the thalami - the so-called triple target. This involves treating the pituitary hypophysis and thalamus to a dose of 90 Gy. These patients will have previously failed to achieve adequate pain control with opioid pain regimens and interventional approaches. The trial will involve a multidisciplinary approach involving radiation oncology, neurosurgery, palliative care, and medical oncology colleagues across UCLA.
Description
Refractory pain is one of the most debilitating challenges in oncology patients, particularly at the end of life. Over 60% of cancer patients experience pain, with 30% of these patients becoming refractory to opioid pain medication. Interventional techniques such as nerve blocks and pain pumps only transiently relieve pain and are often not viable for advanced cancer patients. In patients with diffuse metastatic disease with less than 3-6 months survival, there is a pressing need for a rapid and thorough relief of pain sensation. Recently, using highly focused radiation delivered to very uniq…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Male or female ≥ 18 years of age on day of SRS treatment. 2. Documentation of insufficiently controlled mixed, complex cancer pain based on Brief Pain Inventory (BPI) \>8/10 despite optimization of opioid regimen 3. Not eligible for or willing to undergo further pain-relieving interventions 4. Written informed consent (and assent when applicable) obtained from patient or patient's legal representative and ability for patient to comply with the study requirements and agree to undergo the study's SRS treatment plan. Exclusion Criteria: 1. Pregnant, breastfeeding, or unw…
Interventions
- RadiationRadiosurgery
intracranial functional stereotactic radiosurgery (FnSRS) to the triple target: centromedian-parafasciular complex bilaterally, and the hypophysis
Location
- UCLA / Jonsson Comprehensive Cancer CenterLos Angeles, California