- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02607397
ROCOCO - Low Grade Glioma - Planning Study (ROCOCO LGG)
In Silico Clinical Trial on Irradiation Low Grade Glioma, Comparing Photon and Proton Therapy: A Multicentric Planning Study Based on a Reference Dataset of Patients
Study Overview
Status
Conditions
Detailed Description
Patients with low grade glioma have a far better prognosis than patients with high grade glioma. Despite their low incidence and initial favorable biological behavior, low-grade gliomas are behaving as malignant brain tumours leading to considerable morbidity and mortality especially in young patients. Low-grade infiltrating gliomas in adults include diffuse astrocytoma, oligoastrocytoma and oligodendroglioma. With the WHO 2007 classification the variety within the low grade glioma patient group was large. With the introduction of molecular marker like IDH, MGMT, 1p/19q the classification of glioma's in general is a matter of debate, because shifts in treatments and prognosis. In this context, the importance of molecular markers is recognized and used for designing new trials.
Because of this improved determining of long term survivors like low grade glioma patients, reducing the long term side effect becomes even more relevant. One of the prominent side effect of radiotherapy in low grade glioma patients is the decline in neurocognitive function and loss of memory. This enables patients in their daily activities and causes loss of quality of life. The hippocampus and associated limbic system have long been known to be important in memory formation and pre-clinical models show loss of hippocampal stem cells with radiation as well as changes in architecture and function of mature neurons. Cognitive outcomes in clinical studies are beginning to provide evidence of cognitive effects associated with hippocampal dose and the cognitive benefits of hippocampal sparing. With currently developing IMRT techniques attempts are made to lower the dose to the hippocampus. Besides the hippocampus the dose to the posterior part of the cerebellum seems to influence cognition. Koziol wrote recently the current consensus paper which gathers diverse views on a variety of important roles played by the cerebellum across a range of cognitive and emotional functions. This paper considers the cerebellum in relation to neurocognitive development, language function, working memory, executive function, and the development of cerebellar internal control models and reflects upon some of the ways in which better understanding the cerebellum's status as a "supervised learning machine" can enrich our ability to understand human function and adaptation.
This in silico planning study compares different treatments (photon, proton and C-ion) focusing on normal tissue radiation exposure for a fixed tumor dose, using the same delineation of gross target volume (GTV), clinical target volume (CTV) and planning target volume (PTV). The comparison will be based on dosimetric parameters on normal tissues such as mean hippocampus dose, etc. In addition, the NTCP for a fixed tumor dose or the same expected TCP will be determined. Cobalt Gy equivalent doses will be used when reporting the proton and C-ion dose. In the case of protons, a constant RBE value of 1.1 will be used for both the tumor and the normal tissues. The RBE of C-ions will be calculated based on the models used by the participating centers. The GSI in-house treatment planning system uses RBE values calculated on the basis of the local effect model (LEM). The LEM I (alpha/beta=2) is based on the radial dose distribution of each charged particle crossing into a cell nucleus, as well as on the radiosensitivity and repair capacity of the tissue. The TPSs used by UHM is also based on the LEM model. The model used at NIRS utilizes fixed RBE values that are dependent on the depth in the body, but independent of dose level or tumor type.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Heidelberg, Germany
- University of Heidelberg
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Marburg, Germany
- University Hospital Giessen and Marburg
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Deventer, Netherlands
- Radiotherapy Group
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Nijmegen, Netherlands
- University Medical Center Nijmegen
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Low Grade Glioma patients
- Treated with radical intent
Exclusion Criteria:
- No Low Grade Glioma
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Retrospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Dmean
Time Frame: 1 month
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The normal tissue dose volume parameters per tumor type are defined as Hippocampus: Dmean
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1 month
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Dmax
Time Frame: 1 month
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The normal tissue dose volume parameters per tumor type are defined as Hippocampus: Dmax
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1 month
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Normal Tissue Complication Probability
Time Frame: 1 month
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Based on the OAR's radiation exposure, normal tissue complication probability (NTCP) will be calculated using existing models or existing dose response curves.
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1 month
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ROCOCO LGG
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Clinical Trials on Low Grade Glioma
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University of California, San FranciscoBeiGene USA, Inc.; Pacific Pediatric Neuro-Oncology ConsortiumRecruitingGlioblastoma | Malignant Glioma | Recurrent Glioblastoma | Recurrent WHO Grade III Glioma | WHO Grade III Glioma | IDH2 Gene Mutation | IDH1 Gene Mutation | Low Grade Glioma | Recurrent WHO Grade II Glioma | WHO Grade II GliomaUnited States
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Hospital del Río HortegaCompletedGlioma | Glioblastoma | Low-grade Glioma | Glioma, Malignant | High-grade GliomaSpain
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Massachusetts General HospitalNational Cancer Institute (NCI)Active, not recruitingLow Grade Glioma | WHO Grade 3 Glioma With IDH1 Mutation | WHO Grade 3 Glioma With 1p/19q CodeletionUnited States