- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03606421
CBF and NCF Changes With Brain Radiation
Use of Novel MRI Techniques Before and After Brain Radiotherapy With Parallel Assessments of Neurocognitive Function
This study will be a dual-arm prospective longitudinal cohort study for patients with brain metastases, at least one of which is appropriate for radiotherapy, to explore brain and cognitive changes following SRS or WBRT and evaluate the feasibility of a novel MRI protocol to identify potential radiological biomarkers of NCF decline.
Patients diagnosed with brain mets will be assigned to either Arm A or Arm B, depending on their treatment plan. Patients in Arm A will be treated with SRS. Patients in Arm B will be treated with WBRT.
Patients' neurocognitive function will be assessed before their radiation treatment and followed up for 2 years post treatment.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: David Shultz, MD
- Phone Number: 2127 416-946-4501
- Email: david.shultz@rmp.uhn.ca
Study Locations
-
-
Ontario
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Toronto, Ontario, Canada, L4W4C2
- Recruiting
- University Health Network
-
Contact:
- David Shultz, MD
-
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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:
- Patients with brain metastases will be included in this study. Patients with known malignancies but without brain metastases, or patients with primary brain tumors are not eligible for enrollment.
- MRI confirmed 1-10 lesions. Each lesion must not be intended for resection.
- No prior radiation therapy for brain tumours.
- For patients enrolled to arm B, ability to tolerate RespirAct. Based on studies in patients with severe cerebrovascular disease, an 8 - 16% drop-out rate at the time of the first exposure to RespirAct CVR testing is expected [9]. The fourth generation of this device has been associated with increased tolerability secondary to elimination of a physical rebreathing circuit replaced by a digital re-breath analog. This improvement is expected to achieve a drop-out rate significantly below 10%.
- Patients must have a GPA greater than or equal to 1.0.
- Patients must be able to provide informed consent. Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate.
- Patients must have sufficient fluency in English and sufficient motor and visual functioning (corrected or assisted as required) to complete the NCF-A battery.
- Patients must be accessible for treatment, AE assessment and follow- up.
- Limit to KPS ≥ 70 for patients in arm B; no limit for arm A
- Women/men of childbearing potential must have agreed to use a highly effective contraceptive. Women of childbearing potential will have a pregnancy test to determine eligibility.
Exclusion Criteria:
- Treatment plan respecting normal tissue tolerances using dose fractionation specified within the protocol cannot be achieved.
- Pregnant patients will be excluded from this study.
- Prior cranial radiotherapy
- Inability to complete MRI with contrast of the head, or a known allergy to gadolinium
- Metastatic germ cell tumor, small cell carcinoma, or lymphoma or any primary brain tumor.
- Patients with known malignancies but without brain metastases.
Image Findings
- Widespread definitive leptomeningeal metastasis
- A brain metastasis that is located ≤ 2 mm of the optic chiasm
- Evidence of midline shift
- Fourth ventricular narrowing, concerning for hydrocephalus
- Patients who have undergone surgical resection of brain tumor are not eligible for enrollment.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Arm A
Patients in Arm A will be treated with stereotactic radiosurgery (SRS) which is a modern method of treating brain lesions that delivers a high amount of radiation to a small volume of the brain affected by a tumour; and is the standard of care for patients with a limited number of brain metastases.
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Patients will be assessed for cerebral blood flow and their neurocognitive function based on a series of neurocognitive tests and questionnaires.
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Arm B.
Patients in Arm B will be treated with whole brain radiotherapy, due to the number of lesions in their brain.
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Patients will be assessed for cerebral blood flow and their neurocognitive function based on a series of neurocognitive tests and questionnaires.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
change in neurocognitive function (NCF)
Time Frame: Over 24 months
|
To characterize change in NCF from baseline (pre-SRS treatment), to 24 months following using the NCF-A Battery
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Over 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Symptomatic Radiation Toxicity
Time Frame: 3-24 months
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A diagnosis of symptomatic radiation toxicity will be based on a clinical onset of symptoms and radiological findings of radionecrosis at 3-24 months following radiosurgery, with or without pathological confirmation
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3-24 months
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Local Failure
Time Frame: up to 24 months
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Local failure will be defined as one of the following (follow-up MRI or CT brain scans will be compared to the prior MRI or CT brain scan): Increase of > 25% in the size of any lesion or a new, non- contiguous lesion developed outside the radiosurgical bed (in the brain or meninges).
Radionecrosis will not be considered tumor progression.
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up to 24 months
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Distant Failure
Time Frame: up to 24 months
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Distant disease is considered to be new metastatic lesions in the brain or outside the brain following WBRT and SRS.
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up to 24 months
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Survival
Time Frame: up to 24 months
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Survival time will be measured from the date the patient is enrolled in this study to death, due to any cause
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up to 24 months
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 18-5106
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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