The Efficacy of WVI in Patients With Localized Basal Ganglia Intracranial Germ Cell Tumors

November 7, 2021 updated by: Tao Jiang, Beijing Tiantan Hospital

The Efficacy of Whole-ventricle Irradiation Plus Primary Boost in Patients With Localized Basal Ganglia Germ Cell Tumors: Prospective Phase II Study

Primary endpoint

  1. three-year disease-free survival of patients with localized basal ganglia germ cell tumors receiving whole-ventricle irradiation
  2. Health-related quality of life measured by PedsQL 4.0 and SF-36

Second endpoint

  1. three-year overall survival of patients with localized basal ganglia germ cell tumors receiving whole-ventricle irradiation
  2. Adverse effects of chemoradiotherapy measured by NCI CTCAE 5.0

Study Overview

Detailed Description

Intracranial germ cell tumors originating from the basal ganglia area are rare, accounting for less than 20% of patients. Radiotherapy played a vital role in the treatment of this malignancy. However, the optimal target volume is still undetermined.

Our study regarding relapse patterns of different radiation volumes showed that the ventricular system and ipsilateral frontal lobe were at risk of relapse after focal radiotherapy. Although craniospinal irradiation (CSI) and whole-brain irradiation (WBI) could significantly reduce the relapse in the above areas, the adverse effect on the quality of life is still a concern. As a result, the investigators proposed whole-ventricular irradiation (WVI) in patients with localized basal ganglia germ cell tumors. In order to evaluate its efficacy and safety, the investigators designed this phase II study.

Study Type

Interventional

Enrollment (Anticipated)

150

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Bo Li, MD,PhD
  • Phone Number: (86)10-59975581
  • Email: libo@bjtth.org

Study Locations

      • Beijing, China, 100070
        • Recruiting
        • Beijing Tiantan Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

3 years to 30 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Stratum I: germinoma

Inclusion Criteria:

  • 3 years ≤ age ≤ 30 years
  • Newly diagnosed
  • Unilateral basal ganglia/thalamus lesion
  • Germinoma:Histologically confirmed; and/or serum and/or CSF beta-HCG elevation (≤50IU/L); AFP negative
  • No radiological evidence of additional lesions in the CNS
  • Negative CSF cytology test
  • Adequate organ function
  • Written informed consent

Exclusion Criteria:

  • Bilateral basal ganglia/ thalamus lesions
  • Synchronous pineal or sellar/suprasellar lesion
  • Diabetes insipidus
  • With extracranial lesion(s)
  • Serum/CSF β-HCG >50IU/L without histology
  • Mature teratoma with normal tumor markers
  • Inadequate organ function
  • Poor compliance

Stratum II: non-germinomatous germ cell tumors

Inclusion Criteria:

  • 3 years ≤ age ≤ 30 years
  • Newly diagnosed
  • Unilateral basal ganglia/thalamus lesion
  • NGGCTs: Histologically confirmed; and/or serum and/or CSF AFP elevation; beta-HCG≥500IU/L
  • No radiological evidence of additional lesions in the CNS
  • Negative CSF cytology test
  • Adequate organ function
  • Written informed consent

Exclusion Criteria:

  • Bilateral basal ganglia/ thalamus lesions
  • Synchronous pineal or sellar/suprasellar lesion
  • Diabetes insipitus
  • With extracranial lesion(s)
  • 50IU/L<serum/CSF β-HCG <500IU/L without histology
  • Mature teratoma with normal AFP and β-HCG <500IU/L
  • Inadequate organ function
  • Poor compliance

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: iGCTS

Stratum I (Germinoma) Patients who achieved complete response after induction chemotherapy will receive WVI 2400cGy/15f plus primary boost 640cGy/4f.

Stratum II (NGGCTs) At the time of response evaluation before radiotherapy, those with complete response or residue disease <1.5cm will receive WVI 3060cGy/17f plus primary boost 2340cGy/13f.

Whole-ventricle irradiation will be applied in patients with localized basal ganglia germ cell tumors after induction chemotherapy
Carboplatin/etoposide regimen is applied as induction chemotherapy in patients with basal ganglia germinoma
Ifosfamide/cisplatin/etoposide regimen is applied as induction chemotherapy in patients with basal ganglia non-germinomatous germ cell tumors.
Second-look surgery would be applied to patients who presented residue disease after induction chemotherapy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
3-year event-free survival
Time Frame: From the enrollment to the event (relapse or death of any cause), approximately 3 years. The patients will receive long-term follow-up including MRI and serum tumor markers examination every 3 months until 36 months.
Event-free survival (DFS) is calculated from the date of enrollment to the date of an event (relapse or death of any cause).
From the enrollment to the event (relapse or death of any cause), approximately 3 years. The patients will receive long-term follow-up including MRI and serum tumor markers examination every 3 months until 36 months.
Change of score of the QoL questionnaire (PedsQL 4.0 : Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales, Chinese edition)
Time Frame: Score will be obtained at baseline, 6 months posttreatment, yearly through 3 years posttreatment
The PedsQL 4.0 Generic Core Scale contains 23 items that measures physical (eight items), emotional (five items), social (five items), and school (five items) functions. The Scale comprises parallel patient self-report and parent proxy-report formats. The items are reverse-scored and trans- formed to a 0-100 scale according to the instructions, and higher scores indicate a better HRQOL. (age ≤18 years)
Score will be obtained at baseline, 6 months posttreatment, yearly through 3 years posttreatment
Change of score of the QoL questionnaire (Short form-36)
Time Frame: Evaluation will be conducted at baseline, 6 months posttreatment, yearly through 3 years posttreatment
Altogether, 36 questions with standardized response choices were organized into eight scales, including physical functioning (PF), role limitations as a result of physical health problems (RP), body pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF), role limitations as a result of emotional problems (RE), and general mental health (MH). Additionally, reported health transition (HT) was used to evaluate general health changes during the previous year. The raw scores were converted to a 0-100 scale according to the instructions, and higher scores indicated a better HRQOL. Physical component score (PCS) and mental component score (MCS) were also calculated. (Age >15 years)
Evaluation will be conducted at baseline, 6 months posttreatment, yearly through 3 years posttreatment
Change of score of Chinese Wechsler Intelligence Scale for Children
Time Frame: Score will be obtained at baseline, 6 months posttreatment, yearly through 3 years posttreatment
The intelligence of the child was tested by the China-Wechsler Intelligence Scale for Children (C-WISC), which was revised by Gong and Cai at Hunan Medical University. The C-WISC consists of 11 individual tests that include six verbal tests [Information (I), Comprehend (C), Sorting (S), Arithmetic (A), Vocabulary (V), and Digit symbol (D)] and five performance tests [Picture Completing (PC), Picture Arrangement (PA), Block Pattern (BP), Object Assembly (OA), and Coding (CD)]. Based on individual testing, vocabulary scores (V), procedure scores (P), and full scores (F) were obtained. Furthermore, the VIQ, PIQ, and full intelligence quotient (FIQ) were calculated progressively .
Score will be obtained at baseline, 6 months posttreatment, yearly through 3 years posttreatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
3-year overall survival
Time Frame: From the enrollment to the death of any cause or last follow-up, approximately 3 years.The patients will receive long-term follow-up including MRI and serum tumor markers examination every 3 months until 36 months.
Overall survival is determined from the date of diagnosis to the date of death of any cause or the last follow-up visit
From the enrollment to the death of any cause or last follow-up, approximately 3 years.The patients will receive long-term follow-up including MRI and serum tumor markers examination every 3 months until 36 months.
Short-term adverse effects of treatments
Time Frame: From the beginning to the completion of chemoradiotherapy, approximately 6 months. Grade 3/4 toxicities will be documented
NCI CTCAE 5.0 will be used for adverse effects evaluation
From the beginning to the completion of chemoradiotherapy, approximately 6 months. Grade 3/4 toxicities will be documented

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Tao Jiang, MD, PhD, Beijing Tiantan Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 15, 2021

Primary Completion (Anticipated)

October 31, 2026

Study Completion (Anticipated)

October 31, 2026

Study Registration Dates

First Submitted

October 13, 2021

First Submitted That Met QC Criteria

November 7, 2021

First Posted (Actual)

November 18, 2021

Study Record Updates

Last Update Posted (Actual)

November 18, 2021

Last Update Submitted That Met QC Criteria

November 7, 2021

Last Verified

November 1, 2021

More Information

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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