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Fotonová IMRT nebo radioterapie s protonovým paprskem s eskalací dávky versus radiační terapie se standardní dávkou a temozolomidem při léčbě pacientů s nově diagnostikovaným glioblastomem

9. září 2026 aktualizováno: NRG Oncology

Randomizovaná studie fáze II s hypofrakcionovanou dávkou eskalovanou fotonovou IMRT nebo terapií protonovým svazkem versus konvenční fotonové ozařování se současným a adjuvantním temozolomidem u pacientů s nově diagnostikovaným glioblastomem

This randomized phase II trial studies how well dose-escalated photon intensity-modulated radiation therapy (IMRT) or proton beam radiation therapy works compared with standard-dose radiation therapy when given with temozolomide in patients with newly diagnosed glioblastoma. Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells and shrink tumors. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs, such as temozolomide, may make tumor cells more sensitive to radiation therapy. It is not yet known whether dose-escalated photon IMRT or proton beam radiation therapy is more effective than standard-dose radiation therapy with temozolomide in treating glioblastoma.

Přehled studie

Detailní popis

PRIMARY OBJECTIVE:

I. To determine if dose-escalated and -intensified photon IMRT or proton beam therapy (using a dose-per-fraction escalation with simultaneous integrated boost) with concomitant and adjuvant temozolomide improves overall survival, as compared to standard-dose photon irradiation with concomitant and adjuvant temozolomide.

SECONDARY OBJECTIVES:

I. To indirectly compare dose-escalated and -intensified photon IMRT to dose-escalated and -intensified proton beam therapy in terms of overall survival.

II. To indirectly compare and record toxicities of dose-escalated and -intensified photon IMRT versus dose-escalated and -intensified proton beam therapy and directly compare the toxicities of these approaches versus standard-dose photon irradiation on the backbone of concomitant and adjuvant temozolomide.

III. To determine if dose-escalated and -intensified IMRT or proton beam therapy (using a dose-per-fraction escalation with simultaneous integrated boost) with concomitant and adjuvant temozolomide improves perceived cognitive symptom severity, as compared to standard-dose photon irradiation with concomitant and adjuvant temozolomide.

IV. To determine if dose-escalated and -intensified photon IMRT or proton beam therapy (using a dose-per-fraction escalation with simultaneous integrated boost) with concomitant and adjuvant temozolomide improves neurocognitive function, as compared to standard-dose photon irradiation with concomitant and adjuvant temozolomide.

V. To indirectly determine if dose-escalated and -intensified proton beam therapy with concomitant and adjuvant temozolomide improves perceived cognitive symptom severity, as compared to dose-escalated and -intensified photon IMRT, and to directly compare symptom burden with these approaches versus standard-dose photon irradiation on the backbone of concomitant and adjuvant temozolomide.

VI. To indirectly determine if dose-escalated and -intensified proton beam therapy with concomitant and adjuvant temozolomide improves neurocognitive function, as compared to dose-escalated and -intensified photon IMRT, and to directly compare neurocognitive function with these approaches versus standard-dose photon irradiation on the backbone of concomitant and adjuvant temozolomide.

EXPLORATORY OBJECTIVES:

I. Tissue banking for future translational science projects that will be determined based on the state of the science at the time the primary endpoint is reported and will be submitted to National Cancer Institute (NCI) for review and approval.

II. To prospectively compare CD4 lymphopenia between dose-escalated and intensified proton beam therapy, dose-escalated and -intensified photon IMRT, and standard-dose photon irradiation and determine whether CD4 lymphopenia impacts overall survival.

III. To explore the most appropriate and clinically relevant technological parameters to ensure quality and effectiveness throughout radiation therapy processes, including imaging, simulation, patient immobilization, target and critical structure definition, treatment planning, image guidance and delivery.

IIIa. To establish feasibility and clinical relevancy of quality assurance guidelines.

IIIb. To evaluate efficacy of quality assurance tools. IV. To explore the most appropriate and clinically relevant advanced and standard magnetic resonance imaging (MRI) imaging parameters.

IVa. To evaluate the feasibility of differentiating pseudo-progression and true progression in a multi institutional setting using magnetic resonance (MR) diffusion and perfusion imaging.

IVb. To evaluate for early, imaging biomarkers of response and overall survival.

OUTLINE: Patients are assigned to 1 of 2 groups depending on enrolling institution. Within each group, patients will be randomized 1:2 in favor of the experimental arms.

GROUP 1 = PHOTON IMRT CENTERS. GROUP 2 = PROTON CENTERS.

After completion of study treatment, patients are followed up every 3 months for 1 year, every 4 months for 1 year, and then every 6 months thereafter.

Typ studie

Intervenční

Zápis (Aktuální)

624

Fáze

  • Fáze 2

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • British Columbia
      • Victoria, British Columbia, Kanada, V8R 6V5
        • BCCA-Vancouver Island Cancer Centre
    • Ontario
      • Ottawa, Ontario, Kanada, K1H 8L6
        • Ottawa Hospital and Cancer Center-General Campus
      • Windsor, Ontario, Kanada, N8W 2X3
        • Windsor Regional Cancer Centre
    • Quebec
      • Montreal, Quebec, Kanada, H3H 2R9
        • The Research Institute of the McGill University Health Centre (MUHC)
      • Montreal, Quebec, Kanada, H2X 3E4
        • CHUM - Centre Hospitalier de l'Universite de Montreal
      • Québec, Quebec, Kanada, G1R 2J6
        • CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
    • Saskatchewan
      • Saskatoon, Saskatchewan, Kanada, S7N 4H4
        • Saskatoon Cancer Centre
    • Alabama
      • Birmingham, Alabama, Spojené státy, 35233
        • University of Alabama at Birmingham Cancer Center
    • Arizona
      • Phoenix, Arizona, Spojené státy, 85054
        • Mayo Clinic Hospital in Arizona
      • Phoenix, Arizona, Spojené státy, 85013
        • Saint Joseph's Hospital and Medical Center
      • Scottsdale, Arizona, Spojené státy, 85259
        • Mayo Clinic in Arizona
      • Tucson, Arizona, Spojené státy, 85719
        • Banner University Medical Center - Tucson
      • Tucson, Arizona, Spojené státy, 85704
        • Arizona Oncology Associates-West Orange Grove
    • Arkansas
      • Little Rock, Arkansas, Spojené státy, 72205
        • University of Arkansas for Medical Sciences
    • California
      • Auburn, California, Spojené státy, 95603
        • Sutter Cancer Centers Radiation Oncology Services-Auburn
      • Bakersfield, California, Spojené státy, 93301
        • AIS Cancer Center at San Joaquin Community Hospital
      • Berkeley, California, Spojené státy, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Cameron Park, California, Spojené státy, 95682
        • Sutter Cancer Centers Radiation Oncology Services-Cameron Park
      • Castro Valley, California, Spojené státy, 94546
        • Eden Hospital Medical Center
      • Fresno, California, Spojené státy, 93720
        • Fresno Cancer Center
      • Greenbrae, California, Spojené státy, 94904
        • Marin General Hospital
      • Loma Linda, California, Spojené státy, 92354
        • Loma Linda University Medical Center
      • Los Angeles, California, Spojené státy, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Spojené státy, 90048
        • Cedars Sinai Medical Center
      • Los Angeles, California, Spojené státy, 90033
        • Los Angeles General Medical Center
      • Marysville, California, Spojené státy, 95901
        • Fremont - Rideout Cancer Center
      • Modesto, California, Spojené státy, 95355
        • Memorial Medical Center
      • Oakland, California, Spojené státy, 94611
        • Kaiser Permanente Oakland-Broadway
      • Orange, California, Spojené státy, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Orange, California, Spojené státy, 92868
        • Saint Joseph Hospital - Orange
      • Palo Alto, California, Spojené státy, 94301
        • Palo Alto Medical Foundation Health Care
      • Pomona, California, Spojené státy, 91767
        • Pomona Valley Hospital Medical Center
      • Rancho Cordova, California, Spojené státy, 95670
        • Kaiser Permanente-Rancho Cordova Cancer Center
      • Rohnert Park, California, Spojené státy, 94928
        • Rohnert Park Cancer Center
      • Roseville, California, Spojené státy, 95678
        • The Permanente Medical Group-Roseville Radiation Oncology
      • Roseville, California, Spojené státy, 95661
        • Sutter Cancer Centers Radiation Oncology Services-Roseville
      • Sacramento, California, Spojené státy, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Spojené státy, 95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento, California, Spojené státy, 95823
        • South Sacramento Cancer Center
      • San Francisco, California, Spojené státy, 94115
        • California Pacific Medical Center-Pacific Campus
      • Santa Cruz, California, Spojené státy, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • South San Francisco, California, Spojené státy, 94080
        • Kaiser Permanente Cancer Treatment Center
      • Sunnyvale, California, Spojené státy, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Walnut Creek, California, Spojené státy, 94598
        • John Muir Medical Center-Walnut Creek
    • Colorado
      • Colorado Springs, Colorado, Spojené státy, 80909
        • UCHealth Memorial Hospital Central
      • Fort Collins, Colorado, Spojené státy, 80524
        • Poudre Valley Hospital
    • Connecticut
      • Hartford, Connecticut, Spojené státy, 06102
        • Hartford Hospital
    • Florida
      • Boca Raton, Florida, Spojené státy, 33486
        • Boca Raton Regional Hospital
      • Gainesville, Florida, Spojené státy, 32610
        • UF Health Cancer Institute - Gainesville
      • Jacksonville, Florida, Spojené státy, 32207
        • Baptist MD Anderson Cancer Center
      • Jacksonville, Florida, Spojené státy, 32209
        • University of Florida Health Science Center - Jacksonville
      • Jacksonville, Florida, Spojené státy, 32258
        • Baptist Medical Center South
      • Miami, Florida, Spojené státy, 33176
        • Miami Cancer Institute
      • Tampa, Florida, Spojené státy, 33612
        • Moffitt Cancer Center
    • Georgia
      • Atlanta, Georgia, Spojené státy, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Spojené státy, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Spojené státy, 30308
        • Emory Proton Therapy Center
      • Savannah, Georgia, Spojené státy, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    • Idaho
      • Boise, Idaho, Spojené státy, 83706
        • Saint Alphonsus Cancer Care Center-Boise
    • Illinois
      • Chicago, Illinois, Spojené státy, 60611
        • Northwestern University
      • Chicago, Illinois, Spojené státy, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Spojené státy, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Spojené státy, 60612
        • Rush MD Anderson Cancer Center
      • DeKalb, Illinois, Spojené státy, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur, Illinois, Spojené státy, 62526
        • Decatur Memorial Hospital
      • Geneva, Illinois, Spojené státy, 60134
        • Northwestern Medicine Cancer Center Delnor
      • New Lenox, Illinois, Spojené státy, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • Park Ridge, Illinois, Spojené státy, 60068
        • Advocate Lutheran General Hospital
      • Peoria, Illinois, Spojené státy, 61637
        • OSF Saint Francis Medical Center
      • Springfield, Illinois, Spojené státy, 62781
        • Springfield Memorial Hospital
      • Warrenville, Illinois, Spojené státy, 60555
        • Northwestern Medicine Cancer Center Warrenville
    • Indiana
      • Fort Wayne, Indiana, Spojené státy, 46805
        • Parkview Hospital Randallia
      • Fort Wayne, Indiana, Spojené státy, 46845
        • Parkview Regional Medical Center
      • Fort Wayne, Indiana, Spojené státy, 46804
        • Radiation Oncology Associates PC
      • Indianapolis, Indiana, Spojené státy, 46219
        • Community Cancer Center East
      • Indianapolis, Indiana, Spojené státy, 46227
        • Community Cancer Center South
      • Indianapolis, Indiana, Spojené státy, 46256
        • Community Cancer Center North
      • Indianapolis, Indiana, Spojené státy, 46202
        • IU Health Methodist Hospital
      • Muncie, Indiana, Spojené státy, 47303
        • IU Health Ball Memorial Hospital
    • Iowa
      • Cedar Rapids, Iowa, Spojené státy, 52403
        • Mercy Hospital
      • Des Moines, Iowa, Spojené státy, 50309
        • Iowa Methodist Medical Center
    • Kansas
      • Kansas City, Kansas, Spojené státy, 66160
        • University of Kansas Cancer Center
      • Overland Park, Kansas, Spojené státy, 66210
        • University of Kansas Cancer Center-Overland Park
    • Kentucky
      • Louisville, Kentucky, Spojené státy, 40202
        • Norton Hospital Pavilion and Medical Campus
    • Louisiana
      • New Orleans, Louisiana, Spojené státy, 70121
        • Ochsner Medical Center Jefferson
      • Shreveport, Louisiana, Spojené státy, 71103
        • Willis-Knighton Medical and Cancer Center
    • Maryland
      • Baltimore, Maryland, Spojené státy, 21201
        • University of Maryland/Greenebaum Cancer Center
      • Baltimore, Maryland, Spojené státy, 21201
        • Maryland Proton Treatment Center
      • Bel Air, Maryland, Spojené státy, 21014
        • UM Upper Chesapeake Medical Center
      • Columbia, Maryland, Spojené státy, 21044
        • Central Maryland Radiation Oncology in Howard County
      • Glen Burnie, Maryland, Spojené státy, 21061
        • UM Baltimore Washington Medical Center/Tate Cancer Center
    • Massachusetts
      • Boston, Massachusetts, Spojené státy, 02111
        • Tufts Medical Center
      • Boston, Massachusetts, Spojené státy, 02118
        • Boston Medical Center
      • Boston, Massachusetts, Spojené státy, 02114
        • Massachusetts General Hospital Cancer Center
      • Danvers, Massachusetts, Spojené státy, 01923
        • Mass General/North Shore Cancer Center
      • Lowell, Massachusetts, Spojené státy, 01854
        • Lowell General Hospital
    • Michigan
      • Ann Arbor, Michigan, Spojené státy, 48109
        • University of Michigan Rogel Cancer Center
      • Ann Arbor, Michigan, Spojené státy, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Bay City, Michigan, Spojené státy, 48706
        • McLaren Cancer Institute-Bay City
      • Dearborn, Michigan, Spojené státy, 48124
        • Corewell Health Dearborn Hospital
      • Detroit, Michigan, Spojené státy, 48202
        • Henry Ford Hospital
      • Flint, Michigan, Spojené státy, 48532
        • McLaren Cancer Institute-Flint
      • Grand Rapids, Michigan, Spojené státy, 49503
        • Trinity Health Grand Rapids Hospital
      • Grand Rapids, Michigan, Spojené státy, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Kalamazoo, Michigan, Spojené státy, 49007
        • West Michigan Cancer Center
      • Lapeer, Michigan, Spojené státy, 48446
        • McLaren Cancer Institute-Lapeer Region
      • Livonia, Michigan, Spojené státy, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Mount Clemens, Michigan, Spojené státy, 48043
        • McLaren Cancer Institute-Macomb
      • Mount Pleasant, Michigan, Spojené státy, 48858
        • McLaren Cancer Institute-Central Michigan
      • Owosso, Michigan, Spojené státy, 48867
        • McLaren Cancer Institute-Owosso
      • Petoskey, Michigan, Spojené státy, 49770
        • McLaren Cancer Institute-Northern Michigan
      • Pontiac, Michigan, Spojené státy, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Royal Oak, Michigan, Spojené státy, 48073
        • Corewell Health William Beaumont University Hospital
      • Saint Joseph, Michigan, Spojené státy, 49085
        • Corewell Health Lakeland Hospitals - Saint Joseph Hospital
      • Troy, Michigan, Spojené státy, 48085
        • Corewell Health Beaumont Troy Hospital
    • Minnesota
      • Bemidji, Minnesota, Spojené státy, 56601
        • Sanford Joe Lueken Cancer Center
      • Duluth, Minnesota, Spojené státy, 55805
        • Saint Luke's Hospital of Duluth
      • Rochester, Minnesota, Spojené státy, 55905
        • Mayo Clinic in Rochester
      • Saint Cloud, Minnesota, Spojené státy, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Paul, Minnesota, Spojené státy, 55101
        • Regions Hospital
    • Mississippi
      • Jackson, Mississippi, Spojené státy, 39216
        • University of Mississippi Medical Center
    • Missouri
      • Kansas City, Missouri, Spojené státy, 64154
        • University of Kansas Cancer Center - North
      • Kansas City, Missouri, Spojené státy, 64116
        • North Kansas City Hospital
      • St Louis, Missouri, Spojené státy, 63110
        • Washington University School of Medicine
    • Montana
      • Billings, Montana, Spojené státy, 59101
        • Billings Clinic Cancer Center
    • Nevada
      • Las Vegas, Nevada, Spojené státy, 89148
        • Comprehensive Cancer Centers of Nevada
      • Reno, Nevada, Spojené státy, 89502
        • Renown Regional Medical Center
      • Reno, Nevada, Spojené státy, 89503
        • Saint Mary's Regional Medical Center
    • New Hampshire
      • Lebanon, New Hampshire, Spojené státy, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
    • New Jersey
      • Basking Ridge, New Jersey, Spojené státy, 07920
        • Memorial Sloan Kettering Basking Ridge
      • New Brunswick, New Jersey, Spojené státy, 08903
        • Rutgers Cancer Institute of New Jersey
      • New Brunswick, New Jersey, Spojené státy, 08903
        • Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
      • Pennington, New Jersey, Spojené státy, 08534
        • Capital Health Medical Center-Hopewell
      • Somerset, New Jersey, Spojené státy, 08873
        • ProCure Proton Therapy Center-Somerset
      • Voorhees Township, New Jersey, Spojené státy, 08043
        • Virtua Voorhees
    • New York
      • Brooklyn, New York, Spojené státy, 11215
        • New York-Presbyterian/Brooklyn Methodist Hospital
      • Commack, New York, Spojené státy, 11725
        • Memorial Sloan Kettering Commack
      • Harrison, New York, Spojené státy, 10604
        • Memorial Sloan Kettering Westchester
      • Lake Success, New York, Spojené státy, 11042
        • Northwell Health/Center for Advanced Medicine
      • New York, New York, Spojené státy, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Spojené státy, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Spojené státy, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • The Bronx, New York, Spojené státy, 10467
        • Montefiore Medical Center - Moses Campus
    • North Carolina
      • Asheville, North Carolina, Spojené státy, 28801
        • Mission Hospital
      • Winston-Salem, North Carolina, Spojené státy, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Spojené státy, 27103
        • Novant Health Forsyth Medical Center
    • North Dakota
      • Bismarck, North Dakota, Spojené státy, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Spojené státy, 58122
        • Sanford Roger Maris Cancer Center
    • Ohio
      • Akron, Ohio, Spojené státy, 44307
        • Cleveland Clinic Akron General
      • Beachwood, Ohio, Spojené státy, 44122
        • UHHS-Chagrin Highlands Medical Center
      • Chardon, Ohio, Spojené státy, 44024
        • Geauga Hospital
      • Cincinnati, Ohio, Spojené státy, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cleveland, Ohio, Spojené státy, 44106
        • Case Western Reserve University
      • Cleveland, Ohio, Spojené státy, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Spojené státy, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Spojené státy, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Spojené státy, 43210
        • Ohio State University Comprehensive Cancer Center
      • Elyria, Ohio, Spojené státy, 44035
        • Mercy Cancer Center-Elyria
      • Independence, Ohio, Spojené státy, 44131
        • Cleveland Clinic Cancer Center Independence
      • Mayfield Heights, Ohio, Spojené státy, 44124
        • Hillcrest Hospital Cancer Center
      • Mentor, Ohio, Spojené státy, 44060
        • UH Seidman Cancer Center at Lake Health Mentor Campus
      • Middleburg Heights, Ohio, Spojené státy, 44130
        • UH Seidman Cancer Center at Southwest General Hospital
      • Parma, Ohio, Spojené státy, 44129
        • University Hospitals Parma Medical Center
      • Sandusky, Ohio, Spojené státy, 44870
        • North Coast Cancer Care
      • Sandusky, Ohio, Spojené státy, 44870
        • UH Seidman Cancer Center at Firelands Regional Medical Center
      • Strongsville, Ohio, Spojené státy, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Toledo, Ohio, Spojené státy, 43614
        • University of Toledo
      • West Chester, Ohio, Spojené státy, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Westlake, Ohio, Spojené státy, 44145
        • UHHS-Westlake Medical Center
      • Wooster, Ohio, Spojené státy, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
    • Oklahoma
      • Oklahoma City, Oklahoma, Spojené státy, 73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Eugene, Oregon, Spojené státy, 97401
        • Willamette Valley Cancer Center
      • Gresham, Oregon, Spojené státy, 97030
        • Legacy Mount Hood Medical Center
      • Portland, Oregon, Spojené státy, 97210
        • Legacy Good Samaritan Hospital and Medical Center
    • Pennsylvania
      • Bethlehem, Pennsylvania, Spojené státy, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Dunmore, Pennsylvania, Spojené státy, 18512
        • Northeast Radiation Oncology Center
      • Ephrata, Pennsylvania, Spojené státy, 17522
        • Ephrata Cancer Center
      • Gettysburg, Pennsylvania, Spojené státy, 17325
        • Adams Cancer Center
      • Harrisburg, Pennsylvania, Spojené státy, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Lebanon, Pennsylvania, Spojené státy, 17042
        • Sechler Family Cancer Center
      • Philadelphia, Pennsylvania, Spojené státy, 19107
        • Thomas Jefferson University Hospital
      • Philadelphia, Pennsylvania, Spojené státy, 19114
        • Jefferson Torresdale Hospital
      • Philadelphia, Pennsylvania, Spojené státy, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • West Reading, Pennsylvania, Spojené státy, 19611
        • Reading Hospital
      • York, Pennsylvania, Spojené státy, 17403
        • WellSpan Health-York Cancer Center
    • South Carolina
      • Boiling Springs, South Carolina, Spojené státy, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Spojené státy, 29425
        • Medical University of South Carolina
      • Greenville, South Carolina, Spojené státy, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Spojené státy, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenwood, South Carolina, Spojené státy, 29646
        • Self Regional Healthcare
      • Greer, South Carolina, Spojené státy, 29650
        • Prisma Health Cancer Institute - Greer
      • Seneca, South Carolina, Spojené státy, 29672
        • Prisma Health Cancer Institute - Seneca
    • South Dakota
      • Sioux Falls, South Dakota, Spojené státy, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
    • Tennessee
      • Knoxville, Tennessee, Spojené státy, 37909
        • Tennessee Cancer Specialists-Dowell Springs
    • Texas
      • Austin, Texas, Spojené státy, 78701
        • Dell Seton Medical Center at The University of Texas
      • Austin, Texas, Spojené státy, 78702
        • Austin Cancer Centers-Central Austin
      • Austin, Texas, Spojené státy, 78705
        • Texas Oncology-Austin Midtown
      • Austin, Texas, Spojené státy, 78731
        • Texas Oncology - Central Austin Cancer Center
      • Austin, Texas, Spojené státy, 78745
        • Texas Oncology - South Austin Cancer Center
      • Austin, Texas, Spojené státy, 78758
        • Austin Cancer Centers-North
      • Dallas, Texas, Spojené státy, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Denison, Texas, Spojené státy, 75020
        • Texas Oncology - Denison Cancer Center
      • Flower Mound, Texas, Spojené státy, 75028
        • Texas Oncology-Flower Mound
      • Fort Worth, Texas, Spojené státy, 76104
        • Texas Oncology - Fort Worth Cancer Center
      • Galveston, Texas, Spojené státy, 77555-0565
        • University of Texas Medical Branch
      • Houston, Texas, Spojené státy, 77030
        • M D Anderson Cancer Center
      • Houston, Texas, Spojené státy, 77024
        • Memorial Hermann Memorial City Medical Center
      • League City, Texas, Spojené státy, 77573
        • UTMB Cancer Center at Victory Lakes
      • Lubbock, Texas, Spojené státy, 79410
        • Covenant Medical Center-Lakeside
      • Round Rock, Texas, Spojené státy, 78665
        • Texas Oncology-Seton Williamson
      • Round Rock, Texas, Spojené státy, 78681
        • Texas Oncology - Round Rock Cancer Center
      • San Antonio, Texas, Spojené státy, 78229
        • University of Texas Health Science Center at San Antonio
      • Sugar Land, Texas, Spojené státy, 77479
        • Texas Oncology Cancer Center Sugar Land
      • Tyler, Texas, Spojené státy, 75702
        • Texas Oncology - Tyler
    • Utah
      • Logan, Utah, Spojené státy, 84321
        • Logan Regional Hospital
      • Murray, Utah, Spojené státy, 84107
        • Intermountain Medical Center
      • Ogden, Utah, Spojené státy, 84403
        • McKay-Dee Hospital Center
      • Provo, Utah, Spojené státy, 84604
        • Utah Valley Regional Medical Center
      • Salt Lake City, Utah, Spojené státy, 84112
        • Huntsman Cancer Institute/University of Utah
      • St. George, Utah, Spojené státy, 84770
        • Saint George Regional Medical Center
    • Vermont
      • Berlin Corners, Vermont, Spojené státy, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Spojené státy, 05401
        • University of Vermont Medical Center
      • Saint Johnsbury, Vermont, Spojené státy, 05819
        • Dartmouth Cancer Center - North
    • Virginia
      • Richmond, Virginia, Spojené státy, 23298
        • VCU Massey Comprehensive Cancer Center
    • Washington
      • Seattle, Washington, Spojené státy, 98195
        • University of Washington Medical Center - Montlake
      • Seattle, Washington, Spojené státy, 98133
        • FHCC at Northwest Hospital
      • Seattle, Washington, Spojené státy, 98133
        • FHCC Proton Therapy Center
      • Vancouver, Washington, Spojené státy, 98686
        • Legacy Salmon Creek Hospital
      • Vancouver, Washington, Spojené státy, 98684
        • Compass Oncology Vancouver
    • West Virginia
      • Wheeling, West Virginia, Spojené státy, 26003
        • Wheeling Hospital/Schiffler Cancer Center
    • Wisconsin
      • Antigo, Wisconsin, Spojené státy, 54409
        • Langlade Hospital and Cancer Center
      • La Crosse, Wisconsin, Spojené státy, 54601
        • Gundersen Lutheran Medical Center
      • Madison, Wisconsin, Spojené státy, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Menomonee Falls, Wisconsin, Spojené státy, 53051
        • Froedtert Menomonee Falls Hospital
      • Milwaukee, Wisconsin, Spojené státy, 53226
        • Medical College of Wisconsin
      • Waukesha, Wisconsin, Spojené státy, 53188
        • UW Cancer Center at ProHealth Care
      • Wausau, Wisconsin, Spojené státy, 54401
        • Aspirus Regional Cancer Center

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  • PRIOR TO STEP 1 REGISTRATION

  • A diagnostic contrast-enhanced MRI (no other scan type allowed) of the brain must be performed postoperatively; the residual enhancing tumor and/or resection cavity must have a maximal diameter of 5 cm or less; the tumor diameter will be the greatest diameter as measured on the contrast-enhanced postoperative MRI and will include residual disease and/or the postoperative surgical cavity as appropriate

    • The postoperative brain MRI should be obtained within 72 hours of resection; if it is not obtained within 72 hours post-resection, then an MRI obtained 2 weeks or longer after surgery is required and can be utilized to ensure maximal diameter of residual tumor and/or resection cavity is 5 cm or less
    • For cases where a gross total resection of enhancing tumor is performed, but postoperative surgical cavity is NOT identifiable, the patient will be excluded from the trial
  • Tumor tissue must be available for submission for central pathology review

    • Timing requirements:

      • If MGMT has been assessed locally by LabCorps or MD Anderson Cancer Center Molecular Diagnostics Lab (MDACC-MDL):

        • Tissue for central pathology review and central MGMT assessment and the official LabCorps or MDACC-MDL MGMT result must be received by the NRG Oncology Biospecimen Bank on or before postoperative calendar day 40
        • The site's local MGMT report from LabCorp or MDACC-MDL will then be used to stratify the patient; a post-stratification MGMT central review will be performed, but step 2 registration and protocol treatment can proceed without central review of MGMT
        • Patients whose tissue for central pathology review and official LabCorps or MDACC-MDL MGMT result cannot be received by NRG Oncology Biospecimen Bank on or before 40 calendar days after surgery may NOT enroll on this trial, as central pathology review and stratification will not be complete in time for the patient to start treatment within 49 calendar days following surgery
      • If MGMT has not been assessed locally by LabCorps or MDACC-MDL:

        • Tissue for central pathology review and central MGMT assessment must be received by the NRG Oncology Biospecimen Bank on or before postoperative calendar day 30
        • Central MGMT analysis will be performed at MDACC-MDL and used for patient stratification; results will be conveyed to NRG Oncology within 10 business days of receipt of the tissue
        • Patients who have not had local MGMT assessment by LabCorps or MDACC-MDL and whose tissue for central pathology review cannot be received by NRG Oncology Biospecimen Bank on or before 30 calendar days after surgery may NOT enroll on this trial, as central pathology review and stratification will not be complete in time for the patient to start treatment within 49 calendar days following surgery
    • Tissue Requirements:

      • Patients must have at least 1 block of tumor tissue; submission of 2 blocks is strongly encouraged to maximize the chances of eligibility; in total, at least 1 cubic centimeter of tissue composed primarily of tumor must be present
      • Submission of an accompanying hematoxylin and eosin H&E slide(s) is MANDATORY
      • Diagnosis must be made by surgical excision, either partial or complete; stereotactic biopsy and cavitronic ultrasonic surgical (CUSA) techniques are not allowed
  • The tumor must be located in the supratentorial compartment only (any component involving the brain stem or cerebellum is not allowed)

  • Patients must provide study-specific informed consent prior to step 1 registration

  • PRIOR TO STEP 2 REGISTRATION

  • Histologically proven diagnosis of glioblastoma (World Health Organization [WHO] grade IV) confirmed by central review prior to step 2 registration

  • Tumor tissue that is determined by central pathology review prior to step 2 registration to be of sufficient quantity for central analysis of MGMT status

  • History/physical examination within 28 days prior to step 2 registration

  • The patient must have recovered from effects of surgery, postoperative infection, and other complications within 28 days prior to step 2 registration

  • Documentation of steroid doses within 28 days prior to step 2 registration

  • Karnofsky performance status >= 70 within 28 days prior to step 2 registration

  • Age >= 18

  • Complete blood count (CBC)/differential obtained within 28 days prior to step 2 registration

  • Absolute neutrophil count (ANC) >= 1,500 cells/mm^3 (obtained within 28 days prior to step 2 registration)

  • Platelets >= 100,000 cells/mm^3 (obtained within 28 days prior to step 2 registration)

  • Hemoglobin >= 10.0 g/dl (obtained within 28 days prior to step 2 registration) (note: the use of transfusion or other intervention to achieve hemoglobin [Hgb] >= 10.0 g/dl is acceptable)

  • Bilirubin =< 1.5 upper limit of normal (ULN) (within 28 days prior to step 2 registration)

  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 x ULN (within 28 days prior to step 2 registration)

  • Negative serum pregnancy test obtained for females of child-bearing potential within 28 days prior to step 2 registration

  • As of Amendment 2, if the registering site is a photon center (registering patients to group I), the patient must agree to participate in the advanced imaging sub-study

Exclusion Criteria:

  • Prior invasive malignancy (except non-melanomatous skin cancer) unless disease-free for a minimum of 3 years; (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible)

  • Recurrent or multifocal malignant gliomas

  • Any site of distant disease (for example, drop metastases from the GBM tumor site)

  • Prior chemotherapy or radiosensitizers for cancers of the head and neck region; note that prior chemotherapy for a different cancer is allowable (except temozolomide)

  • Prior use of Gliadel wafers or any other intratumoral or intracavitary treatment are not permitted

  • Prior radiotherapy to the head or neck (except for T1 glottic cancer), resulting in overlap of radiation fields

  • Severe, active co-morbidity, defined as follows:

    • Unstable angina at step 2 registration
    • Transmural myocardial infarction within the last 6 months prior to step 2 registration
    • Evidence of recent myocardial infarction or ischemia by the findings of S-T elevations of >= 2 mm using the analysis of an electrocardiogram (EKG) performed within 28 days prior to step 2 registration (Note: EKG to be performed only if clinical suspicion of cardiac issue)
    • New York Heart Association grade II or greater congestive heart failure requiring hospitalization within 12 months prior to step 2 registration
    • Serious and inadequately controlled arrhythmia at step 2 registration
    • Serious or non-healing wound, ulcer or bone fracture or history of abdominal fistula, intra-abdominal abscess requiring major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to step 2 registration, with the exception of the craniotomy for surgical resection
    • Acute bacterial or fungal infection requiring intravenous antibiotics at the time of step 2 registration
    • Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol
    • Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of step 2 registration
    • Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is because the treatments involved in this protocol may be significantly immunosuppressive with potentially fatal outcomes in patients already immunosuppressed
    • Any other severe immunocompromised condition
    • Active connective tissue disorders, such as lupus or scleroderma, that in the opinion of the treating physician may put the patient at high risk for radiation toxicity
    • End-stage renal disease (ie, on dialysis or dialysis has been recommended)
    • Any other major medical illnesses or psychiatric treatments that in the investigator's opinion will prevent administration or completion of protocol therapy
  • Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic

  • Patients treated on any other therapeutic clinical protocols within 30 days prior to step 2 registration

  • Inability to undergo MRI (e.g., due to safety reasons, such as presence of a pacemaker, or severe claustrophobia)

  • Postoperative tumor plus surgical bed size exceeds 5 cm in maximum diameter

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Aktivní komparátor: Group 1 - Standard RT (Photon) (Arm A1)

Group 1 = Photon IMRT centers. Participants undergo standard-dose postoperative photon radiotherapy using 3-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) administered once daily, 5 days per week. Treatment consists of 46 Gy in 23 fractions followed by a sequential boost to a total dose of 60 Gy in 30 fractions. Participants receive concurrent temozolomide orally once daily during radiotherapy for up to 49 days and adjuvant temozolomide orally once daily on days 1-5 of each 28-day cycle for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

daily fractions

Ostatní jména:
  • Fotonové EBRT
  • Fotonová externí radioterapie
  • Záření, fotonový paprsek
  • Externí radiační terapie pomocí fotonů (postup)
  • Foton
  • PHOTON terapie

tablet

Ostatní jména:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboxamid, 3,4-dihydro-3-methyl-4-oxo-
  • M & B 39831
  • M a B 39831
  • Gliotem
  • Temizol
Aktivní komparátor: Group 2 - Standard RT (Proton) (Arm A2)

Group 2 = Proton centers. Participants undergo the same standard-dose postoperative radiotherapy regimen described for Arm A1 but delivered using proton beam therapy. Participants receive concurrent and adjuvant temozolomide as described for Arm A1.

daily fractions

Ostatní jména:
  • Fotonové EBRT
  • Fotonová externí radioterapie
  • Záření, fotonový paprsek
  • Externí radiační terapie pomocí fotonů (postup)
  • Foton
  • PHOTON terapie

tablet

Ostatní jména:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboxamid, 3,4-dihydro-3-methyl-4-oxo-
  • M & B 39831
  • M a B 39831
  • Gliotem
  • Temizol
Experimentální: Group 1 - Intensified RT (Photon) (Arm B)

Group 1 = Photon IMRT centers. Patients undergo dose-escalated and -intensified photon IMRT QD, 5 days a week for a total of 30 fractions.

In all treatment arms, patients receive temozolomide PO QD on days 1-49 of radiation therapy. Beginning 4 weeks later, patients receive temozolomide PO QD on days 1-5. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity.

daily fractions

Ostatní jména:
  • Fotonové EBRT
  • Fotonová externí radioterapie
  • Záření, fotonový paprsek
  • Externí radiační terapie pomocí fotonů (postup)
  • Foton
  • PHOTON terapie

tablet

Ostatní jména:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboxamid, 3,4-dihydro-3-methyl-4-oxo-
  • M & B 39831
  • M a B 39831
  • Gliotem
  • Temizol
Experimentální: Group 2 - Intensified RT (Proton) (Arm C)

Group 2 = Proton centers. Participants undergo the same radiotherapy regimen described for Arm B but delivered using proton beam therapy. The elective target volume receives 50 Gy(RBE) in 30 fractions, and the boost target volume receives 75 Gy(RBE) in 30 fractions. Participants receive concurrent and adjuvant temozolomide as described for Arm A1.

tablet

Ostatní jména:
  • Temodar
  • SCH 52365
  • Temodal
  • Temcad
  • Metazolastone
  • RP-46161
  • Temomedac
  • TMZ
  • CCRG-81045
  • Imidazo[5,1-d]-1,2,3,5-tetrazin-8-karboxamid, 3,4-dihydro-3-methyl-4-oxo-
  • M & B 39831
  • M a B 39831
  • Gliotem
  • Temizol

Undergo dose-escalated and -intensified proton beam radiation therapy

Ostatní jména:
  • Protonová radiační terapie
  • PBRT
  • Proton
  • Protonová EBRT
  • Protonová externí radioterapie
  • Záření, protonový paprsek
  • PROTONOVÁ terapie
  • Protony radiační terapie zevním paprskem (postup)
  • Externí radioterapie (protony)

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Median Survival Time (Within Center Group)
Časové okno: Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.

Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers). Median survival times were estimated using the Kaplan-Meier method, censoring participants alive at the time of analysis. Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers)

Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Median Survival Time (Between Experimental Arms)
Časové okno: Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.

Per the protocol, this outcome measure would be addressed only if both experimental (intensified RT) arms were statistically significantly different from their respective control (standard RT) arms, as defined in the primary outcome measure. If that condition were satisfied, the experimental (intensified RT) arms from each group would be compared with each other. Median survival times would be estimated using the Kaplan-Meier method, censoring participants alive at the time of analysis.

Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.
Median Progression-free Survival Time
Časové okno: Randomization to progression, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.

Progression is defined as any of the following: ≥25% increase in sum of the products of perpendicular diameters of enhancing lesions; any new lesion; or clinical deterioration, with the treating institution encouraged to differentiate progression from pseudoprogression and radionecrosis using surgical resection, biopsy, and alternative imaging accordingly. Median progression-free survival times were estimated using the Kaplan-Meier method, censoring participants alive at the time of analysis. Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers).

Randomization to progression, death, or last follow-up, whichever occurs first. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.
Proportion of Participants With a Grade 3 or Higher Adverse Event
Časové okno: Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.

Common Terminology Criteria for Adverse Events (version 4.0) grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. Proportions were estimated using an exact binomial distribution. Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers)

Randomization to death or last follow-up. Median follow-up at time of analysis was 16.2 months for Group 1 and 18.3 months for Group 2.
Change From Baseline in the M.D. Anderson Symptom Inventory Brain Tumor (MDASI-BT) Cognitive Factor Score After Cycle 3
Časové okno: Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)

The MD Anderson Symptom Inventory for brain tumor (MDASI-BT) is a 28-item multi-symptom patient-reported outcome measure assessing the severity of symptoms experienced by cancer patients and the interference with daily living caused by these symptoms, with 9 items specific to brain tumors. Each item ranges from 0 (best condition) to 10 (worst condition). A subscale score (Cognitive Factor) is the average of the subscale items, given that a specified minimum numbers of items were completed. A score worse than baseline by at least one is considered deterioration. Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline. Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers).

Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)
Change From Baseline in the M.D. Anderson Symptom Inventory Brain Tumor (MDASI-BT) Cognitive Factor Score After Cycle 12
Časové okno: Baseline and end of cycle 12 of adjuvant temozolomide (approximately 60 weeks after start of chemoradiation)

The MD Anderson Symptom Inventory for brain tumor (MDASI-BT) is a 28-item multi-symptom patient-reported outcome measure assessing the severity of symptoms experienced by cancer patients and the interference with daily living caused by these symptoms, with 9 items specific to brain tumors. Each item ranges from 0 (best condition) to 10 (worst condition). A subscale score (Cognitive Factor) is the average of the subscale items, given that a specified minimum numbers of items were completed. A score worse than baseline by at least one is considered deterioration. Change is calculated as time point - baseline such that a positive change value indicates worse symptoms compared to baseline. Comparisons occur between standard vs. intensified RT arms within group (Group 1: photon IMRT centers; Group 2: proton centers).

Baseline and end of cycle 12 of adjuvant temozolomide (approximately 60 weeks after start of chemoradiation)
Change From Baseline in the Clinical Trial Battery Composite Standardized Score at End of Cycle 3
Časové okno: Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)

The Clinical Trial Battery Composite Standardized Score is calculated as the arithmetic mean of multiple standardized neurocognitive test scores assessing memory, processing speed, executive function, and verbal fluency. Scores are standardized (z-scores) adjusted for age, education, and gender, with a mean of 0 and standard deviation of 1. A participant must have the majority of component scores available to calculate the composite. Possible scores are standardized z-scores that typically range from approximately -3 to +3, with higher scores indicating a better outcome. Change is calculated as time point minus baseline such that a positive change value indicates improvement and a negative change value indicates decline. Comparisons are made between standard-dose and intensified radiation therapy arms within group (Group 1: photon IMRT centers; Group 2: proton centers).

Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)
Change From Baseline in the Clinical Trial Battery Composite Standardized Score at End of Cycle 12
Časové okno: Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)

The Clinical Trial Battery Composite Standardized Score is calculated as the arithmetic mean of multiple standardized neurocognitive test scores assessing memory, processing speed, executive function, and verbal fluency. Scores are standardized (z-scores) adjusted for age, education, and gender, with a mean of 0 and standard deviation of 1. A participant must have the majority of component scores available to calculate the composite. Possible scores are standardized z-scores that typically range from approximately -3 to +3, with higher scores indicating a better outcome. Change is calculated as time point minus baseline such that a positive change value indicates improvement and a negative change value indicates decline. Comparisons are made between standard-dose and intensified radiation therapy arms within group (Group 1: photon IMRT centers; Group 2: proton centers).

Baseline and end of cycle 3 of adjuvant temozolomide (approximately 24 weeks after start of chemoradiation)

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
CD4 Lymphopenia Count
Časové okno: Baseline to up to 5 years

Mean CD4 lymphopenia count change from baseline to each follow-up collection timepoint.

Baseline to up to 5 years
Use of Magnetic Resonance Diffusion and Perfusion Imaging to Differentiate Between Tumor Progression and Pseudo-progression
Časové okno: Baseline - cycle 4

Will be determined retrospectively following central review by an experienced neuro-radiologist blinded to the patient's outcome.

Baseline - cycle 4
Use of Magnetic Resonance Diffusion and Perfusion Imaging as Early Predictors of Overall Survival
Časové okno: Baseline up to 12 months

Cox proportional hazard model will be used to analyze the effect of imaging markers on overall survival. Known prognostic factors and patient baseline characteristics will be included in the multivariate analyses as covariates.

Baseline up to 12 months

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Vrchní vyšetřovatel: Minesh P Mehta, NRG Oncology

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

4. prosince 2014

Primární dokončení (Aktuální)

7. července 2025

Dokončení studie (Odhadovaný)

7. července 2030

Termíny zápisu do studia

První předloženo

27. června 2014

První předloženo, které splnilo kritéria kontroly kvality

27. června 2014

První zveřejněno (Odhadovaný)

1. července 2014

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

1. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

9. září 2026

Naposledy ověřeno

1. září 2026

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

ANO

Popis plánu IPD

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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