Natural History of Brain Function, Quality of Life, and Seizure Control in Patients With Brain Tumor Who Have Undergone Surgery

NCT ID: NCT01417507

Last Updated: 2015-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

82 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-10-31

Study Completion Date

2014-12-31

Brief Summary

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This trial studies the natural history of brain function, quality of life, and seizure control in patients with brain tumor who have undergone surgery. Learning about brain function, quality of life, and seizure control in patients with brain tumor who have undergone surgery may help doctors learn more about the disease and find better methods of treatment and on-going care.

Detailed Description

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PRIMARY OBJECTIVES:

I. To determine if there is difference in the average changes of neurocognitive function (NCF) scores from baseline to the time of radiologic tumor progression or up to 5 years (whichever occurs first), between radiologically progressed and non-progressed patients.

SECONDARY OBJECTIVES:

I. To determine if there is difference in the time to neurocognitive decline, as defined by the Reliable Change Index - Within subjects Standard Deviation (RCI-WSD), between radiologically progressed and non-progressed patients.

II. To evaluate NCF during the postoperative observational period of progression-free survival (PFS) and after radiological progression for a total time on study of 5 years.

III. To determine if the changes in cognitive functioning are an early warning biomarker for radiological progression.

IV. To explore the effect of salvage therapy on cognitive outcomes in patients who progress during the study period for up to 5 years.

V. To evaluate quality-of-life (QOL) as measured by the European Organization for Research and Treatment of Cancer (EORTC) QOL-30 and QOL brain module (BCN20) and health utilities as measured by the European Quality of Life-5 Dimensions (EQ-5D), for a total time on study of 5 years.

VI. To evaluate seizure control for a total time on study of 5 years. VII. To evaluate molecular correlates of QOL, NCF, seizure control, and PFS. VIII. To characterize aberrant molecular pathways in low-grade gliomas (LGGs) and test the hypothesis that activation of signaling pathways will predict worse PFS and overall survival (OS).

IX. To explore the relationship between change in cognitive function and symptomatic progression (defined as worsening seizures or new or progressive neurologic deficits) or clinical progression (defined as initiation of treatment interventions such as radiotherapy, chemotherapy, or additional surgery).

OUTLINE:

Patients undergo neurocognitive assessment using the CogState Test battery (the Detection Test (DET), the Identification Test (IDN), the One Card Learning Test (OCLT), and the Groton Maze Learning Test (GMLT)) at baseline\* and at 12, 24, 36, 42, 48, 54, and 60 months. Patients also complete the EORTC Quality of Life Questionnaire-Core 30 (QOL-30), the Brain Cancer Module-20 (BCM20), and the European Quality of Life-5 Dimensions (EQ-5D) questionnaires at baseline\*, at 12, 24, 36, 48, and 60 months afterwards, and before undergoing any further treatment. Patients are instructed to complete a seizure and medication diary during study.

Patients undergo MRI scans at baseline\*, at 12, 24, 36, 48, and 60 months, and at the time of radiological, clinical, or neurological failure.

NOTE: \* 12 weeks after surgery.

Conditions

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Adult Diffuse Astrocytoma Adult Mixed Glioma Adult Oligodendroglioma Cognitive/Functional Effects Neurotoxicity Psychosocial Effects of Cancer and Its Treatment Seizure

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Supportive care (neurocognitive assessment and MRI)

Patients undergo neurocognitive assessment using the CogState Test battery (the DET, the IDN, the OCLT, and the GMLT) at baseline\* and at 12, 24, 36, 42, 48, 54, and 60 months. Patients also complete the EORTC QOL-30, the BCM20, and the EQ-5D questionnaires at baseline\*, at 12, 24, 36, 48, and 60 months afterwards, and before undergoing any further treatment. Patients are instructed to complete a seizure and medication diary during study.

Patients undergo MRI scans at baseline\*, at 12, 24, 36, 48, and 60 months, and at the time of radiological, clinical, or neurological failure.

cognitive assessment

Intervention Type PROCEDURE

Undergo neurocognitive assessment

magnetic resonance imaging

Intervention Type PROCEDURE

Undergo MRI

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

questionnaire administration

Intervention Type OTHER

Ancillary studies

quality-of-life assessment

Intervention Type PROCEDURE

Ancillary studies

Interventions

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cognitive assessment

Undergo neurocognitive assessment

Intervention Type PROCEDURE

magnetic resonance imaging

Undergo MRI

Intervention Type PROCEDURE

laboratory biomarker analysis

Correlative studies

Intervention Type OTHER

questionnaire administration

Ancillary studies

Intervention Type OTHER

quality-of-life assessment

Ancillary studies

Intervention Type PROCEDURE

Other Intervention Names

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MRI NMR imaging NMRI nuclear magnetic resonance imaging quality of life assessment

Eligibility Criteria

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Inclusion Criteria

* Central pathology confirmed diagnosis of supratentorial grade II oligodendroglioma, astrocytoma, or mixed oligoastrocytoma prior to step 2 registration
* No multifocal disease, based upon the following minimum diagnostic work-up:

* History/physical examination, including neurologic examination, within 84 days prior to step 2 registration
* Brain MRI with and without contrast within 84 days prior to Step 2 registration (Note: MRI 70 days after surgery is preferred and highly encouraged)
* The patient must be within one of the following categories:

* Maximal safe resection with minimal residual disease defined as follows:

* Removal of T2/fluid-attenuated inversion recovery (FLAIR) abnormalities thought to be primarily tumor, with a residual ≤ 2 cm maximal tumor diameter/T2 FLAIR abnormality on MRI to be done within 84 days post-operatively
* If there is \> 2 cm post-operative residual T2/FLAIR abnormality and the neurosurgeon believes this represents edema and not primarily tumor, the neurosurgeon is encouraged to repeat imaging within the allowed study period (up to 84 days post-operatively) to confirm resolution of edema

* MRI at the time of enrollment must document a ≤ 2 cm residual maximal tumor diameter/T2 FLAIR abnormality
* Patients who required a second surgery to obtain a maximal safe resection will be eligible if the second surgery is performed within 84 days of the initial diagnostic procedure
* Age \< 40 (any extent of resection)
* Age \< 50 and preoperative tumor diameter \< 4 cm (any extent of resection)
* Karnofsky performance status ≥ 80%
* No 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)
* Must be able to undergo MRI of the brain with gadolinium
* No plans for adjuvant radiotherapy or chemotherapy after surgery
* No more than 84 days (12 weeks) since prior surgery
* No brain tumor recurrence
* No prior brain tumor surgery, radiation therapy and/or chemotherapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

NRG Oncology

OTHER

Sponsor Role collaborator

Radiation Therapy Oncology Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ali Choucair

Role: PRINCIPAL_INVESTIGATOR

Radiation Therapy Oncology Group

Locations

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The Kirklin Clinic at Acton Road

Birmingham, Alabama, United States

Site Status

University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Providence Hospital

Mobile, Alabama, United States

Site Status

Arizona Oncology Services Foundation

Phoenix, Arizona, United States

Site Status

Arizona Oncology-Deer Valley Center

Phoenix, Arizona, United States

Site Status

Mayo Clinic in Arizona

Scottsdale, Arizona, United States

Site Status

Christiana Care Health System-Christiana Hospital

Newark, Delaware, United States

Site Status

Florida Hospital

Orlando, Florida, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

Queen's Medical Center

Honolulu, Hawaii, United States

Site Status

University of Hawaii

Honolulu, Hawaii, United States

Site Status

Hawaii Medical Center East

Honolulu, Hawaii, United States

Site Status

Leeward Radiation Oncology Center

‘Ewa Beach, Hawaii, United States

Site Status

Evanston CCOP-NorthShore University HealthSystem

Evanston, Illinois, United States

Site Status

Covenant Medical Center

Waterloo, Iowa, United States

Site Status

Norton Health Care Pavilion - Downtown

Louisville, Kentucky, United States

Site Status

Norton Suburban Hospital

Louisville, Kentucky, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Barnes West County Hospital

St Louis, Missouri, United States

Site Status

Billings Clinic

Billings, Montana, United States

Site Status

The Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, United States

Site Status

Geisinger Medical Center

Danville, Pennsylvania, United States

Site Status

Adams Cancer Center

Gettysburg, Pennsylvania, United States

Site Status

Cherry Tree Cancer Center

Hanover, Pennsylvania, United States

Site Status

Penn State Milton S Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Radiation Therapy Oncology Group

Philadelphia, Pennsylvania, United States

Site Status

York Hospital

York, Pennsylvania, United States

Site Status

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah, United States

Site Status

Saint Vincent Hospital

Green Bay, Wisconsin, United States

Site Status

Saint Mary's Hospital

Green Bay, Wisconsin, United States

Site Status

Community Memorial Hospital

Menomonee Falls, Wisconsin, United States

Site Status

Froedtert and the Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Waukesha Memorial Hospital

Waukesha, Wisconsin, United States

Site Status

London Regional Cancer Program

London, Ontario, Canada

Site Status

McGill University Department of Oncology

Montreal, Quebec, Canada

Site Status

Countries

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United States Canada

Other Identifiers

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NCI-2011-02982

Identifier Type: REGISTRY

Identifier Source: secondary_id

CDR0000708271

Identifier Type: -

Identifier Source: secondary_id

U10CA037422

Identifier Type: NIH

Identifier Source: secondary_id

View Link

RTOG 0925

Identifier Type: -

Identifier Source: org_study_id

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