Spectroscopic MRI Guided Proton Therapy in Assessing Metabolic Change in Pediatric Patients With Brain Tumors

NCT ID: NCT04908709

Last Updated: 2024-11-08

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

RECRUITING

Clinical Phase

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-20

Study Completion Date

2030-10-13

Brief Summary

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This trial studies how well spectroscopic magnetic resonance imaging (MRI) guided proton therapy works in assessing metabolic change in pediatric patients with brain tumors. The non-invasive imaging, such as spectroscopic MRI may help to map the differences in tumor metabolism compared to healthy tissue without injection of any contrast agent.

Detailed Description

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PRIMARY OBJECTIVES:

I. To obtain spectroscopic (s)MRI data from pediatric high grade glioma (HGG) patients before receiving standard of care radiation therapy (RT) and correlate baseline Cho/NAA ratios to recurrence patterns. (Cohort 1, observational) II. To assess the feasibility and safety of using sMRI to define proton therapy high dose (60Gy) target volumes for treatment delivery. (Cohort 2, intervention)

SECONDARY OBJECTIVES:

I. To evaluate how Cho/NAA defined radiation target volumes compare to standard of care radiation target volumes in size and resulting radiation delivery to adjacent normal tissue, by creating mock comparison RT plans for each patient.

II. To compare voxel-to-voxel changes in pre-treatment and post-treatment sMRI and evaluate as potential early predictor of tumor response/recurrence.

III. To evaluate sMRI as a tool in identifying pseudoprogression vs. true progression and correlate post-treatment sMRI metabolite ratios with histopathology if collected.

IV. To report patterns of failure in relationship to the RT field (local, marginal, or distant), progression-free survival (PFS) and overall survival (OS) among all patients.

V. To report patient reported outcomes of health related quality of life (QOL) during and after proton therapy for pediatric HGG.

VI. To build a longitudinal tracking database including clinical data, imaging, and genomic molecular profiling for pediatric HGG treatment.

OUTLINE:

Patients undergo sMRI prior to radiation therapy, at 1, 4, and 7 months after RT, and at the time of suspected recurrence.

Conditions

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Malignant Brain Glioma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Diagnostic (sMRI)

Patients undergo sMRI over less than 1 hour within 7 days prior to start of standard of care radiation therapy and at 10 weeks.

Group Type EXPERIMENTAL

Magnetic Resonance Spectroscopic Imaging

Intervention Type PROCEDURE

Undergo sMRI

Proton Therapy

Intervention Type DEVICE

Target volume treatment

Group 2

Patients will undergo 3-4 sMRI scans at baseline prior to RT, 1 month, 4 months, and 7 months after RT, and/or at any time of suspected tumor recurrence.

Group Type ACTIVE_COMPARATOR

Magnetic Resonance Spectroscopic Imaging

Intervention Type PROCEDURE

Undergo sMRI

Proton Therapy

Intervention Type DEVICE

Target volume treatment

Interventions

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Magnetic Resonance Spectroscopic Imaging

Undergo sMRI

Intervention Type PROCEDURE

Proton Therapy

Target volume treatment

Intervention Type DEVICE

Other Intervention Names

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1H- Nuclear Magnetic Resonance Spectroscopic Imaging 1H-nuclear magnetic resonance spectroscopic imaging Magnetic Resonance Spectroscopy MRS MRS Imaging MRSI Proton Magnetic Resonance Spectroscopic Imaging Spectroscopic MRI Proton Radiation Therapy sMRI imaging Magnetic Resonance Spectroscopy 3D whole brain MR spectroscopic imaging sequence

Eligibility Criteria

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Inclusion Criteria

* Pathologically diagnosed high-grade glioma (World Health Organization \[WHO\] grade 3-4). Patients with a radiographically diagnosed high-grade glioma may enroll prior to pathologic confirmation, but would be removed from study if pathology did not confirm the diagnosis of high-grade glioma.
* Primary tumor located within the supratentorial brain.
* Recommended to receive definitive radiation therapy.
* Able to receive MRI scans.
* Both males and females, and members of all races and ethnic groups are eligible for this trial.

Exclusion Criteria

* Patients with pacemakers, non-titanium aneurysm clips, neurostimulators, cochlear implants, non-titanium metal in ocular structures, or other incompatible implants which makes MRI safety an issue are excluded.
* Patients that have any significant medical illnesses that in the investigator's opinion cannot be adequately tolerate MRI scan are excluded.
* Pathology demonstrated low-grade glioma or other benign or non-invasive brain tumor.
Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

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Bree Eaton

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bree R Eaton, MD

Role: PRINCIPAL_INVESTIGATOR

Emory University Hospital/Winship Cancer Institute

Locations

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Emory Proton Therapy Center

Atlanta, Georgia, United States

Site Status RECRUITING

Children's Healthcare of Atlanta - Scottish Rite

Atlanta, Georgia, United States

Site Status NOT_YET_RECRUITING

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Bree Eaton, MD

Role: CONTACT

404-778-3473

Facility Contacts

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Ardith R. DeShay

Role: primary

404-251-0753

Christina Lomba

Role: primary

404-785-4803

Hillary Gaines

Role: primary

Other Identifiers

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NCI-2018-02065

Identifier Type: REGISTRY

Identifier Source: secondary_id

IRB00106849

Identifier Type: -

Identifier Source: secondary_id

RAD4500-18

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA138292

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00106849

Identifier Type: -

Identifier Source: org_study_id

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