SIMPLIFication of Care Pathways for Patients with Rare Brain Tumors Through Artificial Intelligence

NCT ID: NCT06878469

Last Updated: 2025-03-17

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

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-27

Study Completion Date

2026-07-31

Brief Summary

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This study focuses on rare brain tumors, which are heterogeneous entities with different morphological, biological, and clinical characteristics. Due to their rarity, many of these tumors fall under the RARECARE definition of rare tumors. The main objective of the study is to standardize care models and pathways for patients with rare brain tumors, using Artificial Intelligence (AI) and Machine Learning (ML) techniques to identify specific predictors of postoperative outcomes.

The study includes both retrospective and prospective phases, with the collection of clinical, cognitive, and psychological data at various time points. Patients will undergo an early neuro-cognitive rehabilitation program using the RehaCom software, which will be conducted at home. The goal is to improve the quality of life and care for patients through a multidisciplinary and innovative approach.

Detailed Description

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Participants will be adults with rare brain tumors and will be enrolled at two neurosurgery centers in Italy. The study aims to create a network of professionals specialized in predicting surgical outcomes, thereby improving the overall quality of care and the quality of life for patients.

This study aims to improve the care and outcomes for patients with rare brain tumors (rBT) by standardizing clinical pathways and utilizing advanced technologies such as Artificial Intelligence (AI) and Machine Learning (ML). Rare brain tumors, including astrocytomas, oligodendrogliomas, neuronal tumors, malignant meningiomas, and embryonal tumors, are defined as rare due to their low incidence (\<6 cases per 100,000 people/year).

The study will be conducted in two phases: a retrospective phase and a prospective phase. The retrospective phase will involve the use of existing neurosurgical databases to implement ML algorithms. The prospective phase will include the collection of clinical, cognitive, and psychological data at multiple time points (pre-surgery, discharge, 3 months post-surgery, and 12 months post-surgery).

Patients will participate in an early neuro-cognitive rehabilitation program using the RehaCom software, designed to enhance cognitive functions potentially affected by surgery. The rehabilitation will be conducted at the patient's home.

The primary objective is to develop a common evaluation protocol that includes clinical, cognitive, psychological, and sociodemographic measures. Secondary objectives include identifying predictors of surgical outcomes through retrospective and prospective studies and developing predictive models for rare brain tumors.

The study will enroll approximately 200 adult patients from two neurosurgery centers in Italy. Inclusion criteria include adults (≥18 years) undergoing craniotomy for rare brain tumors, while exclusion criteria include patients undergoing stereotactic biopsy, those with psychiatric disorders, or those lacking the necessary technology for home-based rehabilitation.

The ultimate goal is to create a multidisciplinary network of professionals specialized in predicting surgical outcomes, thereby improving the overall quality of care and the quality of life for patients with rare brain tumors.

Conditions

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Brain Tumors

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This group includes all adult participants with rare brain tumors who will receive early neuro-cognitive rehabilitation using the RehaCom software.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Single Group

This group includes all adult participants with rare brain tumors who will receive early neuro-cognitive rehabilitation using the RehaCom software.

Group Type EXPERIMENTAL

RehaCom

Intervention Type DEVICE

Participants will receive a personalized neuro-cognitive rehabilitation program using the RehaCom software. Sessions will last approximately 30/40 minutes and will be held twice a week for 8 weeks. The rehabilitation will be aimed at enhancing and/or recovering cognitive functions that may have been compromised by the neurosurgical intervention.

Interventions

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RehaCom

Participants will receive a personalized neuro-cognitive rehabilitation program using the RehaCom software. Sessions will last approximately 30/40 minutes and will be held twice a week for 8 weeks. The rehabilitation will be aimed at enhancing and/or recovering cognitive functions that may have been compromised by the neurosurgical intervention.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adults (age ≥18 years)
* Both sexes
* Patients with rare brain tumors (incidence \<6 cases per 100,000 people/year)
* Candidates for craniotomy for rare brain tumors
* Native Italian speakers for cognitive and psychological evaluation and neuro-cognitive rehabilitation

Exclusion Criteria

* Patients undergoing stereotactic/frameless biopsy
* Patients with psychiatric disorders or on psychotropic medications
* Patients with known cognitive decline (not due to the lesion)
* Patients admitted on the same day as the surgery
* Patients with severe impairments referred to rehabilitation centers
* Patients without a Windows PC or laptop with Internet connection for neuro-cognitive rehabilitation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ASL 1 Avezzano Sulmona L'Aquila

OTHER

Sponsor Role collaborator

Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Paolo Ferroli, MD

Role: PRINCIPAL_INVESTIGATOR

Fondazione IRCCS Istituto Neurologico Carlo Besta

Alessandro Ricci, MD

Role: PRINCIPAL_INVESTIGATOR

ASL 1 Abruzzo Avezzano-Sulmona-L'Aquila

Locations

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Fondazione IRCCS Istituto Neurologico Carlo Besta

Milan, PA, Italy

Site Status RECRUITING

ASL 1 Abruzzo Avezzano-Sulmona-L'Aquila

L’Aquila, , Italy

Site Status NOT_YET_RECRUITING

Countries

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Italy

Central Contacts

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GIORGIA CAMARDA, Master's degree

Role: CONTACT

+23 02 2394 ext. 2949

Facility Contacts

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GIORGIA CAMARDA

Role: primary

02 2394 ext. 2949

Alessandro Ricci, MD

Role: primary

+ 02 2394 ext. 2949

References

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Fan FL, Xiong J, Li M, Wang G. On Interpretability of Artificial Neural Networks: A Survey. IEEE Trans Radiat Plasma Med Sci. 2021 Nov;5(6):741-760. doi: 10.1109/trpms.2021.3066428. Epub 2021 Mar 17.

Reference Type BACKGROUND
PMID: 35573928 (View on PubMed)

Sagberg LM, Drewes C, Jakola AS, Solheim O. Accuracy of operating neurosurgeons' prediction of functional levels after intracranial tumor surgery. J Neurosurg. 2017 Apr;126(4):1173-1180. doi: 10.3171/2016.3.JNS152927. Epub 2016 Jun 17.

Reference Type BACKGROUND
PMID: 27315026 (View on PubMed)

Lopez-Nunez O, Alaggio R, John I, Ciolfi A, Pedace L, Mastronuzzi A, Gianno F, Giangaspero F, Rossi S, Donofrio V, Cinalli G, Surrey LF, Tartaglia M, Locatelli F, Miele E. Melanotic Neuroectodermal Tumor of Infancy (MNTI) and Pineal Anlage Tumor (PAT) Harbor A Medulloblastoma Signature by DNA Methylation Profiling. Cancers (Basel). 2021 Feb 9;13(4):706. doi: 10.3390/cancers13040706.

Reference Type BACKGROUND
PMID: 33572349 (View on PubMed)

Bunevicius A, Tamasauskas S, Deltuva V, Tamasauskas A, Radziunas A, Bunevicius R. Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective. Acta Neurochir (Wien). 2014 Feb;156(2):367-74. doi: 10.1007/s00701-013-1930-7. Epub 2013 Nov 20.

Reference Type BACKGROUND
PMID: 24254135 (View on PubMed)

Rolston JD, Han SJ, Lau CY, Berger MS, Parsa AT. Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011. J Neurosurg. 2014 Mar;120(3):736-45. doi: 10.3171/2013.10.JNS122419. Epub 2013 Nov 22.

Reference Type BACKGROUND
PMID: 24266542 (View on PubMed)

Broggi M, Zattra C, Ferroli P. How to compare outcomes and complications in neurosurgery: We must make the mission possible! Surg Neurol Int. 2018 Mar 19;9:65. doi: 10.4103/sni.sni_424_17. eCollection 2018. No abstract available.

Reference Type BACKGROUND
PMID: 29629232 (View on PubMed)

Ferroli P, Broggi M, Schiavolin S, Acerbi F, Bettamio V, Caldiroli D, Cusin A, La Corte E, Leonardi M, Raggi A, Schiariti M, Visintini S, Franzini A, Broggi G. Predicting functional impairment in brain tumor surgery: the Big Five and the Milan Complexity Scale. Neurosurg Focus. 2015 Dec;39(6):E14. doi: 10.3171/2015.9.FOCUS15339.

Reference Type BACKGROUND
PMID: 26621412 (View on PubMed)

Senders JT, Staples PC, Karhade AV, Zaki MM, Gormley WB, Broekman MLD, Smith TR, Arnaout O. Machine Learning and Neurosurgical Outcome Prediction: A Systematic Review. World Neurosurg. 2018 Jan;109:476-486.e1. doi: 10.1016/j.wneu.2017.09.149. Epub 2017 Oct 3.

Reference Type BACKGROUND
PMID: 28986230 (View on PubMed)

Schiavolin S, Raggi A, Scaratti C, Leonardi M, Cusin A, Visintini S, Acerbi F, Schiariti M, Zattra C, Broggi M, Ferroli P. Patients' reported outcome measures and clinical scales in brain tumor surgery: results from a prospective cohort study. Acta Neurochir (Wien). 2018 May;160(5):1053-1061. doi: 10.1007/s00701-018-3505-0. Epub 2018 Mar 3.

Reference Type BACKGROUND
PMID: 29502163 (View on PubMed)

Reponen E, Tuominen H, Korja M. Evidence for the use of preoperative risk assessment scores in elective cranial neurosurgery: a systematic review of the literature. Anesth Analg. 2014 Aug;119(2):420-432. doi: 10.1213/ANE.0000000000000234.

Reference Type BACKGROUND
PMID: 25046789 (View on PubMed)

Other Identifiers

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PNRR-TR1-2023-12378146

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SIMPLIF-AI

Identifier Type: -

Identifier Source: org_study_id

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