Low Grade Gliomas
Conditions
Keywords
proton radiation therapy, photon radiation therapy
Brief summary
In this research study, we are looking to study the side effects from the use of proton radiation in treating people with low-grade gliomas that are recommended radiation treatment. We expect response of the tumors to be the same with proton radiation as compared to standard 3D conformal radiation therapy, but also expect less side effects from radiation.
Detailed description
* Participants will receive radiation therapy for 6 weeks, given in daily doses, Monday through Friday, for a total of 30 treatments. * A medical history and physical examination will be performed prior to the start of radiation treatment, weekly during the 6 weeks of radiation and after the finish of radiation performed at 3 and 6 months and then annually for 5 years. * Hormonal function tests will be taken prior to the start of radiation treatment and after the finish of radiation treatment at 3 and 6 months, and annually for five years to assess the participants hormonal functions as they relate to the pituitary gland's function. * A brain MRI will be performed prior to the start of radiation treatment and then performed at 3 and 6 months after radiation treatment then annually for 5 years. * A neurocognitive exam will be performed prior to the start of radiation therapy, a limited exam 6 months after the completion of radiation therapy, and a complete exam annually for 5 years. * Quality of Life and Emotional Well-Being Questionnaires will be done before radiation begins, 2 months after radiation treatment, 6 months after radiation treatment and then annually for 5 years.
Interventions
RADIATIONProton Radiation Therapy
Once daily, Monday through Friday, for 6 weeks.
Sponsors
National Cancer Institute (NCI)
Massachusetts General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically confirmed low-grade gliomas, WHO classification II/IV or equivalent low grade histology, including protoplasmic, fibrillary, gemistocytic astrocytomas, and mixed variants such as oligoastrocytomas * Must have at least one of: (1) progressive or recurrent disease as defined by imaging, (2) persistence or progression of debilitating neurological symptoms, or (3) at risk of early progression as defined by either (a) age of 40 or older or (b) MIB-1 of 3% or greater * KPS of 70 or greater * 18 years of age or older * Surgical and medical/chemotherapeutic interventions are per physician's discretion and are acceptable * Must be able to speak and comprehend English
Exclusion criteria
* Other baseline neurocognitive or emotional disorders or deficits, including but not limited to head injury, CVA, TIA, or other cerebral insults with residual neuropsychiatric deficits, psychiatric disorders, learning disabilities, HIV positivity or other medical conditions at high risk of causing neurocognitive decline or emotional instability * Prior history of cranial irradiation * Pregnancy at the time of radiation treatment * Unable to undergo MRI scans (e.g., embedded ferromagnetic metal or pacemakers) * Comorbid illness or reason to suggest a life expectancy of less than 5 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of Participants With Late Effects > 3 Months Post RT | 5 years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Progression Free Survival | At 1, 3, and 5 years | Clinical and/or radiographic assessments Percentages were estimated by Kaplan Meier |
| Percentage of Participants With Overall Survival | At 1, 3, and 5 years | Percentages were estimated by Kaplan Meier |
Countries
United States
Participant flow
Recruitment details
A large number of patients with brain tumors in the greater area are referred to one or more of the MGH multidisciplinary brain tumor specialists for evaluation and further care.
Participants by arm
| Arm | Count |
|---|---|
| Proton Radiation Therapy Proton radiation therapy daily (Monday through Friday) for six weeks. This is a single arm study. | 20 |
| Total | 20 |
Baseline characteristics
| Characteristic | Proton Radiation Therapy |
|---|---|
| Age, Continuous | 37.5 years |
| Region of Enrollment United States | 20 participants |
| Sex: Female, Male Female | 7 Participants |
| Sex: Female, Male Male | 13 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 20 / 20 |
| serious Total, serious adverse events | 0 / 20 |
Outcome results
Primary
Number of Participants With Late Effects > 3 Months Post RT
Time frame: 5 years
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Proton Radiation Therapy | Number of Participants With Late Effects > 3 Months Post RT | 20 Participants |
Secondary
Percentage of Participants With Overall Survival
Percentages were estimated by Kaplan Meier
Time frame: At 1, 3, and 5 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Proton Radiation Therapy | Percentage of Participants With Overall Survival | 1 Year | 100 % of participants |
| Proton Radiation Therapy | Percentage of Participants With Overall Survival | 3 Year | 95 % of participants |
| Proton Radiation Therapy | Percentage of Participants With Overall Survival | 5 Year | 84 % of participants |
Secondary
Percentage of Participants With Progression Free Survival
Clinical and/or radiographic assessments Percentages were estimated by Kaplan Meier
Time frame: At 1, 3, and 5 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Proton Radiation Therapy | Percentage of Participants With Progression Free Survival | 1 Year | 100 % of participants |
| Proton Radiation Therapy | Percentage of Participants With Progression Free Survival | 3 Year | 85 % of participants |
| Proton Radiation Therapy | Percentage of Participants With Progression Free Survival | 5 Year | 40 % of participants |