Lymphoma
Conditions
Keywords
Positron-Emission Tomography, chemotherapy-induced brain damage, neuro-cognitive function alteration
Brief summary
Positron emission tomography (PET) with 18-fluoro-deoxy-glucose (PET-FDG) is emerging as a promising approach for detecting brain lesions in dementia, among which Alzheimer's disease has been the most widely studied.
Detailed description
Alteration of neuro-cognitive function induced by chemotherapy has been extensively documented in breast carcinoma patients. These modifications consist in the decrease of memory, intellectual capacity, speed analysis, and represent a real limitation for patients, sometimes durable. Aggressive lymphomas (diffuse large B cell lymphomas/DLBCL) represent a common disease, the standard being Rituximab-Cyclophosphamide-Doxorubicine-Vincristine-Prednisone (RCHOP) regiment which contains, as for breast cancer patients, anthracyclines. However, very little is known about the incidence and severity of cognitive function alteration in these patients. The occurrence of such complications should also be facilitated because of frail cognitive states due to age and co-morbidity. Cognitive function alteration is usually measured by neuropsychological tests (NPT) which are easy to handle and sensitive, but could lack specificity, in the context of general degradation which is often observed in hematological patients. Positron emission tomography with 18-fluoro-deoxy-glucose (PET-FDG) is emerging as a promising approach for detecting brain lesions in dementia, among which Alzheimer's disease has been the most widely studied. In our center, the investigators have already described glucidic hypometabolism in several brain territories associated with Alzheimer's disease and other dementia. Moreover, uptake quantification and topography are useful markers for determining the type of the disease and progression. PET-FDG received very little attention for the detection of chemotherapy-induced brain damages.
Interventions
DEVICEPET-FDG brain imaging and NPT
PET-FDG brain imaging and NPT should be performed at T0, at Tf (within 1 month after chemotherapy termination), T+12. Several PET parameters should be calculated: minimal SUV (Standard Uptake Value), maximum SUV, and mean SUV for each of 20 cortical and sub-cortical territories.
Sponsors
University Hospital, Toulouse
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* histologically documented DLBCL * previously untreated * with International Prognostic Index (IPI) 0 or 1, or 2 without general state alteration (OMS≤2) * submitted to RCHOP regimen (according to GELA's standard protocol) * normal pre-treatment brain CT scan * able to give informed consent * speaking well French language * benefiting from general medical insurance * registered in the national listing of patients for biomedical research.
Exclusion criteria
* IPI \> or =3 * medical history of another cancer, or psychiatric or pre-dementia disorder, or convulsion * barbituric regular use which can't be stop * human immunodeficiency virus (HIV) patients * unstable diabetes mellitus * pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change of Standard Uptake Value | 1 month after chemotherapy termination |
Secondary
| Measure | Time frame |
|---|---|
| change of functional learning test (WAIS) | 1 month after chemotherapy termination |
| change of depression scale | 1 month after chemotherapy termination |
Countries
France
Outcome results
None listed