Anaplastic Astrocytoma, Glioblastoma Multiforme, Radiotherapy
Conditions
Brief summary
Glioblastoma is the most common malignant brain tumor in adults. The primary treatment consists of maximal tumor removal followed by radiotherapy (RT) with concomitant and adjuvant temozolomide. Tumor recurrence after chemoradiotherapy has previously been shown to be predominantly within or at the margin of the irradiated volume, but distant failure are not rare, especially in patients with MGMT methylation.Traditionally, RT has been planned based on on planning CT with co-registered postoperative MRI, with the addition of a clinical target volume margin of 2-3 cm to account for infiltrative odema. To better characterize the disease, more specific physiological and/or metabolical markers of tumor cells, vascularization and hypoxia measured on multiparametric MRI as perfusion, diffusion and spectroscopy alongside with PET tracer like Fluoroéthyl-L-tyrosine (\[18F\]-FET) are now available and suggest that aggressive areas, like uptake of PET tracer and vascularity are present outside areas of contrast enhancement usually irradiated. These informations could be incorporated to optimize the treatment of radiotherapy.
Interventions
None listed
Sponsors
University Hospital, Brest
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 Years or older * Histologically confirmed newly diagnosed glioblastoma or anaplastic astrocytoma * Patients must have undergone surgery with macroscopic complete resection or incomplete resection with residual disease less than 5 cm on MRI * An MRI or a scan 48h after surgery should be available * WHO ≤ 2 * Indication for adjuvant radiotherapy * Surgery must have been performed 45 days before the start of radiotherapy. * Ability to understand and to give consent
Exclusion criteria
* Age \< 18 Years. * Prior radiation therapy to the brain * Any usual formal indication against MRI (claustrophobia, metallic objects or implanted medical devices in body: pacemaker, clips, prostheses ...) * Allergic reaction to FET * Pregnant women or nursing mothers * Refusal to use effective contraception at study entry and throughout the study if patient is of childbearing age.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Target volumes contoured on standard MRI and planning CT, FET-PET and multiparametric MRI images | 12 months | Increase in at least 10% of irradiation target volumes compared to the result of the MRI+scanner reference technique. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Treatment failure pattern in respect to the target volume based on standard MRI, multiparametric MRI and FET-PET. | 12 months | Irradiation target volumes associated with standard MRI |
| Sites of failures with composite and standard MRI based RT planning | 12 months | Irradiation target volumes associated with standard MRI based RT planning |
| Progression-free Survival | 12 months | — |
Countries
France
Contacts
Primary ContactUlrick SCHICK
Outcome results
None listed