search
Back to results

The Clinical Trial of Low Dose Irradiation for Alzheimer's Disease (LDRT-AD-02)

Primary Purpose

Alzheimer Disease

Status
Recruiting
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Low-dose whole brain irradiation
Sponsored by
Kyung Hee University Hospital at Gangdong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring radiation therapy, Low-dose whole brain irradiation

Eligibility Criteria

60 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: All of the following criteria are satisfied for the subjects to be included in the study: Aged between 60 and 85 years. Diagnosed with probable Alzheimer's disease (AD) dementia based on the new diagnostic criteria for Alzheimer's disease outlined by the National Institute on Aging and Alzheimer's Association (NIA-AA). Stably maintaining the general AD drug treatment (donepezil, galantamine, rivastigmine, or memantine) for more than 3 months. Amyloid accumulation in brain confirmed by Amyloid PET. Mild AD (score range of 13 to 24 on the Korean Mini-Mental State Examination (K-MMSE) or 0.5 or 1 on the Clinical Dementia Rating scale (CDR)). Able to perform cognitive function tests and imaging tests. Accompanied by a guardian who provides information on the subject's overall status, cognitive function, and functional changes. Written informed consent was provided by the subject or the guardian to participate in this trial. Exclusion Criteria: Subjects who fall under any of the following criteria are excluded from the study: Previous history of radiation to the brain. History of seizure within the previous 10 years of the screening time. Skin disease on the scalp. Previous history of malignancy. Pregnancy or breastfeeding. Subjects with cognitive decline associated with drugs or neurological / neurodegenerative conditions, not AD (i.e., drug abuse, vitamin B12 deficiency, thyroid dysfunction, stroke or other cerebrovascular conditions, Lewy body dementia, frontotemporal dementia, and head trauma). Clinically significant, unstable mental illness (i.e., uncontrolled depression, schizophrenia, and bipolar disorder) within the last 6 months. Subjects whose brain MRI confirms evidence of: acute or subacute hemorrhage, prior macro hemorrhage (defined as >1 cm in diameter, T2 sequence) or prior subarachnoid hemorrhage unless it can be documented that the finding is not due to an underlying structural or vascular abnormality, more than 4 microhemorrhages, cortical infarct (defined as >1.5 cm in diameter, irrespective of anatomic location), >1 lacunar infarct (defined as >1.5 cm in diameter), superficial siderosis, and history of diffuse white matter disease as defined by a score of 3 on the age-related white matter changes scale. Any finding that, in the opinion of the investigator, might be a contributing cause of the subject's dementia, or pose a risk to the subject, or might prevent a satisfactory MRI assessment for safety monitoring are also included in the exclusion criteria. Those who have other findings that are considered clinically important, and those who are judged by the researcher to be inappropriate for participation in this study.

Sites / Locations

  • Kyung Hee University Hospital at GangdongRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Sham Comparator

Arm Label

Low-dose whole brain irradiation group 1 (4cGy/day)

Low-dose whole brain irradiation group 2 (50cGy/day)

Sham RT group

Arm Description

Low-dose whole brain irradiation with general AD medication treatment (4cGy/day, 2times/1wk, total 24cGy, 6 times/3wks)

Low-dose whole brain irradiation with general AD medication treatment (50cGy/day, 2times/1wk, total 300cGy, 6 times/3wks)

Sham RT wtih general AD medication treatment (0cGy/day, 2times/1wk, total 0cGy, 6 times/3wks)

Outcomes

Primary Outcome Measures

saftey and efficacy
1) Changes in cognitive function test score compared to baseline after six months are estimated using Alzheimer's disease assessment scale-Korea (ADAS-K) (range 0-70, higher scrores mean a worse outcome). The amount of change is evaluated as a valid response if it shows an improvement of 5% or more compared to the baseline score.
saftey and efficacy
2) Number of adverse events 6 months after baseline determined by the Radiation Therapy Oncology Group (RTOG) toxicity grading system.

Secondary Outcome Measures

Changes in cognitive function test score
If the cognitive function test such as Korean-Mini-Mental Status Examination (K-MMSE)(range 0-30, higher scrores mean a better outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Changes in cognitive function test score
If the cognitive function test such as Clinical Dementia Rating scale (CDR)(range 0-3, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Changes in cognitive function test score
If the cognitive function test such as Caregiver Administered-Neuropsychiatric Inventory (CGA-NPI)(range 0-144, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Changes in cognitive function test score
If the cognitive function test such as Korean Intstrumental Activities of Daily Living (K-iADL)(range 10-33, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Changes in the standardized uptake value ratio (SUVR)
Changes in the standardized uptake value ratio (SUVR) of the amyloid PET in the frontal, parietal, lateral temporal, anterior wedge lobe, and the posterior gyrus are evaluated. It was considered as an effective response if the change of SUVR shows an improvement of 5% or more 6 months after the completion of LDIR.

Full Information

First Posted
October 28, 2022
Last Updated
October 23, 2023
Sponsor
Kyung Hee University Hospital at Gangdong
Collaborators
Korea Hydro&Nuclear Power Radiation Health Institute, Chungbuk National University Hospital, SMG-SNU Boramae Medical Center
search

1. Study Identification

Unique Protocol Identification Number
NCT05635968
Brief Title
The Clinical Trial of Low Dose Irradiation for Alzheimer's Disease
Acronym
LDRT-AD-02
Official Title
The Multicenter Phase II Clinical Trial for Evaluation of Safety and Efficacy Using Low Dose Irradiation With Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 15, 2022 (Actual)
Primary Completion Date
April 15, 2024 (Anticipated)
Study Completion Date
April 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Kyung Hee University Hospital at Gangdong
Collaborators
Korea Hydro&Nuclear Power Radiation Health Institute, Chungbuk National University Hospital, SMG-SNU Boramae Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a phase II, multicenter, prospective, randomized controlled trial to treat patients with Alzheimer's disease (AD) using low-dose irradiation (LDIR). This study aims to evaluate the safety and efficacy of LDIR to whole brain in patients with AD and to determine the potentially applicable radiation dose.
Detailed Description
Screening tests, cognitive function tests, brain MRI, and amyloid PET are performed on subjects who voluntarily consent in writing to participate in the trial to determine whether they meet the inclusion/exclusion criteria. Randomization is assigned to eligible subjects. The experimental groups are irradiated six times for 3 weeks according to the radiation dose determined for each group, and the control group is irradiated with sham radiation. The patients assigned to the experimental group receive whole brain irradiation with 6 MV energy using a linear accelerator. In the experimental group (1), 20 patients receive 4cGy x 6 times, a total of 24 cGy of irradiation. In the experimental group (2), 20 patients receive 50 cGy x 6 times, a total of 300 cGy of irradiation. All experimental groups and control group visit the hospital about 1, 6, and 12 months after irradiation to evaluate efficacy and safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
radiation therapy, Low-dose whole brain irradiation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Masking Description
single blinded (subject)
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Low-dose whole brain irradiation group 1 (4cGy/day)
Arm Type
Experimental
Arm Description
Low-dose whole brain irradiation with general AD medication treatment (4cGy/day, 2times/1wk, total 24cGy, 6 times/3wks)
Arm Title
Low-dose whole brain irradiation group 2 (50cGy/day)
Arm Type
Experimental
Arm Description
Low-dose whole brain irradiation with general AD medication treatment (50cGy/day, 2times/1wk, total 300cGy, 6 times/3wks)
Arm Title
Sham RT group
Arm Type
Sham Comparator
Arm Description
Sham RT wtih general AD medication treatment (0cGy/day, 2times/1wk, total 0cGy, 6 times/3wks)
Intervention Type
Radiation
Intervention Name(s)
Low-dose whole brain irradiation
Intervention Description
In the experimental group (1), 20 patients receive 4cGy x 6 times, a total of 24 cGy of irradiation. In the experimental group (2), 20 patients receive 50 cGy x 6 times, a total of 300 cGy of irradiation. All experimental groups and control group visit the hospital about 1, 6, and 12 months after irradiation to evaluate efficacy and safety.
Primary Outcome Measure Information:
Title
saftey and efficacy
Description
1) Changes in cognitive function test score compared to baseline after six months are estimated using Alzheimer's disease assessment scale-Korea (ADAS-K) (range 0-70, higher scrores mean a worse outcome). The amount of change is evaluated as a valid response if it shows an improvement of 5% or more compared to the baseline score.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Title
saftey and efficacy
Description
2) Number of adverse events 6 months after baseline determined by the Radiation Therapy Oncology Group (RTOG) toxicity grading system.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Secondary Outcome Measure Information:
Title
Changes in cognitive function test score
Description
If the cognitive function test such as Korean-Mini-Mental Status Examination (K-MMSE)(range 0-30, higher scrores mean a better outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Title
Changes in cognitive function test score
Description
If the cognitive function test such as Clinical Dementia Rating scale (CDR)(range 0-3, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Title
Changes in cognitive function test score
Description
If the cognitive function test such as Caregiver Administered-Neuropsychiatric Inventory (CGA-NPI)(range 0-144, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Title
Changes in cognitive function test score
Description
If the cognitive function test such as Korean Intstrumental Activities of Daily Living (K-iADL)(range 10-33, higher scrores mean a worse outcome) showed an improvement of 5% or more after six months, it was evaluated as an effective response.
Time Frame
6 months after completion of low-dose irradiation to whole brain
Title
Changes in the standardized uptake value ratio (SUVR)
Description
Changes in the standardized uptake value ratio (SUVR) of the amyloid PET in the frontal, parietal, lateral temporal, anterior wedge lobe, and the posterior gyrus are evaluated. It was considered as an effective response if the change of SUVR shows an improvement of 5% or more 6 months after the completion of LDIR.
Time Frame
6 months after completion of low-dose irradiation to whole brain

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All of the following criteria are satisfied for the subjects to be included in the study: Aged between 60 and 85 years. Diagnosed with probable Alzheimer's disease (AD) dementia based on the new diagnostic criteria for Alzheimer's disease outlined by the National Institute on Aging and Alzheimer's Association (NIA-AA). Stably maintaining the general AD drug treatment (donepezil, galantamine, rivastigmine, or memantine) for more than 3 months. Amyloid accumulation in brain confirmed by Amyloid PET. Mild AD (score range of 13 to 24 on the Korean Mini-Mental State Examination (K-MMSE) or 0.5 or 1 on the Clinical Dementia Rating scale (CDR)). Able to perform cognitive function tests and imaging tests. Accompanied by a guardian who provides information on the subject's overall status, cognitive function, and functional changes. Written informed consent was provided by the subject or the guardian to participate in this trial. Exclusion Criteria: Subjects who fall under any of the following criteria are excluded from the study: Previous history of radiation to the brain. History of seizure within the previous 10 years of the screening time. Skin disease on the scalp. Previous history of malignancy. Pregnancy or breastfeeding. Subjects with cognitive decline associated with drugs or neurological / neurodegenerative conditions, not AD (i.e., drug abuse, vitamin B12 deficiency, thyroid dysfunction, stroke or other cerebrovascular conditions, Lewy body dementia, frontotemporal dementia, and head trauma). Clinically significant, unstable mental illness (i.e., uncontrolled depression, schizophrenia, and bipolar disorder) within the last 6 months. Subjects whose brain MRI confirms evidence of: acute or subacute hemorrhage, prior macro hemorrhage (defined as >1 cm in diameter, T2 sequence) or prior subarachnoid hemorrhage unless it can be documented that the finding is not due to an underlying structural or vascular abnormality, more than 4 microhemorrhages, cortical infarct (defined as >1.5 cm in diameter, irrespective of anatomic location), >1 lacunar infarct (defined as >1.5 cm in diameter), superficial siderosis, and history of diffuse white matter disease as defined by a score of 3 on the age-related white matter changes scale. Any finding that, in the opinion of the investigator, might be a contributing cause of the subject's dementia, or pose a risk to the subject, or might prevent a satisfactory MRI assessment for safety monitoring are also included in the exclusion criteria. Those who have other findings that are considered clinically important, and those who are judged by the researcher to be inappropriate for participation in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Weon-Kuu Chung, MD, PhD
Phone
8224407402
Email
wkchung16@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Weon-Kuu Chung, MD, PhD
Organizational Affiliation
Kyung Hee University Hospital at Gangdong
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kyung Hee University Hospital at Gangdong
City
Seoul
ZIP/Postal Code
05278
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
DONG-YUN KIM, MD
Phone
8224407402
Email
dy0106@khnmc.ac.kr
First Name & Middle Initial & Last Name & Degree
Weon-Kuu Chung, MD, PhD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Clinical Trial of Low Dose Irradiation for Alzheimer's Disease

We'll reach out to this number within 24 hrs