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Neurocognition After Radiotherapy in CNS- and Skull-base Tumors (NARCiS)

Primary Purpose

Cognition, Brain Tumor, Magnetic Resonance Imaging

Status
Recruiting
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Neurocognitive tests: WAIS digit span, HVLT-R, COWAT, MOCA, WAIS digit symbol substitution, TMT A&B, Stroop Color Word Test
MRI
Questionnaires: EORTC QLQ C30 & BN20, STAI, CFQ, BDI-II, BRIEF-A, FACIT-F, PSQI
Toxicity scoring
Sponsored by
Universitaire Ziekenhuizen KU Leuven
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Cognition

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Adult patients (≥ 18 years at the time of diagnosis) with a primary brain or base of skull tumour, who are amenable for conventionally fractionated radiotherapy (photon or proton irradiation) Exclusion Criteria: Patients with tumours with poor prognostic characteristics (e.g. IDH1/2 wild type glioma, grade III meningioma, H3K27M midline glioma) Patients with tumours requiring craniospinal irradiation (CSI)/whole ventricular irradiation (WVI) Hypofractionated/stereotactic radiation (fraction sizes > 2 Gy per fraction) Inability to perform the cognitive tests or self-report inventories because of motor/sensory deficits or insufficient Dutch language proficiency Mental retardation documented before diagnosis Pre-diagnosis/pre-existing psychiatric diagnosis resulting in cognitive deficits like psychoses, neurodevelopmental disorders (autism/learning disorders) Relapse priory treated by chemo and/or radiation therapy Genetic syndrome (e.g. Down) Unable to perform MR imaging (claustrophobia, metallic implants like pacemaker/ICD/neurostimulator)

Sites / Locations

  • University Hospitals GhentRecruiting
  • UZ LeuvenRecruiting
  • Gasthuis Zusters AntwerpenRecruiting

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Primary brain and skull-base tumors

Arm Description

Primary brain and skull-base tumors who are amenable for radiotherapy (photon or proton therapy) will all be examined with neurocognitive tests, questionnaires and advanced MR imaging

Outcomes

Primary Outcome Measures

Prevalence of neurocognitive decline (changes in z-scores) compared to baseline at one year post-radiotherapy, for all cognitive domains (memory, executive functioning, attention and language)
Development of a Normal Tissue Complication Probability model (NTCP-model) for each cognitive domain (memory, executive functioning, attention and language)
Construct NTCP models to predict neurocognitive decline based on RT dosimetric and other explanatory variables (gender, age at diagnosis, comorbidities, level of education, social factors such as social activity and occupation, tumour size and localization, pathological/genetic/molecular characteristics, therapy protocols (surgery, radiotherapy and/or chemotherapy)) in an NTCP model for each cognitive domain

Secondary Outcome Measures

Early (3 months post-radiotherapy) changes identified on structural and functional MR imaging (graph measures)
Changes on advanced MR imaging at 3 months post-RT compared to baseline
Late (12 months post-radiotherapy) changes identified on structural and functional MR imaging (graph measures)
Changes on advanced MR imaging at 12 months post-RT compared to baseline

Full Information

First Posted
January 13, 2023
Last Updated
March 27, 2023
Sponsor
Universitaire Ziekenhuizen KU Leuven
Collaborators
University Hospital, Ghent, Gasthuis Zusters Antwerpen
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1. Study Identification

Unique Protocol Identification Number
NCT05727605
Brief Title
Neurocognition After Radiotherapy in CNS- and Skull-base Tumors
Acronym
NARCiS
Official Title
Neurocognition After Radiotherapy in Adult Brain and Base of Skull Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 8, 2023 (Actual)
Primary Completion Date
February 1, 2026 (Anticipated)
Study Completion Date
February 1, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Universitaire Ziekenhuizen KU Leuven
Collaborators
University Hospital, Ghent, Gasthuis Zusters Antwerpen

4. Oversight

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

5. Study Description

Brief Summary
The goal of this multicenter prospective longitudinal study is to study the long-term impact of multimodal treatment (chemotherapy, radiotherapy and surgery) in adult brain and base of skull tumors on neurocognitive functioning. All included patients will complete a self-report inventory (subjective cognitive functioning, QoL, confounders), a cognitive test battery, an advanced MR at multiple timepoints. Moreover, toxicity will be scored according to the CTCAEv5.0 in these patients over time.
Detailed Description
This study will combine MR imaging techniques together with elaborate neuropsychological assessments and RT dosimetry in 120 patients who will be examined baseline (before RT) and followed longitudinally after RT. The first objective is to build an NTCP model for neurocognitive decline after RT (for each cognitive domain separately), linking dose-volume parameters to structures within the brain susceptible to neurological damage and neurocognitive decline after radiotherapy. These NTCP models can be used to make predictions on neurocognitive decline in future primary brain tumour patients receiving cranial RT. The second objective is to evaluate dose-dependent neurocognitive decline. In particular, the investigators will assess: Prevalence and severity of neurocognitive decline after RT for all cognitive domains Brain structures or functional brain connections important in neurocognitive functioning (based on dedicated MRI). Dose-dependencies of specific neurocognitive skills after RT in adult brain tumour patients Correlations between RT dosimetry and early brain changes (MRI)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cognition, Brain Tumor, Magnetic Resonance Imaging, Meningioma, Glioma, Pituitary Adenoma

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Primary brain and skull-base tumors
Arm Type
Other
Arm Description
Primary brain and skull-base tumors who are amenable for radiotherapy (photon or proton therapy) will all be examined with neurocognitive tests, questionnaires and advanced MR imaging
Intervention Type
Behavioral
Intervention Name(s)
Neurocognitive tests: WAIS digit span, HVLT-R, COWAT, MOCA, WAIS digit symbol substitution, TMT A&B, Stroop Color Word Test
Intervention Description
Primary brain tumour patients will be evaluated longitudinally at the following timepoints: baseline (minimal 4 weeks after surgery, before radiotherapy), three months after end of radiotherapy, 1 year after end of radiotherapy and 2 years after end of radiotherapy. At each visit, neurocognitive testing, a self-report inventory and/or advanced MR imaging will take place. Time points: baseline, 12 months post-radiotherapy and 24 months post-radiotherapy
Intervention Type
Diagnostic Test
Intervention Name(s)
MRI
Intervention Description
Advanced MRI: all participants will be scanned on a 3T Siemens of Philips MR scanner (multicenter protocol): MPRAGE, FLAIR, T2, DWI, rsfMRI, SWI & ASL Time points: baseline, 3 months post-radiotherapy and 12 months post-radiotherapy
Intervention Type
Behavioral
Intervention Name(s)
Questionnaires: EORTC QLQ C30 & BN20, STAI, CFQ, BDI-II, BRIEF-A, FACIT-F, PSQI
Intervention Description
Time points: baseline, 12 months post-radiotherapy and 24 months post-radiotherapy
Intervention Type
Other
Intervention Name(s)
Toxicity scoring
Intervention Description
During and after radiotherapy and at at the end of the study, adverse events will be monitored using CTCAEv5.0.
Primary Outcome Measure Information:
Title
Prevalence of neurocognitive decline (changes in z-scores) compared to baseline at one year post-radiotherapy, for all cognitive domains (memory, executive functioning, attention and language)
Time Frame
2 years
Title
Development of a Normal Tissue Complication Probability model (NTCP-model) for each cognitive domain (memory, executive functioning, attention and language)
Description
Construct NTCP models to predict neurocognitive decline based on RT dosimetric and other explanatory variables (gender, age at diagnosis, comorbidities, level of education, social factors such as social activity and occupation, tumour size and localization, pathological/genetic/molecular characteristics, therapy protocols (surgery, radiotherapy and/or chemotherapy)) in an NTCP model for each cognitive domain
Time Frame
4 years
Secondary Outcome Measure Information:
Title
Early (3 months post-radiotherapy) changes identified on structural and functional MR imaging (graph measures)
Description
Changes on advanced MR imaging at 3 months post-RT compared to baseline
Time Frame
4 years
Title
Late (12 months post-radiotherapy) changes identified on structural and functional MR imaging (graph measures)
Description
Changes on advanced MR imaging at 12 months post-RT compared to baseline
Time Frame
4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult patients (≥ 18 years at the time of diagnosis) with a primary brain or base of skull tumour, who are amenable for conventionally fractionated radiotherapy (photon or proton irradiation) Exclusion Criteria: Patients with tumours with poor prognostic characteristics (e.g. IDH1/2 wild type glioma, grade III meningioma, H3K27M midline glioma) Patients with tumours requiring craniospinal irradiation (CSI)/whole ventricular irradiation (WVI) Hypofractionated/stereotactic radiation (fraction sizes > 2 Gy per fraction) Inability to perform the cognitive tests or self-report inventories because of motor/sensory deficits or insufficient Dutch language proficiency Mental retardation documented before diagnosis Pre-diagnosis/pre-existing psychiatric diagnosis resulting in cognitive deficits like psychoses, neurodevelopmental disorders (autism/learning disorders) Relapse priory treated by chemo and/or radiation therapy Genetic syndrome (e.g. Down) Unable to perform MR imaging (claustrophobia, metallic implants like pacemaker/ICD/neurostimulator)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Laurien De Roeck, MD
Phone
016 34 76 00
Email
Laurien.deroeck@uzleuven.be
First Name & Middle Initial & Last Name or Official Title & Degree
Maarten Lambrecht, MD PhD
Phone
016 34 76 00
Email
Maarten.lambrecht@uzleuven.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maarten Lambrecht, MD PhD
Organizational Affiliation
UZ Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospitals Ghent
City
Gent
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tom Boterberg, MD PhD
Facility Name
UZ Leuven
City
Leuven
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Maarten Lambrecht, MD PhD
Facility Name
Gasthuis Zusters Antwerpen
City
Wilrijk
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Katrien Erven, MD PhD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Neurocognition After Radiotherapy in CNS- and Skull-base Tumors

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