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Short Course vs. Standard Course Radiotherapy in Elderly and/or Frail Patients With Glioblastoma Multiforme

Primary Purpose

Glioblastoma Multiforme

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Radiotherapy
Radiotherapy
Sponsored by
International Atomic Energy Agency
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioblastoma Multiforme focused on measuring GBM, fractionation, short course, standard course

Eligibility Criteria

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

Inclusion Criteria:

  • Histopathologically confirmed newly diagnosed glioblastoma multiforme (GBM, WHO grade IV). The histological diagnosis must have been made locally after biopsy or neurosurgical tumour resection.
  • Initial surgery/biopsy at diagnosis performed < 6 weeks (42 days) prior to randomization.
  • Patient's age is 50 years or older.
  • Karnofsky performance status is 50% or higher.
  • Patients may have received and continue to receive corticosteroids, but they have to be on a stable or decreasing dose for at least 14 days prior to randomization.
  • Patients must not have received prior chemotherapy or radiotherapy.
  • Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life questionnaires in either English or any other language the questionnaire is officially translated into. The baseline assessment (prior to start of radiotherapy) must already have been completed. Inability (illiteracy, loss of sight, or other equivalent reason) to complete the questionnaires will not make the patient ineligible for the study. In centres where patients are not able to read or write, proxy interviews will be conducted in-person or via telephone by the nurse at that particular centre.
  • Patient consent must be obtained according to local institutional policy. It will be the responsibility of the local participating investigators to obtain the necessary local clearance, and to indicate in writing to the IAEA Study Coordinator that such clearance has been obtained, before the trial can commence in that centre. A copy of the initial full board ERB approval and approved consent form must be sent to the Project Officer at IAEA. The patient must sign the consent form prior to randomization or registration.
  • Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients randomized on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
  • Protocol treatment is to begin within 2 weeks of patient randomization.

Exclusion Criteria:

  • Patients with a history of other malignancies, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumours curatively treated with no evidence of disease for 3 or more years.
  • Patients with a serious active infection or other serious underlying medical conditions that would impair the ability of the patient to receive protocol treatment or comply with protocol.

Sites / Locations

  • Fundacion Escuela de Medicina Nuclear
  • N.N. Alexandrov National Cancer Centre of Belarus
  • Irmandade de Santa Casa de Misericordia de Porto Alegre
  • Hospital "A.C. Camargo", Fundacao "Antonio Prudente"
  • Wilson Roa Professional Corporation
  • Instituto de Radiomedicina (IRAM)
  • Regionaalhailga
  • High Technology Medical Center, University Clinic
  • Postgraduate Institute of Medical Education and Research (PGIMER)
  • Cipto Magunkusumo General Hospital, University of Indonesia
  • ICORG The All Ireland Cooperative Oncology
  • Marie Curie- Sklodowska Institute of Oncology
  • Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University
  • Institut National de Cancer Salah Aziz, Ministere de la Sante Publique
  • Ege University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm 1 - Short Course Radiotherapy

Arm 2 - Standard Course Radiotherapy

Arm Description

Short Course

Standard Course

Outcomes

Primary Outcome Measures

Overall Survival
The time from randomization to the time of death from any cause.

Secondary Outcome Measures

Progression-free survival
2.5 years including six months of follow-up after initial accrual.
Quality of Life
Quality of life will be assessed prior to study randomization and 4 weeks following completion of radiotherapy.

Full Information

First Posted
October 10, 2011
Last Updated
March 23, 2015
Sponsor
International Atomic Energy Agency
Collaborators
Fundación Escuela de Medicina Nuclear, N.N. Alexandrov National Cancer Centre of Belarus, Hospital A.C. Camargo, Irmandade Santa Casa de Misericórdia de Porto Alegre, Instituto de Radiomedicina (IRAM), Postgraduate Institute of Medical Education and Research, Dr Cipto Mangunkusumo General Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Chiang Mai University, Salah Azaïz Cancer Institute, Wilson Roa Professional Corporation, Cancer Trials Ireland, Ege University, High Technology Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01450449
Brief Title
Short Course vs. Standard Course Radiotherapy in Elderly and/or Frail Patients With Glioblastoma Multiforme
Official Title
A Randomized Phase III Study of Short Course (One-week) Radiation Therapy Versus Standard Course (Three-week) Radiation Therapy in Elderly and/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
February 2009 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International Atomic Energy Agency
Collaborators
Fundación Escuela de Medicina Nuclear, N.N. Alexandrov National Cancer Centre of Belarus, Hospital A.C. Camargo, Irmandade Santa Casa de Misericórdia de Porto Alegre, Instituto de Radiomedicina (IRAM), Postgraduate Institute of Medical Education and Research, Dr Cipto Mangunkusumo General Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Chiang Mai University, Salah Azaïz Cancer Institute, Wilson Roa Professional Corporation, Cancer Trials Ireland, Ege University, High Technology Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multi-centre prospective, non-inferiority trial. Patients will be randomized to two treatment groups in a 1:1 ratio and will be stratified by age, Karnofsky Performance Status and extent of the surgical resection. This study will assess the effect of a one-week radiotherapy regimen in comparison with a three-week radiotherapy regimen on the survival of elderly and/or frail patients with glioblastoma multiforme (Frail: ≥>50 years old and with a KPS of 50% or less50%-70%; Elderly and frail: ≥65 years and with a KPS of 50% - 70%; Elderly: ≥65 years and with a KPS of 80% - 100%).
Detailed Description
This is a multi-centre prospective, non-inferiority trial. Patients will be randomized to two treatment groups in a 1:1 ratio and will be stratified by: Age (<65 and ≥65 years old) Karnofsky Performance Status (≤70 and > 7050 or higher) Extent of the resection at surgery (biopsy only versus complete/near total and gross total or incomplete /partial resection) Randomization: Patients will be randomized to receive one of the two following treatments: Arm 1: Short Radiotherapy 25 Gy/5 fractions 1 week (5 fractions per week) Arm 2: Regular Radiotherapy 40 Gy/15 fractions 3 weeks (5 fractions per week)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioblastoma Multiforme
Keywords
GBM, fractionation, short course, standard course

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
115 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1 - Short Course Radiotherapy
Arm Type
Experimental
Arm Description
Short Course
Arm Title
Arm 2 - Standard Course Radiotherapy
Arm Type
Active Comparator
Arm Description
Standard Course
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy
Intervention Description
25 Gy in 5 daily fractions over 1 week
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy
Intervention Description
40 Gy in 15 daily fractions over 3 weeks
Primary Outcome Measure Information:
Title
Overall Survival
Description
The time from randomization to the time of death from any cause.
Time Frame
2.5 years
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
2.5 years including six months of follow-up after initial accrual.
Time Frame
2.5 years
Title
Quality of Life
Description
Quality of life will be assessed prior to study randomization and 4 weeks following completion of radiotherapy.
Time Frame
2.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histopathologically confirmed newly diagnosed glioblastoma multiforme (GBM, WHO grade IV). The histological diagnosis must have been made locally after biopsy or neurosurgical tumour resection. Initial surgery/biopsy at diagnosis performed < 6 weeks (42 days) prior to randomization. Patient's age is 50 years or older. Karnofsky performance status is 50% or higher. Patients may have received and continue to receive corticosteroids, but they have to be on a stable or decreasing dose for at least 14 days prior to randomization. Patients must not have received prior chemotherapy or radiotherapy. Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life questionnaires in either English or any other language the questionnaire is officially translated into. The baseline assessment (prior to start of radiotherapy) must already have been completed. Inability (illiteracy, loss of sight, or other equivalent reason) to complete the questionnaires will not make the patient ineligible for the study. In centres where patients are not able to read or write, proxy interviews will be conducted in-person or via telephone by the nurse at that particular centre. Patient consent must be obtained according to local institutional policy. It will be the responsibility of the local participating investigators to obtain the necessary local clearance, and to indicate in writing to the IAEA Study Coordinator that such clearance has been obtained, before the trial can commence in that centre. A copy of the initial full board ERB approval and approved consent form must be sent to the Project Officer at IAEA. The patient must sign the consent form prior to randomization or registration. Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients randomized on this trial will be available for complete documentation of the treatment, adverse events, and follow-up. Protocol treatment is to begin within 2 weeks of patient randomization. Exclusion Criteria: Patients with a history of other malignancies, except: adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or other solid tumours curatively treated with no evidence of disease for 3 or more years. Patients with a serious active infection or other serious underlying medical conditions that would impair the ability of the patient to receive protocol treatment or comply with protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elena Fidarova
Organizational Affiliation
International Atomic Energy Agency
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fundacion Escuela de Medicina Nuclear
City
Mendoza
ZIP/Postal Code
5500
Country
Argentina
Facility Name
N.N. Alexandrov National Cancer Centre of Belarus
City
Minsk
ZIP/Postal Code
223040
Country
Belarus
Facility Name
Irmandade de Santa Casa de Misericordia de Porto Alegre
City
Porto Alegre
ZIP/Postal Code
90050-70
Country
Brazil
Facility Name
Hospital "A.C. Camargo", Fundacao "Antonio Prudente"
City
Sao Paulo
ZIP/Postal Code
01509-010
Country
Brazil
Facility Name
Wilson Roa Professional Corporation
City
Edmonton
ZIP/Postal Code
Alberta T6R 2A9
Country
Canada
Facility Name
Instituto de Radiomedicina (IRAM)
City
Santiago
ZIP/Postal Code
6671407
Country
Chile
Facility Name
Regionaalhailga
City
Tallinn
Country
Estonia
Facility Name
High Technology Medical Center, University Clinic
City
Tbilisi
ZIP/Postal Code
0144
Country
Georgia
Facility Name
Postgraduate Institute of Medical Education and Research (PGIMER)
City
Chandigarh
ZIP/Postal Code
160 012
Country
India
Facility Name
Cipto Magunkusumo General Hospital, University of Indonesia
City
Jakarta
ZIP/Postal Code
10430
Country
Indonesia
Facility Name
ICORG The All Ireland Cooperative Oncology
City
Dublin
ZIP/Postal Code
2
Country
Ireland
Facility Name
Marie Curie- Sklodowska Institute of Oncology
City
Warsaw
ZIP/Postal Code
02-781
Country
Poland
Facility Name
Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University
City
Chiang Mai
ZIP/Postal Code
50002
Country
Thailand
Facility Name
Institut National de Cancer Salah Aziz, Ministere de la Sante Publique
City
Tunis
ZIP/Postal Code
1006
Country
Tunisia
Facility Name
Ege University Hospital
City
Izmir
Country
Turkey

12. IPD Sharing Statement

Citations:
PubMed Identifier
2851647
Citation
Newall J, Ransohoff J, Kaplan B. Glioblastoma in the older patient: how long a course of radiotherapy is necessary? J Neurooncol. 1988 Dec;6(4):325-7. doi: 10.1007/BF00177427.
Results Reference
background
PubMed Identifier
8040031
Citation
Bauman GS, Gaspar LE, Fisher BJ, Halperin EC, Macdonald DR, Cairncross JG. A prospective study of short-course radiotherapy in poor prognosis glioblastoma multiforme. Int J Radiat Oncol Biol Phys. 1994 Jul 1;29(4):835-9. doi: 10.1016/0360-3016(94)90573-8.
Results Reference
background
PubMed Identifier
9212001
Citation
Kleinberg L, Slick T, Enger C, Grossman S, Brem H, Wharam MD Jr. Short course radiotherapy is an appropriate option for most malignant glioma patients. Int J Radiat Oncol Biol Phys. 1997 Apr 1;38(1):31-6. doi: 10.1016/s0360-3016(97)00222-8.
Results Reference
background
PubMed Identifier
10582674
Citation
Jeremic B, Shibamoto Y, Grujicic D, Milicic B, Stojanovic M, Nikolic N, Dagovic A, Aleksandrovic J. Short-course radiotherapy in elderly and frail patients with glioblastoma multiforme. A phase II study. J Neurooncol. 1999 Aug;44(1):85-90. doi: 10.1023/a:1006356021734.
Results Reference
background
PubMed Identifier
15051755
Citation
Roa W, Brasher PM, Bauman G, Anthes M, Bruera E, Chan A, Fisher B, Fulton D, Gulavita S, Hao C, Husain S, Murtha A, Petruk K, Stewart D, Tai P, Urtasun R, Cairncross JG, Forsyth P. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol. 2004 May 1;22(9):1583-8. doi: 10.1200/JCO.2004.06.082. Epub 2004 Mar 29.
Results Reference
background
PubMed Identifier
26392096
Citation
Roa W, Kepka L, Kumar N, Sinaika V, Matiello J, Lomidze D, Hentati D, Guedes de Castro D, Dyttus-Cebulok K, Drodge S, Ghosh S, Jeremic B, Rosenblatt E, Fidarova E. International Atomic Energy Agency Randomized Phase III Study of Radiation Therapy in Elderly and/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme. J Clin Oncol. 2015 Dec 10;33(35):4145-50. doi: 10.1200/JCO.2015.62.6606. Epub 2015 Sep 21.
Results Reference
derived

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Short Course vs. Standard Course Radiotherapy in Elderly and/or Frail Patients With Glioblastoma Multiforme

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