Impact of Surgery on the Treatment of Supratentorial Malignant Gliomas in Subjects Aged 70 and Over (CSA)

Assistance Publique - Hôpitaux de Paris

Status and phase

Completed

Phase 3

Conditions

Malignant Glioma

Treatments

Procedure: Surgery

Radiation: radiotherapy

Study type

Interventional

Funder types

Other

Identifiers

NCT02892708

K060215

ID RCB : 2007-A00522-51 (Other Identifier)

Details and patient eligibility

About

The objective of this study is to evaluate the efficacy and safety of surgical resection in elderly patients 70 years or older with a supratentorial glioblastoma de novo. The sensitivity of Magnetic Resonance Spectroscopy with perfusion sequences in the diagnosis of malignant glioma in the elderly will also be studied.

Full description

Currently, the standard treatment for gliomas is based on surgical resection followed by radiation therapy.

However in patients 70 and older, surgery is not systematic, before radiotherapy. Moreover, at these ages, surgery is likely to be less well tolerated in general terms.

The aim of this study is to try to determine the best treatment between radiation therapy associated with the surgical treatment and care by radiotherapy alone, after a brain biopsy. This is a randomized, two arms, multicenter, open study.

In the two weeks following the radiological diagnosis of a lesion highly suggestive of a high-grade glioma, patients will be randomized to either arm surgery (partial or complete excision) + radiotherapy or in the radiotherapy alone arm. Within 5 weeks after surgery (biopsy or excision), all patients will receive treatment with focal radiotherapy.

A central review blades and MRI data will be organized after the inclusion of patients.

A maximum of 135 patients will participate in this trial.

Enrollment

107 patients

Sex

All

Ages

70+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Highly suggestive radiological aspect of a high-grade glioma
Operability of the lesion, defined according to standard criteria of literature: lobar tumor, cortico-subcortical, well limited, without deep infiltration and without involvement of the basal ganglia. This operability is to reassess based on surgical experience and the ability to remove more or less completely a tumor of this type in a given location
Age greater than or equal to 70 years
Preoperative Karnofsky Index ≥ 50
Information given to the patient or his family and signed written consent.

Exclusion criteria

Existence of a cons-indication to MRI
Non operability of the lesion
Unbalanced concomitant serious pathology that might be an indication against-formal anesthetic (ASA 4-5) (see annex)
Previous history of radiotherapy or chemotherapy prior to this injury
Patient under guardianship or under judicial protection