eprintid: 19411
rev_number: 16
eprint_status: archive
userid: 1589
dir: disk0/00/01/94/11
datestamp: 2015-12-22 09:21:21
lastmod: 2024-07-02 02:30:13
status_changed: 2015-12-22 09:21:21
type: article
metadata_visibility: show
creators_name: Giordano, Frank Anton
creators_name: Brehmer, Stefanie
creators_name: Abo-Madyan, Yasser
creators_name: Welzel, Grit
creators_name: Sperk, Elena
creators_name: Keller, Anke
creators_name: Schneider, Frank
creators_name: Clausen, Sven
creators_name: Herskind, Carsten
creators_name: Schmiedek, Peter
creators_name: Wenz, Frederik
title: INTRAGO: intraoperative radiotherapy in glioblastoma multiforme – a Phase I/II dose escalation study
subjects: ddc-610
divisions: i-61230
divisions: i-63500
abstract: Background: Glioblastoma multiforme (GBM) is the most frequent primary malignant brain tumor in adults. Despite multimodal therapies, almost all GBM recur within a narrow margin around the initial resected lesion. Thus, novel therapeutic intensification strategies must target both, the population of dispersed tumor cells around the cavity and the postoperative microenvironment. Intraoperative radiotherapy (IORT) is a pragmatic and effective approach to sterilize the margins from persistent tumor cells, abrogate post-injury proliferative stimuli and to bridge the therapeutic gap between surgery and radiochemotherapy. Therefore, we have set up INTRAGO, a phase I/II dose-escalation study to evaluate the safety and tolerability of IORT added to standard therapy in newly diagnosed GBM. In contrast to previous approaches, the study involves the application of isotropic low-energy (kV) x-rays delivered by spherical applicators, providing optimal irradiation properties to the resection cavity.   Methods/Design: INTRAGO includes patients aged 50 years or older with a Karnofsky performance status of at least 50% and a histologically confirmed (frozen sections) supratentorial GBM. Safety and tolerability (i.e., the maximum tolerated dose, MTD) will be assessed using a classical 3 + 3 dose-escalation design. Dose-limiting toxicities (DLT) are wound healing deficits or infections requiring surgical intervention, IORT-related cerebral bleeding or ischemia, symptomatic brain necrosis requiring surgical intervention and early termination of external beam radiotherapy (before the envisaged dose of 60 Gy) due to radiotoxicity. Secondary end points are progression-free and overall survival.   Trial registration: The study is registered with clinicaltrials.gov, number: NCT02104882  (Registration Date: 03/26/2014).  
date: 2014
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1653685883
own_urn: urn:nbn:de:bsz:16-heidok-194110
language: eng
bibsort: GIORDANOFRINTRAGOINT2014
full_text_status: public
publication: BMC Cancer
volume: 15
number: 992
place_of_pub: London
pagerange: 1-9
issn: 1471-2407
citation:   Giordano, Frank Anton ; Brehmer, Stefanie ; Abo-Madyan, Yasser ; Welzel, Grit ; Sperk, Elena ; Keller, Anke ; Schneider, Frank ; Clausen, Sven ; Herskind, Carsten ; Schmiedek, Peter ; Wenz, Frederik  (2014) INTRAGO: intraoperative radiotherapy in glioblastoma multiforme – a Phase I/II dose escalation study.  BMC Cancer, 15 (992).  pp. 1-9.  ISSN 1471-2407     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/19411/1/12885_2014_Article_5159.pdf