Lesueur Paul, Joly Florence, Clarisse Benedicte, Lequesne Justine, Stefan Dinu, Balosso Jacques, Lange Marie, Thureau Sebastien, Capel Aurelie, Castera Marie, Legrand Berenice, Goliot Nicolas, Grellard Jean Michel, Tessonnier Thomas, Castel Helene, Valable Samuel
Department of Radiation Oncology, François Baclesse center, Caen, 14000, France.
ISTCT UMR 6030-CNRS, Université de Caen-Normandie, Caen, France.
Radiat Oncol. 2025 Jan 29;20(1):16. doi: 10.1186/s13014-025-02591-1.
Radiotherapy as a complement or an alternative to neurosurgery has a central role in the treatment of skull base grade I-II meningiomas. Radiotherapy techniques have improved considerably over the last two decades, becoming more effective and sparing more and more the healthy tissue surrounding the tumour. Currently, hypo-fractionated stereotactic radiotherapy (SRT) for small tumours and normo-fractionated intensity-modulated radiotherapy (IMRT) or proton-therapy (PT) for larger tumours are the most widely used techniques. It is expected a decrease of the risk of cognitive impairment with these modern techniques. However prospective data about cognitive long-term consequences of partial brain irradiation with SRT, PT, or IMRT remain very scarce to date.
CANCER COG is one of the first multicentric study in the world to prospectively assess the cognitive performances of patients following different modalities of cerebral radiotherapy (stereotactic radiotherapy, proton therapy, intensity modulated radiotherapy) for the treatment of grade I-II skull base meningioma, up to at least 10 years after the end of radiotherapy. This longitudinal study includes the follow-up of 3 cohorts, including: patients treated with PRT, IMRT, and SRT. An additionally control group will be formed. The primary objective is to report long-term cognitive deterioration in each cohort until 10 years after the end of irradiation. The rate of clinical symptomatology improvement over time after irradiation, the evolution of health-related quality-of-life, anxiety/depression, fatigue, over time after irradiation, the tumoral local control after irradiation, the progression-free survival (PFS), the professional reintegration for working-age patients will also be assessed. CANCER COG aims to help clinicians to choose the best irradiation techniques with the best benefit/risk ratio. Inclusions started on september 2023.
The study was registered on clinicaltrials.gov with the following number: NCT06036706.
放射治疗作为神经外科手术的补充或替代方法，在颅底I-II级脑膜瘤的治疗中起着核心作用。在过去二十年中，放射治疗技术有了显著改进，变得更加有效，对肿瘤周围健康组织的损伤也越来越小。目前，针对小肿瘤的低分割立体定向放射治疗（SRT）以及针对大肿瘤的常规分割调强放射治疗（IMRT）或质子治疗（PT）是最广泛使用的技术。人们期望这些现代技术能降低认知障碍的风险。然而，迄今为止，关于SRT、PT或IMRT局部脑照射对认知的长期影响的前瞻性数据仍然非常稀少。
CANCER COG是世界上首批多中心研究之一，旨在前瞻性评估接受不同脑放射治疗方式（立体定向放射治疗、质子治疗、调强放射治疗）治疗I-II级颅底脑膜瘤的患者的认知表现，随访时间至少为放疗结束后10年。这项纵向研究包括对3个队列的随访，其中包括：接受PRT、IMRT和SRT治疗的患者。另外还将组建一个对照组。主要目标是报告每个队列在放疗结束后10年内的长期认知衰退情况。还将评估放疗后随时间推移临床症状的改善率、健康相关生活质量、焦虑/抑郁、疲劳的变化情况，放疗后的肿瘤局部控制情况、无进展生存期（PFS）以及工作年龄患者的职业再融入情况。CANCER COG旨在帮助临床医生选择具有最佳效益/风险比的最佳放射治疗技术。纳入工作于2023年9月开始。
该研究已在clinicaltrials.gov上注册，注册号为：NCT06036706。
