MRI Mapping in Planning Radiation Therapy to the Base of Skull and Brain in Patients With Nonmetastatic Head and Neck Cancer

Abramson Cancer Center at Penn Medicine3 enrolled

Overview

RATIONALE: Diagnostic procedures, such as specialized types of magnetic resonance imaging (MRI), may help in planning radiation therapy that does less damage to normal tissues. PURPOSE: This phase I trial is studying using functional MRI to see how well it works in planning radiation therapy in patients undergoing radiation therapy to the base of the skull and/or brain for nonmetastatic head and neck cancer.

OBJECTIVES: * To determine the feasibility of applying established MRI techniques to map functional anatomic regions at potential risk in irradiated normal brain tissue of patients undergoing radiotherapy to the base of the skull and brain for head and neck neoplasms. * To determine changes in cerebral blood flow and blood volume with perfusion MRI techniques in irradiated regions of the brain as a function of the radiation dose. OUTLINE: Patients undergo MRI perfusion imaging and functional (fMRI) (standard structural imaging sequences, diffusion tensor imaging, arterial spin labeled perfusion imaging at rest, blood oxygen level dependent, and dynamic susceptibility contrast perfusion weighted MRI) at baseline and 3 and 6 months after completion of radiotherapy. Patients may perform tasks for fMRI studies, including finger tapping, photic stimulation with a flashing light, solving math problems, comparing shapes, giving a speech, or listening to and reciting lists of words during fMRI image acquisition. Patients also undergo daily fractionated intensity-modulated radiotherapy.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Head and Neck Cancer

Interventions

blood-oxygen-level-dependent functional magnetic resonance imagingPROCEDURE

diffusion tensor imagingPROCEDURE

dynamic contrast-enhanced magnetic resonance imagingPROCEDURE

functional magnetic resonance imaging

Eligibility

Sex: ALLMin age: 18 YearsMax age: 120 Years

Medical Language ↔ Plain English

DISEASE CHARACTERISTICS: * Histologically confirmed head and neck cancer that requires radiotherapy to the base of the skull * No evidence of metastatic disease PATIENT CHARACTERISTICS: * ECOG performance status 0-1 * Life expectancy ≥ 1 year * Not pregnant * Negative pregnancy test * Able to undergo standard CT simulation and radiotherapy treatment planning and delivery, including the capacity to comply with standard immobilization devices to the head and neck for daily irradiation * Able to undergo standard MRI and deemed capable of complying with the immobilization needs and tasks required for functional MRIs * No claustrophobia * No patients with pacemakers, metal fragments in the eye, or certain metallic implants PRIOR CONCURRENT THERAPY: * Not specified

Locations (1)

Abramson Cancer Center of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Outcomes

Primary Outcomes

Feasability, as assessed by the proportion of study patients with functional regions identified within the brain as receiving exit irradiation

Time frame: 90 days

Secondary Outcomes

Summary parameters of the dose volume histograms to the functional regions identified

Time frame: One year

Cerebral blood flow and blood volume quantitated by relative measures normalized to regions of the brain not receiving any irradiation

Time frame: 90 days

Data from ClinicalTrials.gov

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