Brain Re-Irradiation Or Chemotherapy: a phase II randomised trial of re-irradiation and chemotherapy in patients with recurrent glioblastoma

Funder: JP Moulton Charitable Foundation

Background: Glioblastoma (GBM) is the most common adult malignant brain tumour. Despite intensive treatment (surgery, radiotherapy, chemotherapy), GBM almost always returns. When GBM returns, survival is short and quality-of-life becomes extremely important to patients and carers. Chemotherapy is often used when GBM returns to try and slow cancer growth and maintain quality-of-life. Chemotherapy takes over six months to complete and outcomes are often disappointing. Small studies suggest that repeat radiotherapy (termed re-irradiation), delivered over two weeks, may be an effective alternative. However, there is very little information about how re-irradiation or chemotherapy impacts on quality-of-life and survival. There is an urgent need, therefore, to investigate these treatments within the same trial, focusing on quality-of-life and survival.
This trial will evaluate chemotherapy and re-irradiation in patients with recurrent GBM. Whether patients receive chemotherapy or re-irradiation will be decided by randomisation.

• To gather detailed quality of life information about re-irradiation and chemotherapy
• To assess how long patients live after each treatment.

Methods: Chemotherapy will be given up to six times, every six weeks (this is standard practice). Re-irradiation will involve ten radiotherapy outpatient treatments, delivered daily, Monday to Friday, over two weeks. Patients will see their oncology doctor every six weeks and complete quality-of-life questionnaires at each visit. Brain scans will be performed every 3-months. Patient and carer interviews will allow us to understand better the impact of treatments on quality-of-life.

Study team:
Dr Louise Murray (PI)
Prof David Sebag-Montefiore
Prof Susan Short
Mr John Lilley
Dr Stuart Currie
Dr Florien Boele
Dr Helen Bulbeck
Ms Alexandra Smith
Dr Samantha Noutch
Ms Lucy McParland
Ms Jo Webster