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| Name | Class |
|---|---|
| Canadian Cancer Society (CCS) | OTHER |
| University of Toronto | OTHER |
| McMaster University | OTHER |
| University of British Columbia |
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Patients with newly-diagnosed GBM will be given personalized exercise regimes during concurrent chemo-radiation and up to 3 months later. Study aims are to investigate the feasibility and preliminary efficacy of the exercise program on progression free survival. Secondary outcomes of interest include cognition, fatigue, and quality of life.
Background: Glioblastoma (GBM) is the most common malignant glioma in adults, with a very poor prognosis, limited new treatment options, and neurological sequelae, including physical and cognitive decline that adversely affect quality of life (QOL). Physical activity may be an intervention that attenuates the cognitive and physical decline associated with GBM. However, few studies examine physical activity in brain tumor patients, perhaps due to challenges in trial design, measuring outcomes, and complexity of care. Aims of this work are to develop and implement an individualized exercise intervention for GBM patients to support functional independence, and to delay tumor progression and cognitive decline. Methods: GBM patients scheduled to be treated with concurrent radiation and chemotherapy will be recruited from the neuro-oncology clinic at the Princess Margaret Cancer Centre. Participants will receive an individualized, home-based exercise program that includes aerobic and resistance training, tailored to prior level of fitness, current physical status, and individual interests. They will undergo 1-hr standardized, validated assessments of physical and neurocognitive functions, mood, fatigue, and QOL, prior to radiation, and then 3, 6, 12, and 18 months later. Significance: Identifying interventions that preserve or improve mobility and cognitive function will enhance QOL and may lengthen progression-free survival in brain tumor patients. Moreover, finding ways to help patients maintain self-care will lessen the strain on the health care system (e.g., fewer hospitalizations, delayed utilization of palliative care hospice).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise in GBM | Experimental | All patients will be assigned a three-month exercise intervention according to their own capabilities and current activity levels |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Behavioral | The patients meet with a registered physiotherapist and receive individualized exercise programs starting the second week of treatment, and continuing up to 3 months later. |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-Free Survival | Time to tumor progression, based on Response Assessment in Neuro-Oncology (RANO) criteria | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive Decline | Tests will be scored according to published criteria, converted to z-scores based on population norms, and averaged to create an overall cognitive function score. COgnitive decline will be defined as declined scores at a given time point (preservation of cognitive functions will be defined as stable or improved scores at a given time point). | 3 months, 6 months, 12 months, 18 months post-treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kim Edelstein, PhD, C.Psych. | University of Toronto, University Health Network | Principal Investigator |
| Warren Mason, MD | University of Toronto, University Health Network | Principal Investigator |
| Kristin Campbell, PhD | University of British Columbia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Princess Margaret Hospital, University Health Network | Toronto | Ontario | M5G 2M9 | Canada |
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| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| D001932 | Brain Neoplasms |
| D005910 | Glioma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| D026741 | Physical Therapy Modalities |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| OTHER |
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|
| Cognitive Complaints | as measured by a validated questionnaire | 3 months, 6 months, 12 months, 18 months post-treatment |
| Overall survival | rate of overall survival | Up to 18 months post-treatment |
| Personality Changes | as measured by a standardized questionnaire | 3, 6, 12 and 18 months post-treatment |
| Quality of Life | as measured by a validated questionnaire | 3, 6, 12 and 18 months post-treatment |
| Mood | as measured by a validated questionnaire | 3, 6, 12 and 18 months post-treatment |
| Interference with valued activities and interests | as measured by a validated questionnaire | 3, 6, 12 and 18 months post-treatment |
| Sleep Quality | as measured by a validated questionnaire | 3, 6, 12 and 18 months post-treatment |
| Physical Function | strength, balance, cardiovascular endurance | 3, 6, 12 and 18 months post-treatment |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |