Clinical trial NCT03370809: Assessment of Positron Emission Tomography to Early Detect Frailty in Onco-geriatry
Official title: Assessment of Positron Emission Tomography to Early Detect Frailty in Onco-geriatry
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Patients Over 75 Years Old With a Cancer Discovery
Keywords: Frailty
Oncogeriatric
PET 18F-FDG
SPM (Statistical Parametric Mapping)
Neurology
Lead sponsor: Central Hospital, Nancy, France
Sponsor class: OTHER
First posted: 2017-12-12
Enrollment: 37
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief summary: Oncogeriatric frailty assessment is a multifactorial approach to determine the most appropriate treatment for the health status of elderly cancer patients and this assessment is recommended for patients over 75 years of age.

Oncogeriatric frailty is based on the SIOG-2 (International Society of Geriatric Oncology-2) clinical scale (assessing comorbidities, autonomy, nutrition, cognitive and thymic domains) defining 3 levels of frailty: (1) harmonious aging, (2) vulnerability (reversible stage), (3) fragility (irreversible stage).

So,the management of very old or very frailty patients with poor tolerance or compliance to treatment, often requires to defer standard treatment and monitoring procedures. That is detrimental to these patients prognosis. By contrast with elderly or very old patients without frailty criteria, could benefit from more efficient procedures.

More generally, frailty is associated directly with a cerebral impact on a cognitive or thymic status or indirectly with the cognitive or thymic impacts related with other components (nutritional or autonomy or walking poor status, comorbidities) 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET), is routinely performed in follow-up cancer patients in most cases, including older patients, to detect neoplastic localizations on the whole body. It also accurately quantifies cerebral glycolytic metabolism when early brain recording is performed. Brain metabolism reflects the neuronal synaptic activity. It is generally decreased in particular brain areas due of neurodegenerative damage with a little or no symptom, of thymic involvement particular in depression or during accelerated cerebral aging of vascular origin. The impairment of the brain function of the elderly, as evidenced by 18F-FDG PET, is most often multifactorial, as frailty. Above all, brain changes are visualized with 18F-FDG PET much earlier than using neuropsychological tests, especially for cognitive impairment.

Our hypothesis is that with 18F-FDG PET, performed routinely in the initial assessment in elderly patients with cancer, it is also possible to obtain reliable and objective parameters of brain function and frailty. 18F-FDG PET is already used to identify cognitive and thymic impairment. This exam would help to assess the frailty and to adapt as best oncologic treatments some of which can also be neurotoxic. 18F-FDG PET is therefore related to brain function in frail patients


Eligibility criteria: Inclusion Criteria:

* patients who are more than 75 years old with written informed consent
* patients referred for 18F-FDG PET in an oncological disease newly diagnosed
* patients insured under social security

Exclusion Criteria:

* patients with disease in final stage and life expectancy less than 6 months
* patients under guardianship or curators
* patients with abnormal neurological tests: MMS\< 27, with neoplastic or other brain lesions or showing ischemic or cerebral stroke damage
* confused or agitated patient unable to realize a PET
* radiotherapy ou chemiotherapy one year at least of the patient enrollment

Primary outcomes:
measure: Volume of brain with damages detected by quantitative analysis SPM (Statistical Parametric Mapping)
timeFrame: through the completion of the study on average 24 months
Secondary outcomes:
measure: Volume of brain with damages detected by quantitative analysis SPM between 2 patient's group with MMSE (MiniMental State Examination) results and threshold value as 24
timeFrame: 20 months, according to the results of neurology tests at the initial visit and at the 6 month
measure: Volume of brain with damages detected by quantitative analysis SPM between 2 patient's groups with GDS (Geriatric Depression Scale) results and threshold value as 5
timeFrame: 20 months, according to the results of neurology tests at the initial visit and at the 6 month
measure: Volume of brain with damages detected by quantitative analysis SPM between different groups according to the SIOG-2 scale
timeFrame: 20 months, according to the results of neurology tests at the initial visit and at the 6 month
measure: Volume of brain with damages detected by quantitative analysis SPM between 2 patient's groups according to an unscheduled hospitalisation over 6 months or no
timeFrame: 20 months,according to the results of neurology tests at the initial visit and at the 6 month
measure: Volume of brain with damages detected by quantitative analysis SPM between 2 patient's groups according to non cancer related death at 12 months or no
timeFrame: 24 months,according to the death or not of the patients asked 12 months after the inclusion
Other outcomes:
Locations:
city: Vandoeuvre les Nancy cedex
country: France
facility: CHRU NANCY Brabois, nuclear medicine department
Study officials:
affiliation: CHRU NANCY, IADI INSERM U1254
name: Antoine VERGER, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: