<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT01711580</url>
  </required_header>
  <id_info>
    <org_study_id>12-01-25/01-intern-6810</org_study_id>
    <nct_id>NCT01711580</nct_id>
  </id_info>
  <brief_title>Re-irradiation of High Grade Gliomas: a Quality of Life Study</brief_title>
  <official_title>Re-irradiation of High Grade Gliomas: a Quality of Life Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Maastricht Radiation Oncology</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Maastricht Radiation Oncology</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Patients with a high grade glioma have an increasing overall survival and progression free&#xD;
      survival after initial treatment. Because of a better performance status these patients are&#xD;
      more often eligible for re-treatment with for example radiotherapy. However, to date only a&#xD;
      few prospective studies on re-irradiation of gliomas exist and very little is known about the&#xD;
      effects of re-irradiation on quality of life and cognition. This trial is designed to&#xD;
      longitudinally establish the effects of re-irradiation on quality of life, cognition and&#xD;
      physical performance in patients with a high grade glioma. Based on the currently available&#xD;
      information the investigators hypothesize that quality of life after re-irradiation can be&#xD;
      kept stable until further tumour progression.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Current treatment regimes, with the addition of temozolomide, have improved progression-free&#xD;
      survival as well as overall survival for patients with a high grade glioma. The median&#xD;
      overall survival (MOS) for patients with a glioblastoma (GBM) is 14.6 months, with a&#xD;
      progression free survival (PFS) of 6.9 months.&#xD;
&#xD;
      Due to longer survival and a better performance status, patients often reach a point at which&#xD;
      re-treatment is feasible. Treatment options for recurrent glioblastoma and anaplastic glioma&#xD;
      can include surgery, chemotherapy and re-irradiation. Re-irradiation of patients with&#xD;
      recurrent high grade glioma is slowly becoming standard of care. It provides a comparable&#xD;
      overall survival to palliative chemotherapy. In case of GBM there is a median time to&#xD;
      progression after treatment of 20-27 weeks and a MOS of 26 to 60 weeks.&#xD;
&#xD;
      Patients with tumor recurrence have a significantly worse quality of life compared to&#xD;
      patients without recurrence at the same follow-up. They experience significantly more&#xD;
      problems with physical functioning (e.g. motor dysfunction, weakness of legs, visual&#xD;
      disorders), work or other daily activities, mental health (e.g. future uncertainty) and&#xD;
      general health.&#xD;
&#xD;
      With regard to re-irradiation, current available data is mostly provided by retrospective&#xD;
      studies which often lack solid quality of life data. Endpoints include e.g. performance&#xD;
      status, clinical (neurological) status and decreased steroid requirement after treatment.&#xD;
      These endpoints are however inadequate to determine quality of life accurately.&#xD;
&#xD;
      Several studies have used the European Organization for Research and Treatment of Cancer&#xD;
      Quality of Life Questionnaire core 30 (EORTC QLQ-C30) and the brain cancer module (QLQ-BN20)&#xD;
      scales to assess quality of life. The latter consists of 20 items including visual disorder,&#xD;
      motor dysfunction, various disease symptoms, treatment toxicity and future uncertainty. A&#xD;
      change of 10 points or more on these scales can be considered clinically relevant.&#xD;
&#xD;
      To date only Ernst-Stecken and colleagues have used the EORTC QLQ-C30 to prospectively&#xD;
      evaluate the quality of life in patients with a recurrent malignant glioma after&#xD;
      radiotherapy. In this study patients were treated with hypofractionation. The quality of life&#xD;
      questionnaire score could be kept stable in two thirds of patients with a median follow-up of&#xD;
      9 months. They conclude that hypofractionated stereotactic radiotherapy is an effective&#xD;
      treatment that helps to maintain quality of life for an acceptable period, comparable to the&#xD;
      results found with chemotherapeutic regimes.&#xD;
&#xD;
      In patients with glioma, the tumor, radiotherapy as well as chemotherapy can disrupt&#xD;
      cognitive function. Cognitive functioning can be evaluated by a cognitive screening&#xD;
      instrument and/or comprehensive neuropsychological test batteries. The most well-known and&#xD;
      convenient screening instrument is the Mini Mental-State Examination (MMSE). However, the&#xD;
      MMSE is developed to assess dementia and does not include items related to executive&#xD;
      function. As such, the MMSE is insufficient to assess frontal-subcortical network dysfunction&#xD;
      associated with cognitive damage after irradiation. More sensitive cognitive tests should be&#xD;
      administered to determine the effects of re-irradiation on cognition. There is however still&#xD;
      little consensus on which test should be used. Although comprehensive neuropsychological test&#xD;
      batteries are most sensitive, a brief cognitive screening is preferable in the present&#xD;
      setting. For this trial, the investigators intend to use a number of relevant standard tests&#xD;
      including the Hopkins Verbal Learning Test-Revised (HVLT-R, the Trail Making Test and&#xD;
      Controlled Oral Word Association (COWA) as suggested by the Radiation Therapy Oncology Group&#xD;
      (RTOG). The Stroop colour-word test (Stroop) is added to the battery in order to assess&#xD;
      visual attention.&#xD;
&#xD;
      Physical functioning has a major impact on quality of life in patients with cancer. A number&#xD;
      of studies have investigated the effects of exercise on physical functioning. They have&#xD;
      shown, predominantly in patients with breast cancer, that exercise has beneficial effects on&#xD;
      health and well-being. Physical performance can be measured by several means. The hand grip&#xD;
      strength (HGS) test has been validated in previous studies for the evaluation of general&#xD;
      health status. This test is performed with the Jamar hand dynamometer which displays hand&#xD;
      strength in kilograms. By comparing data after re-irradiation to the data collected before&#xD;
      the treatment the amount of muscle strength loss can be determined.&#xD;
&#xD;
      Another method of measuring physical performance is by analyzing fatigue. This is a very&#xD;
      common symptom in cancer patients and negatively influences their quality of life. Fatigue in&#xD;
      patients with cancer can be determined with the use of both the EORTC QLQ-C30 and the more&#xD;
      specific Fatigue Questionnaire (EORTC QLQ-FA13).&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Withdrawn</overall_status>
  <why_stopped>
    Another study was commenced for this patient group&#xD;
  </why_stopped>
  <start_date>March 2013</start_date>
  <completion_date type="Anticipated">September 2015</completion_date>
  <primary_completion_date type="Anticipated">March 2015</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Change from baseline in the palliative effect of re-irradiation in patients with a high grade glioma, defined by quality-of-life parameters</measure>
    <time_frame>baseline, 6-8weeks, 12 weeks, 18-20 weeks, 30-32 weeks</time_frame>
    <description>These Quality of life parameters include:&#xD;
The change in the EORTC QLQ-C30 score from baseline to endpoint&#xD;
The change in the EORTC QLQ-BN20 score from baseline to endpoint&#xD;
The change in the EORTC QLQ-FA13 score from baseline to endpoint&#xD;
The change in cognition from baseline to endpoint as measured by the HVLT-R, the TMT, the Stroop-test and the COWA&#xD;
The change in grip strength from baseline to endpoint</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Overall survival of patients with glioblastoma and anaplastic glioma after re-irradiation</measure>
    <time_frame>6 months after the last patient is included</time_frame>
    <description>- Months from the start of re-irradiation to death</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Progression free survival of patients with glioblastoma and anaplastic glioma after re-irradiation</measure>
    <time_frame>6 months after the last patient is included</time_frame>
    <description>- Months from the start of re-irradiation to tumorprogression</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Actual">0</enrollment>
  <condition>Anaplastic Astrocytoma</condition>
  <condition>Glioblastoma Multiforme</condition>
  <condition>Anaplastic Oligoastrocytoma</condition>
  <arm_group>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
    <description>EORTC QLQ-C30 EORTC QLQ-BN20 Hopkins Verbal Learning Test-Revised (HVLT-R) Trail Making Test (TMT) Stroop color-word test Controlled oral word association test (COWA) Jamar hand dynamometer EORTC QLQ- FA13 Short Form health survey (SF-36)</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>EORTC QLQ-C30</intervention_name>
    <description>The EORTC QLQ-C30 is a questionnaire developed to assess the quality of life of cancer patients. It is supplemented by disease specific modules for e.g. Breast, Lung, Head &amp; Neck, Oesophageal, Ovarian, Gastric, Cervical cancer, Multiple Myeloma, Oesophago-Gastric, Prostate, Colorectal Liver Metastases, Colorectal and Brain cancer which are distributed from the EORTC Quality of Life Department. Other disease specific modules are under development but not yet validated.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>EORTC QLQ-BN20</intervention_name>
    <description>The EORTC QLQ-C30 is a questionnaire developed to assess the quality of life of cancer patients. It is supplemented by disease specific modules for e.g. Breast, Lung, Head &amp; Neck, Oesophageal, Ovarian, Gastric, Cervical cancer, Multiple Myeloma, Oesophago-Gastric, Prostate, Colorectal Liver Metastases, Colorectal and Brain cancer which are distributed from the EORTC Quality of Life Department. Other disease specific modules are under development but not yet validated.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Hopkins Verbal Learning Test-Revised (HVLT-R)</intervention_name>
    <description>The HVLT-R is a cognitive test to assess verbal learning and memory.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Stroop color-word test</intervention_name>
    <description>The Stroop Color and Word Test is a brief five minute test which is used to assess brain dysfunction, cognition, and psychopathology.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Controlled oral word association test (COWA)</intervention_name>
    <description>The COWA is a measure of verbal fluency that requires expressive language and executive functions.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Jamar hand dynamometer</intervention_name>
    <description>The Jamar hand dynamometer is a screening instrument that is used to assess grip strength.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>EORTC QLQ- FA13</intervention_name>
    <description>The Fatigue Questionnaire (QLQ-FA13) is a 13-item questionnaire to assess fatigue in patients with cancer. It is meant to be used in conjunction with the EORTC QLQ-C30</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Trail Making Test (TMT)</intervention_name>
    <description>The TMT The Trail Making Test is a neuropsychological test of visual attention and task switching. It consists of two parts in which the subject is instructed to connect a set of 25 dots as fast as possible while still maintaining accuracy.</description>
    <arm_group_label>Re-irradiation, high grade glioma</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        The study population will consist of subjects with a histologically proven high-grade&#xD;
        glioma (anaplastic astrocytoma, anaplastic oligodendroglioma or glioblastoma multiforme) at&#xD;
        primary diagnosis, who are now eligible for re-irradation because of a recurrence.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Histologically proven high-grade glioma anaplastic astrocytoma or glioblastoma&#xD;
&#xD;
          -  Age ≥ 18 years&#xD;
&#xD;
          -  WHO performance status ≤ 2&#xD;
&#xD;
          -  Scheduled for re-irradiation of a high grade glioma&#xD;
&#xD;
          -  The patient is willing and capable to comply with study procedure&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        • Life expectancy &lt; 3 months&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Brigitta Baumert, MD, MBA</last_name>
    <role>Principal Investigator</role>
    <affiliation>Maastro Clinic, The Netherlands</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Maastricht Radiation Oncology</name>
      <address>
        <city>Maastricht</city>
        <zip>6229 ET</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Netherlands</country>
  </location_countries>
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  <verification_date>May 2015</verification_date>
  <study_first_submitted>October 12, 2012</study_first_submitted>
  <study_first_submitted_qc>October 18, 2012</study_first_submitted_qc>
  <study_first_posted type="Estimate">October 22, 2012</study_first_posted>
  <last_update_submitted>May 11, 2015</last_update_submitted>
  <last_update_submitted_qc>May 11, 2015</last_update_submitted_qc>
  <last_update_posted type="Estimate">May 12, 2015</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Recurrent glioma</keyword>
  <keyword>Quality of life</keyword>
  <keyword>Glioblastoma multiforme</keyword>
  <keyword>Anaplastic glioma</keyword>
  <keyword>Cognition</keyword>
  <keyword>Re-irradiation</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Glioblastoma</mesh_term>
    <mesh_term>Glioma</mesh_term>
    <mesh_term>Astrocytoma</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT01711580
org study id: 12-01-25/01-intern-6810
nct id: NCT01711580
lead sponsor: 
has dmc: Yes
Patients with a high grade glioma have an increasing overall survival and progression free
      survival after initial treatment. Because of a better performance status these patients are
      more often eligible for re-treatment with for example radiotherapy. However, to date only a
      few prospective studies on re-irradiation of gliomas exist and very little is known about the
      effects of re-irradiation on quality of life and cognition. This trial is designed to
      longitudinally establish the effects of re-irradiation on quality of life, cognition and
      physical performance in patients with a high grade glioma. Based on the currently available
      information the investigators hypothesize that quality of life after re-irradiation can be
      kept stable until further tumour progression.
Current treatment regimes, with the addition of temozolomide, have improved progression-free
      survival as well as overall survival for patients with a high grade glioma. The median
      overall survival (MOS) for patients with a glioblastoma (GBM) is 14.6 months, with a
      progression free survival (PFS) of 6.9 months.

      Due to longer survival and a better performance status, patients often reach a point at which
      re-treatment is feasible. Treatment options for recurrent glioblastoma and anaplastic glioma
      can include surgery, chemotherapy and re-irradiation. Re-irradiation of patients with
      recurrent high grade glioma is slowly becoming standard of care. It provides a comparable
      overall survival to palliative chemotherapy. In case of GBM there is a median time to
      progression after treatment of 20-27 weeks and a MOS of 26 to 60 weeks.

      Patients with tumor recurrence have a significantly worse quality of life compared to
      patients without recurrence at the same follow-up. They experience significantly more
      problems with physical functioning (e.g. motor dysfunction, weakness of legs, visual
      disorders), work or other daily activities, mental health (e.g. future uncertainty) and
      general health.

      With regard to re-irradiation, current available data is mostly provided by retrospective
      studies which often lack solid quality of life data. Endpoints include e.g. performance
      status, clinical (neurological) status and decreased steroid requirement after treatment.
      These endpoints are however inadequate to determine quality of life accurately.

      Several studies have used the European Organization for Research and Treatment of Cancer
      Quality of Life Questionnaire core 30 (EORTC QLQ-C30) and the brain cancer module (QLQ-BN20)
      scales to assess quality of life. The latter consists of 20 items including visual disorder,
      motor dysfunction, various disease symptoms, treatment toxicity and future uncertainty. A
      change of 10 points or more on these scales can be considered clinically relevant.

      To date only Ernst-Stecken and colleagues have used the EORTC QLQ-C30 to prospectively
      evaluate the quality of life in patients with a recurrent malignant glioma after
      radiotherapy. In this study patients were treated with hypofractionation. The quality of life
      questionnaire score could be kept stable in two thirds of patients with a median follow-up of
      9 months. They conclude that hypofractionated stereotactic radiotherapy is an effective
      treatment that helps to maintain quality of life for an acceptable period, comparable to the
      results found with chemotherapeutic regimes.

      In patients with glioma, the tumor, radiotherapy as well as chemotherapy can disrupt
      cognitive function. Cognitive functioning can be evaluated by a cognitive screening
      instrument and/or comprehensive neuropsychological test batteries. The most well-known and
      convenient screening instrument is the Mini Mental-State Examination (MMSE). However, the
      MMSE is developed to assess dementia and does not include items related to executive
      function. As such, the MMSE is insufficient to assess frontal-subcortical network dysfunction
      associated with cognitive damage after irradiation. More sensitive cognitive tests should be
      administered to determine the effects of re-irradiation on cognition. There is however still
      little consensus on which test should be used. Although comprehensive neuropsychological test
      batteries are most sensitive, a brief cognitive screening is preferable in the present
      setting. For this trial, the investigators intend to use a number of relevant standard tests
      including the Hopkins Verbal Learning Test-Revised (HVLT-R, the Trail Making Test and
      Controlled Oral Word Association (COWA) as suggested by the Radiation Therapy Oncology Group
      (RTOG). The Stroop colour-word test (Stroop) is added to the battery in order to assess
      visual attention.

      Physical functioning has a major impact on quality of life in patients with cancer. A number
      of studies have investigated the effects of exercise on physical functioning. They have
      shown, predominantly in patients with breast cancer, that exercise has beneficial effects on
      health and well-being. Physical performance can be measured by several means. The hand grip
      strength (HGS) test has been validated in previous studies for the evaluation of general
      health status. This test is performed with the Jamar hand dynamometer which displays hand
      strength in kilograms. By comparing data after re-irradiation to the data collected before
      the treatment the amount of muscle strength loss can be determined.

      Another method of measuring physical performance is by analyzing fatigue. This is a very
      common symptom in cancer patients and negatively influences their quality of life. Fatigue in
      patients with cancer can be determined with the use of both the EORTC QLQ-C30 and the more
      specific Fatigue Questionnaire (EORTC QLQ-FA13).
observational model: Cohort
time perspective: Prospective
measure: Change from baseline in the palliative effect of re-irradiation in patients with a high grade glioma, defined by quality-of-life parameters
time frame: baseline, 6-8weeks, 12 weeks, 18-20 weeks, 30-32 weeks
description: These Quality of life parameters include:
The change in the EORTC QLQ-C30 score from baseline to endpoint
The change in the EORTC QLQ-BN20 score from baseline to endpoint
The change in the EORTC QLQ-FA13 score from baseline to endpoint
The change in cognition from baseline to endpoint as measured by the HVLT-R, the TMT, the Stroop-test and the COWA
The change in grip strength from baseline to endpoint
measure: Overall survival of patients with glioblastoma and anaplastic glioma after re-irradiation
time frame: 6 months after the last patient is included
description: - Months from the start of re-irradiation to death
measure: Progression free survival of patients with glioblastoma and anaplastic glioma after re-irradiation
time frame: 6 months after the last patient is included
description: - Months from the start of re-irradiation to tumorprogression
arm group label: Re-irradiation, high grade glioma
description: EORTC QLQ-C30 EORTC QLQ-BN20 Hopkins Verbal Learning Test-Revised (HVLT-R) Trail Making Test (TMT) Stroop color-word test Controlled oral word association test (COWA) Jamar hand dynamometer EORTC QLQ- FA13 Short Form health survey (SF-36)
intervention type: Other
intervention name: EORTC QLQ-C30
description: The EORTC QLQ-C30 is a questionnaire developed to assess the quality of life of cancer patients. It is supplemented by disease specific modules for e.g. Breast, Lung, Head & Neck, Oesophageal, Ovarian, Gastric, Cervical cancer, Multiple Myeloma, Oesophago-Gastric, Prostate, Colorectal Liver Metastases, Colorectal and Brain cancer which are distributed from the EORTC Quality of Life Department. Other disease specific modules are under development but not yet validated.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: EORTC QLQ-BN20
description: The EORTC QLQ-C30 is a questionnaire developed to assess the quality of life of cancer patients. It is supplemented by disease specific modules for e.g. Breast, Lung, Head & Neck, Oesophageal, Ovarian, Gastric, Cervical cancer, Multiple Myeloma, Oesophago-Gastric, Prostate, Colorectal Liver Metastases, Colorectal and Brain cancer which are distributed from the EORTC Quality of Life Department. Other disease specific modules are under development but not yet validated.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: Hopkins Verbal Learning Test-Revised (HVLT-R)
description: The HVLT-R is a cognitive test to assess verbal learning and memory.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: Stroop color-word test
description: The Stroop Color and Word Test is a brief five minute test which is used to assess brain dysfunction, cognition, and psychopathology.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: Controlled oral word association test (COWA)
description: The COWA is a measure of verbal fluency that requires expressive language and executive functions.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: Jamar hand dynamometer
description: The Jamar hand dynamometer is a screening instrument that is used to assess grip strength.
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: EORTC QLQ- FA13
description: The Fatigue Questionnaire (QLQ-FA13) is a 13-item questionnaire to assess fatigue in patients with cancer. It is meant to be used in conjunction with the EORTC QLQ-C30
arm group label: Re-irradiation, high grade glioma
intervention type: Other
intervention name: Trail Making Test (TMT)
description: The TMT The Trail Making Test is a neuropsychological test of visual attention and task switching. It consists of two parts in which the subject is instructed to connect a set of 25 dots as fast as possible while still maintaining accuracy.
arm group label: Re-irradiation, high grade glioma
study pop: 
sampling method: Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Brigitta Baumert, MD, MBA
role: Principal Investigator
affiliation: Maastro Clinic, The Netherlands
facility: 
country: Netherlands
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responsible party type: Sponsor
mesh term: Glioblastoma
mesh term: Glioma
mesh term: Astrocytoma