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Nasopharyngeal CarcinomaNCT06881225

Regulation of Blood-Brain Barrier Permeability by APOE Gene Polymorphism and Its Impact on Cognitive Function Post-Radiotherapy in Nasopharyngeal Carcinoma: An MRI Study

An observational study of Nasopharyngeal Carcinoma, run by Sun Yat-sen University at 1 site in China.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

adiotherapy-induced cognitive dysfunction is a severe complication following radiotherapy for nasopharyngeal carcinoma (NPC). Our previous studies have demonstrated that abnormalities in brain function and structural connectivity after radiotherapy play a significant role in the occurrence of radiation-induced… Read more about this study

Who is it for?
Ages 20 to 60 years
Conditions the study is for
Nasopharyngeal Carcinoma
What is being tested?
Using DCE-MRI, fMRI, and DSI, establish a longitudinal brain functional and structural imaging database for three groups of nasopharyngeal carcinoma patients before and 18 months after radiotherapy.
How many people
300 participants
Where
1 siteChina
Study dates
1 Jan 2024to 31 Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Study population: Collect nasopharyngeal carcinoma patients who seek medical treatment at Sun Yat - sen University Cancer Center

Who may be able to join

  • Patients newly diagnosed with nasopharyngeal carcinoma, pathologically confirmed, and who have not received anti - tumor treatments such as surgery, induction chemotherapy, or radiotherapy.
  • All patients are of Han ethnicity and right - handed. Patients are aged between 20 and 60 years old, with an educational level of junior high school or above.
  • The clinical stage of the included patients is AJCC 8th edition stage I - IVa, without distant metastasis, and patients are scheduled to receive intensity - modulated radiotherapy (IMRT) according to the clinical plan.
  • Patients have no other serious systemic diseases except nasopharyngeal carcinoma.
  • There is no intracranial invasion of nasopharyngeal carcinoma. Routine MRI examinations (including T1WI, T2WI, and FLAIR) are negative. The baseline basic cognitive assessment scales (MoCA and MMSE) before radiotherapy are normal.
  • Patients have no family history of mental illness. Patients have no history of neurological diseases or head trauma. After fully understanding the experimental content, the subjects agree to participate in this project and sign the informed consent form

Who cannot join

  • Patients diagnosed with Alzheimer's disease (AD) before being included. AD is diagnosed by psychiatrists according to the 9th Revision of the International Classification of Diseases, Clinical Modification (ICD - 9 - CM).
  • Patients with intracranial lesions detected by routine MRI examinations. Patients with contraindications to magnetic resonance examinations. Patients with concurrent other diseases. Patients with tumor recurrence who need re - radiotherapy, or those who cannot adhere to and complete IMRT treatment.
  • Left - handed or ambidextrous patients. Patients with a history of head trauma or mental/neurological diseases. Patients aged less than 20 or more than 60 years old. Patients with serious systemic diseases such as heart, lung, or kidney diseases.
  • Patients with diabetes or hypertension. Patients who cannot cooperate to complete the neurocognitive scale tests.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy

    Guangzhou, Guangdong, 523000

Other trials in China

About this study

Official title: Study on the Regulation of Blood-Brain Barrier Permeability by APOE Gene Polymorphism and Its Impact on Cognitive Function After Radiotherapy for Nasopharyngeal Carcinoma: An MRI Investigation

adiotherapy-induced cognitive dysfunction is a severe complication following radiotherapy for nasopharyngeal carcinoma (NPC). Our previous studies have demonstrated that abnormalities in brain function and structural connectivity after radiotherapy play a significant role in the occurrence of radiation-induced cognitive dysfunction. However, the key risk factors and underlying neural mechanisms remain unclear. Research has shown that increased blood-brain barrier (BBB) permeability after radiotherapy is an important mechanism leading to cognitive dysfunction, and different APOE gene subtypes can regulate BBB permeability. Therefore, APOE gene polymorphisms are likely to influence post-radiotherapy vascular barrier permeability in NPC patients, thereby affecting their brain function and structural connectivity changes, and ultimately impacting their cognitive function.

This project aims to establish a longitudinal brain imaging database for NPC patients with different APOE genotypes before and after radiotherapy, based on previous research findings. The project will integrate dynamic contrast-enhanced MRI (DCE-MR), resting-state functional MRI (fMRI), and diffusion spectrum imaging (DSI) techniques. By comparing DCE-derived metrics across different genotype groups, the study seeks to identify brain regions with BBB damage differences between APOE genotype groups before and after radiotherapy. Furthermore, it will investigate how BBB damage in these brain regions mediates functional and structural connectivity abnormalities, and their relationship with radiation-induced cognitive dysfunction. The goal is to clarify the neural regulation mechanism of APOE gene polymorphisms in radiation-induced cognitive dysfunction and to identify risk factors for radiation-induced cognitive dysfunction. This research will provide a theoretical basis and valuable reference for the individualized prevention and treatment of radiation-induced cognitive dysfunction.

Being tested
Using DCE-MRI, fMRI, and DSI, establish a longitudinal brain functional and structural imaging database for three groups of nasopharyngeal carcinoma patients before and 18 months after radiotherapy.
Medical subject headings
Nasopharyngeal Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Using DCE-MRI, fMRI, and DSI, establish a longitudinal brain functional and structural imaging database for three groups of nasopharyngeal carcinoma patients before and 18 months after radiotherapy.Other

    1. Resting-state fMRI: Use the Gradient Echo Echo Planar Imaging (GRE-EPI) sequence with the following parameters: repetition time (TR) = 2000 ms, echo time (TE) = 30 ms, flip angle (FA) = 90°, slice thickness = 3.0 mm, slice spacing = 0.8 mm, field of view (FOV) = 240 mm × 240 mm, matrix = 128 × 128, in-plane resolution = 64 × 64, 39 axial slices scanned, 240 dynamic scans.
    2. DSI: Use diffusion-sensitive imaging (DSI) with 64 diffusion directions, b-values of 0 and 1000 s/mm², TR = 3000 ms, TE = 64 ms, number of excitations (NEX) = 1, matrix = 112 × 112, FOV = 224 mm × 224 mm, slice thickness = 2 mm, no spacing between slices, full brain coverage, and 75 slices scanned.
    3. Three-dimensional brain structural MRI:

    Sagittal data acquisition is performed with the following parameters: TR = 8.16 ms, TE = 3.18 ms, inversion time (TI) = 800 ms, flip angle (FA) = 8°, matrix = 256 × 256, FOV = 256 mm × 256 mm, voxel size = 1 mm × 1 mm × 1 mm, and 176 slices scanned.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Blood-Brain Barrier Permeability as Measured by Ktrans Values from DCE-MRI

    The change in blood-brain barrier permeability will be quantified using the volume transfer constant (Ktrans) derived from Dynamic Contrast-Enhanced MRI (DCE-MRI). Ktrans values will be measured at baseline (pre-radiotherapy) and at 18 months post-radiotherapy. The difference in Ktrans values between these time points will be calculated to assess the change in permeability.

    Measured: From enrollment to 18 months after the completion of radiotherapy

  2. Change in Functional Connectivity as Measured by Resting-State fMRI

    Functional connectivity will be assessed using resting-state functional MRI (fMRI). The strength of functional connections between specific brain regions, particularly those identified as having significant blood-brain barrier damage, will be measured at baseline and at 18 months post-radiotherapy. The change in functional connectivity strength will be calculated and reported.

    Measured: From enrollment to 18 months after the completion of radiotherapy

  3. Change in Structural Connectivity as Measured by Diffusion Spectrum Imaging (DSI)

    Structural connectivity will be evaluated using Diffusion Spectrum Imaging (DSI). The integrity of white matter tracts, particularly those connecting regions with significant blood-brain barrier damage, will be measured at baseline and at 18 months post-radiotherapy. The change in structural connectivity, as indicated by metrics such as fractional anisotropy (FA) and mean diffusivity (MD), will be calculated and reported.

    Measured: From enrollment to 18 months after the completion of radiotherapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2025
  2. Study start1 Jan 2024
  3. Primary completion31 Dec 2024
  4. Study completion31 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
300 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06881225
Sponsor's protocol ID
G2024-069-01
Status last verified
Mar 2025
First submitted
15 Feb 2025
Last updated
18 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lozupone M, Imbimbo BP, Balducci C, Lo Vecchio F, Bisceglia P, Latino RR, Leone M, Dibello V, Solfrizzi V, Greco A, Daniele A, Watling M, Seripa D, Panza F. Does the imbalance in the apolipoprotein E isoforms underlie the pathophysiological process of sporadic Alzheimer's disease? Alzheimers Dement. 2023 Jan;19(1):353-368. doi: 10.1002/alz.12728. Epub 2022 Jul 28.

    PubMed 35900209
  • Main BS, Villapol S, Sloley SS, Barton DJ, Parsadanian M, Agbaegbu C, Stefos K, McCann MS, Washington PM, Rodriguez OC, Burns MP. Apolipoprotein E4 impairs spontaneous blood brain barrier repair following traumatic brain injury. Mol Neurodegener. 2018 Apr 4;13(1):17. doi: 10.1186/s13024-018-0249-5.

    PubMed 29618365
  • Jackson RJ, Meltzer JC, Nguyen H, Commins C, Bennett RE, Hudry E, Hyman BT. APOE4 derived from astrocytes leads to blood-brain barrier impairment. Brain. 2022 Oct 21;145(10):3582-3593. doi: 10.1093/brain/awab478.

    PubMed 34957486
  • Bell RD, Winkler EA, Singh I, Sagare AP, Deane R, Wu Z, Holtzman DM, Betsholtz C, Armulik A, Sallstrom J, Berk BC, Zlokovic BV. Apolipoprotein E controls cerebrovascular integrity via cyclophilin A. Nature. 2012 May 16;485(7399):512-6. doi: 10.1038/nature11087.

    PubMed 22622580
  • Tang Y, Luo D, Rong X, Shi X, Peng Y. Psychological disorders, cognitive dysfunction and quality of life in nasopharyngeal carcinoma patients with radiation-induced brain injury. PLoS One. 2012;7(6):e36529. doi: 10.1371/journal.pone.0036529. Epub 2012 Jun 11.

    PubMed 22701557
  • Penn IW, Chung CH, Huang YC, Chen MC, Sun CA, Yip PK, Chien WC. Increased risk of dementia in patients with nasopharyngeal cancer treated with radiation therapy: A nationwide population-based cohort study. Arch Gerontol Geriatr. 2021 Mar-Apr;93:104303. doi: 10.1016/j.archger.2020.104303. Epub 2020 Nov 22.

    PubMed 33302001
  • Zheng Z, Wang B, Zhao Q, Zhang Y, Wei J, Meng L, Xin Y, Jiang X. Research progress on mechanism and imaging of temporal lobe injury induced by radiotherapy for head and neck cancer. Eur Radiol. 2022 Jan;32(1):319-330. doi: 10.1007/s00330-021-08164-6. Epub 2021 Jul 29.

    PubMed 34327577
  • Hsiao KY, Yeh SA, Chang CC, Tsai PC, Wu JM, Gau JS. Cognitive function before and after intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma: a prospective study. Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):722-6. doi: 10.1016/j.ijrobp.2009.06.080. Epub 2010 Jan 13.

    PubMed 20044217
  • Tofilon PJ, Fike JR. The radioresponse of the central nervous system: a dynamic process. Radiat Res. 2000 Apr;153(4):357-70. doi: 10.1667/0033-7587(2000)153[0357:trotcn]2.0.co;2.

    PubMed 10798963
  • McDowell LJ, Ringash J, Xu W, Chan B, Lu L, Waldron J, Rock K, So N, Huang SH, Giuliani M, Hope A, O'Sullivan B, Bratman SV, Cho J, Kim J, Jang R, Bayley A, Bernstein LJ. A cross sectional study in cognitive and neurobehavioral impairment in long-term nasopharyngeal cancer survivors treated with intensity-modulated radiotherapy. Radiother Oncol. 2019 Feb;131:179-185. doi: 10.1016/j.radonc.2018.09.012. Epub 2018 Sep 29.

    PubMed 30279047

Questions about this trial

What is this clinical trial studying?

An observational study of Nasopharyngeal Carcinoma, run by Sun Yat-sen University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 18 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Blood-Brain Barrier Permeability as Measured by Ktrans Values from DCE-MRI (time frame: From enrollment to 18 months after the completion of radiotherapy). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06881225, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2025.

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