Research and treatment protocols for brain tumoursRResearch and treatment protocols for brain tumoursResearch and treatment protocols for brain tumoursEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-08-14T04:00:00ZEric Bouffet, MD, FRCPC9.0000000000000054.00000000000001312.00000000000Flat ContentHealth A-Z<p>An in-depth explanation of treatment protocols and their importance for treating childhood brain tumours. Answers by Canadian Paediatric Hospitals</p><p>A protocol is a written plan that describes in detail how to treat a particular brain tumour. It describes the drugs, dosages, and tests that are needed. It tells the treatment team how often and when each drug should be given based on a schedule. Each protocol is based on research that shows which treatments are more effective. </p><h2>Key points</h2> <ul><li>Protocols ensure that the treatment is the same for all children with the same tumour.</li> <li>One type of protocol is where all participants receive the same treatment while another protocol compares two treatment plans to improve results.</li> <li>Experts from many hospitals work together to develop protocols.</li></ul>
Recherche et protocoles de traitement et les tumeurs cérébralesRRecherche et protocoles de traitement et les tumeurs cérébralesResearch and treatment protocols for brain tumoursFrenchNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-08-14T04:00:00ZEric Bouffet, MD, FRCPC9.0000000000000054.00000000000001312.00000000000Flat ContentHealth A-Z<p>Explication approfondie des protocoles de traitement et de leur importance dans le traitement des tumeurs cérébrales chez les enfants. Réponses des hôpitaux pédiatriques canadiens.</p><p>Un protocole est un plan écrit où l’on indique en détail comment traiter une tumeur cérébrale en particulier. On y décrit les médicaments, les doses et les tests nécessaires. Il indique à l’équipe de traitement à quelle fréquence et quel moment chaque médicament doit être administré selon un calendrier. Chaque protocole se fonde sur des recherches qui montrent quels traitements sont les plus efficaces. </p><h2>À retenir</h2> <ul><li>Le protocole permet de s’assurer que le traitement est le même pour tous les enfants atteints de la même tumeur.</li> <li>Dans un type de protocole, tous les participants reçoivent le même traitement alors que dans l’autre type de protocole, on compare deux plans traitements afin d’améliorer les résultats.</li> <li>Des experts de nombreux hôpitaux travaillent en collaboration afin d’élaborer des protocoles.</li></ul>

 

 

Research and treatment protocols for brain tumours1387.00000000000Research and treatment protocols for brain tumoursResearch and treatment protocols for brain tumoursREnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-08-14T04:00:00ZEric Bouffet, MD, FRCPC9.0000000000000054.00000000000001312.00000000000Flat ContentHealth A-Z<p>An in-depth explanation of treatment protocols and their importance for treating childhood brain tumours. Answers by Canadian Paediatric Hospitals</p><p>A protocol is a written plan that describes in detail how to treat a particular brain tumour. It describes the drugs, dosages, and tests that are needed. It tells the treatment team how often and when each drug should be given based on a schedule. Each protocol is based on research that shows which treatments are more effective. </p><h2>Key points</h2> <ul><li>Protocols ensure that the treatment is the same for all children with the same tumour.</li> <li>One type of protocol is where all participants receive the same treatment while another protocol compares two treatment plans to improve results.</li> <li>Experts from many hospitals work together to develop protocols.</li></ul><h2>What is a protocol?</h2> <p>A protocol ensures that:</p> <ul> <li> The treatment is the same for all children with the same tumour at the same hospital.</li> <li> The treatment is the same for all children with the same tumour at many different hospitals. This type of protocol is organized by associations, such as the Children’s Oncology Group (COG). </li></ul> <p>There are two types of protocols:</p> <ol> <li> <p>One type of protocol is where all participants receive the same treatment. It is done simply to collect information about that approach. The terminology used to describe this type of protocol can be confusing. This type of protocol is sometimes called a treatment study, a phase II study, or a pilot study. </p></li> <li> <p>The other type of protocol is a Phase III clinical trial. This type of protocol compares one standard plan of care with another plan that seeks to improve results and reduce side effects. Most treatment breakthroughs happen with a randomized study. For example, the current treatment for a medulloblastoma is based on the results of seven randomized studies, including three from the International Society of Paediatric Oncology (SIOP), and three from the Children’s Cancer Group (CCG). As a result of these studies, the researchers learned that delaying radiation therapy could have a negative affect on the results of treatment. This is why radiation therapy is given soon after surgery to treat a medulloblastoma . </p></li></ol> <h2>How are research protocols organized?</h2> <p>Experts from many hospitals work together to develop protocols. The results from each hospital are gathered and studied. Because brain tumours are so rare, gathering the results helps researchers to see whether a treatment actually works for a particular tumour in a large number of children. </p> <p>Researchers have developed international groups to oversee and coordinate these efforts. The main organization that develops research protocols for children in North America is called the Children’s Oncology Group (COG). An example of a protocol is COG protocol 0332 for children with high risk medulloblastoma . </p> <p>Protocols can change if new research shows there are other drugs, or combinations of drugs and radiation, that are more effective.</p> <p>Drug companies are not involved in organizing COG protocols.</p> <h2>What is a randomization?</h2> <p>Randomization is used in studies that involve two or more groups. Each group gets a different treatment, and patients have to be placed in one of the groups. Randomization means that the patients are placed in a group by chance. This makes sure the results are not biased and will apply to greater numbers of people. A bias may be possible if a person decides who goes in which group. Usually a computer will assign a patient to a group. Most research protocols need randomization at diagnosis. </p> <h2>Why do different hospitals have different protocols for the same tumour?</h2> <p>Different groups of experts may develop their own protocols. In some cases, an individual hospital might have its own protocol for a particular tumour. </p> <p>It’s important to realize two general points. First, the initial treatment for a tumour is fairly standard. Although there might be differences in protocols, they are small differences. Second, everyone who develops a protocol has the same goals: to improve the results of treatment, and reduce side effects. </p> <p>Each protocol is reviewed and approved by a regulatory board.</p> <p>Even though there may be different protocols, the treatment team must follow its own protocol precisely to make sure that they are providing the exact same treatment for all patients with the same diagnosis. </p> <h3>My child has just been diagnosed with a brain tumour. Should I enrol my child in a clinical trial or research protocol?</h3> <p>This is a difficult decision for many parents. Not only must you deal with your child having a serious illness, but you are also asked to make an additional decision about joining a study. Some parents worry that their doctor is only interested in research and that their child is simply a “guinea pig.” Another factor that can make this a stressful decision is the fact that the treatment might be based on randomization — your child will get one of two treatments based on chance. Parents worry that their child may get into the “wrong” group. </p> <p>There are some questions you should ask to help you make a decision. For example, it’s important to know the phase of the study. In many cases, on diagnosis, the doctor will be talking to you about a phase III study, which involves randomization. The study will compare the standard treatment to a second treatment that seems to be promising to see which is better. </p> <p>In a phase III study, researchers know a lot about this second treatment. It has shown some benefits in phase II trials. The researchers are doing the study because they want to know for certain if there is some advantage of the experimental treatment — such as a greater improvement than the standard treatment or a reduction of risks associated with the standard treatment — for your child’s particular tumour. So in this case, the study might not be as “experimental” as you might have feared. </p> <p>However, if your child has a tumour with a low cure rate, then the doctor might talk about doing a phase I or phase II study. These are more experimental studies done on small numbers of patients. </p> <p>Before you make any decision, make sure the doctor or nurse addresses all your questions and worries. Consider the advantages and disadvantages of clinical trials. </p> <p>Even if you decide not to have your child participate, your doctor may ask for your permission to do further research on the sample of your child’s tumour. This would have been removed during surgery. This is called a biological study. This approval calls for no additional effort from you or your child. Learning more about the biology of tumour cells may help researchers develop new treatments in the future. </p> <h2>Questions you may want to ask about a clinical trial</h2> <ul> <li> What is the purpose of the study?</li> <li> What phase is the study?</li> <li> What is involved in the treatment plan?</li> <li> What are the benefits of participating?</li> <li> What are the risks of participating?</li> <li> Is there any information about how other children have responded to the same treatment?</li> <li> What are the side effects, both in the short-term and long term? How will the side effects be prevented or managed?</li> <li> Are any extra diagnostic tests required? </li> <li> How will participating in the trial affect my child’s daily life?</li> <li> What effect might this have on other family members?</li></ul> <h2>How will my child be protected if we agree to join a clinical trial?</h2> <p>There is a system in place to protect people who participate in clinical trials. First, the protocol must be approved by a review committee and research ethics board. During the trial, these committees make sure the plan is being followed. Participants must be told in detail about the treatments, tests, possible benefits, and risks of the trial. This is called informed consent. Then they can make a decision. At any time, they may withdraw from a clinical trial. </p> <h2>What are the advantages and disadvantages of putting my child in a clinical trial?</h2> <p>Here are some general advantages and disadvantages to consider and talk to your doctor about.</p> <h3>Advantages</h3> <ul> <li> your child gains access to new treatments that are not otherwise available</li> <li> participation contributes to medical research and may help others in the future</li> <li> your child may benefit from the improvement associated with an experimental treatment</li></ul> <h3>Disadvantages</h3> <ul> <li> your child may need to have more clinic visits, hospital stays, tests, or other complex drug requirements</li> <li> depending on the phase of the trial, the result may not be known and the treatment may not work</li> <li> there may be unknown side effects or reactions</li></ul>Research and treatment protocols for brain tumours

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