Natural History of Patients With Brain and Spinal Cord Tumors
Natural History of Patients With Brain and Spinal Cord Tumors
This study offers evaluation of patients with brain and spinal cord tumors. Its purpose is
 threefold: 1) to allow physicians in NIH s Neuro-Oncology Branch to increase their knowledge
 of the course of central nervous system tumors and identify areas that need further research;
 2) to inform participants of new studies at the National Cancer Institute and other centers
 as they are developed; and 3) to provide patients consultation on possible treatment options.

 Children (at least 1 year old) and adults with primary malignant brain and spinal cord tumors
 may be eligible for this study. Participants will have a medical history, physical and
 neurological examinations and routine blood tests. They may also undergo one or more of the
 following procedures:

 -  Magnetic resonance imaging (MRI) MRI is a diagnostic tool that uses a strong magnetic
 field and radio waves instead of X-rays to show detailed changes in brain structure and
 chemistry. For the procedure, the patient lies on a table in a narrow cylinder
 containing a magnetic field. A contrast material called gadolinium may be used (injected
 into a vein) to enhance the images. The procedure takes about an hour, and the patient
 can speak with a staff member via an intercom system at all times.

 -  Computed axial tomography (CAT or CT) CT is a specialized form of X-ray imaging that
 produces 3-dimensional images of the brain in sections. The scanner is a ring device
 that surrounds the patient and contains a moveable X-ray source. The scan takes about 30
 minutes and may be done with or without the use of a contrast dye.

 -  Positron emission tomography (PET) PET is a diagnostic test that is based on differences
 in how cells take up and use glucose (sugar), one of the body s main fuels. The patient
 is given an injection of radioactive glucose. A special camera surrounding the patient
 detects the radiation emitted by the radioactive material and produces images that show
 how much glucose is being used by various tissues. Fast-growing cells, such as tumors,
 take up and use more glucose than normal cells do, and therefore, the scan might
 indicate the overall activity or aggressiveness of the tumor. The procedure takes about
 an hour.

 When all the tests are completed, the physician will discuss the results and potential
 treatment options with the patient. Follow-up will vary according to the individual. Some
 patients may end the study with just one visit to NIH, while others may be followed at NIH
 regularly, in conjunction with their local physicians. Patients with aggressive tumors may be
 seen every 3 or 4 months, while those with less active tumors may be seen every 6 to 12
 months. Permission may be requested for telephone follow-up (with the patient or physician)
 of patients not seen regularly at NIH.

 ...
Background:

 This protocol is designed to evaluate patients with tumors of the central nervous system
 (CNS) who appear to be probable candidates for future protocol entry or have disease
 manifestations that are of unique scientific interest, importance, and/or educational value.

 Objective:

 To evaluate patients with tumors of the central nervous system (CNS) who are probable future
 candidates for NCI Phase I and II protocols.

 To follow patients with tumors of the CNS that are representative of important scientific
 and/or clinical principles.

 To allow a steady flow of patients with tumors of the CNS at the NIH for the purpose of
 educating nurses, medical students, residents, clinical fellows, and physicians in the
 management and care of this specialized subgroup of cancer patients.

 Eligibility:

 All patients greater than 12 months of age with tumors of the CNS of interest to the NOB, who
 may be candidates for another NOB trial at some point in the future.

 Patients with tumors of the CNS that are of particular interest to members of the NOB because
 they pose important clinical and/or scientific questions and/or shed light on important
 aspects of the disease.

 Patients with tumors of the CNS who offer an important educational benefit to neuro-oncology
 trainees and staff.

 Ability of subject or Legally Authorized Representative (LAR) to understand and the
 willingness to sign a written informed consent document. Availability of a parent or legal
 guardian to give informed consent for children.

 Design:

 All patients will undergo an initial evaluation at the Clinical Center by a member of the NOB
 where past medical and oncologic histories will be obtained as well as relevant data such as
 neuroimaging and pathology review. A total of 3,000 patients will be accrued to this study.

 Patients may be seen at the NIH Clinical Center at varying intervals depending on the
 clinical situation but data related to the natural history of their disease course and
 outcome will be collected at least every six months.
-  INCLUSION CRITERIA:

 All patients greater than or equal to 12 months of age with tumors of the CNS of interest
 to the NOB, who may be candidates for another NOB trial at some point in the future.

 Patients with tumors of the CNS that are of particular interest to members of the NOB
 because they pose important clinical and/or scientific questions and/or shed light on
 important aspects of the disease.

 Patients with tumors of the CNS who offer an important educational benefit to
 neuro-oncology trainees and staff.

 Ability of subject or Legally Authorized Representative (LAR) to understand and the
 willingness to sign a written informed consent document. Availability of a parent or legal
 guardian to give informed consent for children.

 EXCLUSION CRITERIA:

 Patients less than 12 months of age.