Anesthesia Induced Brain Cancer Survival (ABC Survival): A Feasibility Study
Status:
Not yet recruiting
Trial end date:
2022-12-30
Target enrollment:
Participant gender:
Summary
Cancer is a leading cause of death worldwide. It is estimated that approximately 55,000
Canadians are surviving with brain tumors. It is projected that around 3000 persons will be
diagnosed with brain and spinal cord tumors, and approximately 75 percent patients will not
survive. Out of all brain cancers, high-grade gliomas [Glioblastoma Multiforme (GBM)] impose
highest morbidity and mortality. Therefore, it is important to explore ways in which
Investigators can improve and prolong the lives of patients suffering from brain cancers,
particularly high-grade glioma, which is the most common and aggressive primary brain tumor.
So far the Investigators know that the surgery, chemotherapy and radiotherapy are the three
corner stones management options for these patients, and majority of the research have been
conducted on these three major domains. Therefore, it is imperative to explore the other
variables those may impact survival characteristics. One of the integral variables of the
brain cancer surgery is anesthesia. Interestingly, the role of anesthetics was explored in
some other non-brain solid organ tumor surgeries. It is observed that out of the two main
types of anesthesia [one is through intravenous (propofol) and other one is gaseous
(sevoflurane)], intravenous based anesthesia maintenance regime may delay the cancer
progression and prolong the recurrence free period. In addition, two very large retrospective
studies with approximately 11,000 and 18,000 patients respectively, showed that as compared
to gaseous (volatile anesthetics) based, intravenous (propofol) based anesthesia conferred
some protection against cancer progression and was also associated with lesser overall
mortality. The exact nature of these protective mechanisms is not known but in animal and
other laboratory-based experiments, propofol seems to inhibit cancer formation steps, delays
inflammation and provide protection from cancer cell growth. This is a feasibility study for
knowing various aspects of workflow; recruitment characteristics of participants and various
obstacles in implying anesthesia based protocols so that the Investigators can conduct a
well-designed multicenter international randomized study.