Cognitive Changes of IDH-mutant and IDH-wildtype Glioma Patients After Chemoradiotherapy With Radiation Dose to the Resting State Networks

Inclusion Criteria:

• Cohort A: histological diagnosis of IDH-mutant astrocytoma or oligodendroglioma, WHOgrade II-IV. IDH-mutation may be either by immunohistochemistry (IHC) ornext-generation sequencing (NGS) as per routine clinical care.

• Cohort B: histological diagnosis of IDH-wildtype astrocytoma, WHO grade II-IV.IDH-wildtype status or absence of IDH-mutation may be either by IHC or NGS as perroutine clinical care. The IDH-wildtype patients should have >80% probability to bealive in 6 months, and the online nomogram calculator below may be used to estimatethe 6-month probability: http://cancer4.case.edu/rCalculator/rCalculator.html (Gittleman et al., 2016). The ideal patients are favorable IDH-wildtype astrocytomapatients who are expected to have prolonged survival, such as age ≤ 40 or grade 2-3tumors.

• Cohort C: any non-infiltrative benign brain tumor histology, including but notlimited to meningioma, pituitary tumor, schwannoma, craniopharngioma,hemangioblastoma, hemangiopericytoma, pineal tumor, pilocytic astrocytoma, andganglioglioma.

• At least 18 years of age.

• Karnofsky performance status (KPS) of at least 70%

• Eligible for and planning to receive standard fractionated RT, which can be eitherphoton-based or proton beam therapy.

• May be part of other clinical trials and can receive chemotherapy or experimentalagents concurrently with or after RT as long as the other clinical trial does notexclude participation in this non-therapeutic study.

• Females of childbearing potential (defined as a female who is non-menopausal orsurgically sterilized) must be willing to use an acceptable method of birth control (i.e., hormonal contraceptive, intra-uterine device, diaphragm with spermicide,condom with spermicide, or abstinence) for the duration of the study. Should a womanbecome pregnant or suspect she is pregnant while participating in this study, shemust inform her treating physician immediately.

• Able to understand and willing to sign an IRB-approved written informed consentdocument (legally authorized representative permitted).

Exclusion Criteria:

• Prior cranial RT or RT to the head and neck where potential field overlap may exist

• Gliomatosis, leptomeningeal, or metastatic involvement.

• Medical contraindication to MRI (e.g., unsafe foreign metallic implants,incompatible pacemaker, inability to lie still for long periods, severe to end-stagekidney disease or on hemodialysis).

• Require anesthesia to undergo MRI (e.g. severe claustrophobia), which wouldinterfere with RS-fMRI acquisition and processing.

• Pregnant or breastfeeding.

• Non-English speaking, as the cognitive assessments will only be available inEnglish.