A trial giving radiotherapy again for glioblastoma (BRIOChe)

Cancer type:

Brain (and spinal cord) tumours




Phase 2

This trial compares having radiotherapy again with chemotherapy for glioblastoma that has come back after treatment. 

It is open to people who have a brain tumour called glioblastoma that has come back after initial treatment. 

More about this trial

Glioblastoma is a type of brain tumour. Doctors can treat glioblastoma with:

  • surgery
  • radiotherapy
  • chemotherapy 

Unfortunately for some people the glioblastoma can start to grow again. Doctors in the UK usually treat this with chemotherapy. 

We know from research that having radiotherapy a second time can help treat glioblastomas that have come back. 

In this trial half the people will have radiotherapy again. And the other half will have standard chemotherapy Open a glossary item

The aims of the trial are to find out:

  • how well having radiotherapy again works 
  • how the treatments affect quality of life. Open a glossary item
  • more about the side effects of both treatments

Who can enter

The following bullet points are a summary of the entry conditions for this trial. Talk to your doctor or the trial team if you are unsure about any of these. They will be able to advise you. 

Who can take part

You may be able to join this trial if all of the following apply. You:

  • have a brain tumour called glioblastoma that has come back after your initial treatment. You can also join if your glioblastoma had come back once, you had surgery to remove it and no other treatment. 
  • finished your initial radiotherapy at least 6 months ago 
  • had at least 2 weeks of temozolomide with your initial radiotherapy
  • had an MRI scan Open a glossary item using a contrast dye Open a glossary item to confirm the glioblastoma has come back within 3 weeks of going into a treatment group (randomisation Open a glossary item)
  • can look after yourself but might not be able to do all your usual activities or active work (Karnofsky performance status 70 to 100)
  • have satisfactory blood test results
  • are willing to use contraception during treatment and for a time after if you or your partner could become pregnant
  • can swallow tablets and capsules
  • are at least 18 years old

Who can’t take part

Cancer related
You cannot join this trial if any of these apply. You:

  • have cancer that has come back in the tissue surrounding the brain or spinal cord  
  • have already had systemic treatment Open a glossary item such as chemotherapy for the glioblastoma that has come back
  • have already had radiotherapy for glioblastoma that has come back
  • have already had very high doses of radiotherapy to certain parts of the brain. Your doctor will know if you have.   
  • only have glioblastoma that has come back that the contrast dye has not highlighted on the MRI scan. Your doctor will know about this. 
  • have more than 3 areas where the glioblastoma has come back 
  • have certain gene changes (mutations Open a glossary item) in your glioblastoma. Your doctor will know about this. 
  • have had another cancer apart from non melanoma skin cancer Open a glossary item. You can join if you have had treatment for another cancer and there has been no sign of it for at least a year. 
  • are not able to have chemotherapy or radiotherapy 
  • have ongoing side effects from previous treatment
  • are taking part in another clinical trial using an experimental drug or device 

Medical conditions
You cannot join this trial if any of these apply. You:

  • are not able to have an MRI scan with the contrast dye. This could be because you have metal such as surgical clips in your body or you are allergic to the dye. There are other reasons that your doctor will know about. 
  • have an inherited Open a glossary item condition where your body is not able to absorb sugars such as lactose, galactose and glucogalactose. You also cannot join if you are allergic to these sugars. 
  • have a disease that affects the spinal cord or the lower back part of the brain
  • have another medical condition or mental health problem that could affect you taking part in the trial

You cannot join this trial if any of these apply. You

  • have had an allergic reaction to nitrosoureas Open a glossary item
  • are pregnant or breastfeeding

Trial design

This is a phase 2 trial. The team need 61 people to join. 

It is a randomised trial. A computer puts you into a treatment group. Neither you nor your doctor choose which group you are in. There are 2 groups:

  • radiotherapy 
  • chemotherapy 

Out of every 3 people who join the trial 2 will go into the radiotherapy group.

You have radiotherapy once a day Monday to Friday for 2 weeks. It takes about 15 minutes each time. Before your radiotherapy starts you have a planning appointment.

Your doctor will explain which is the best chemotherapy for you. This can be one of the following standard treatments:

You have chemotherapy once every 6 weeks. Each 6 weeks period is a cycle of treatment Open a glossary item. You have up to 6 cycles of treatment as long as it is working and the side effects aren’t too bad. 

Lomustine is a capsule. You take it once at the start of each cycle of treatment. You take it at bedtime on an empty stomach. Your doctor will tell you how many to take. 

Procarbazine is a capsule. You take it for 10 days at the start of each cycle of treatment. Your doctor will tell you how many to take. 

You have vincristine as a drip into a vein. You have it once at the start of each cycle of treatment. 

Quality of life
You fill in questionnaires at the start of the treatment and then every 6 weeks for up to 18 months. 

The questions ask about:

  • side effects
  • symptoms
  • general health and wellbeing
  • what you are able to do

These are quality of life questionnaires.

The team will ask a small number of people and their partners or carers for an interview. A member of the team will contact you to arrange a time and place convenient to you. The interview can take place:

  • at a clinic appointment
  • over the phone
  • using video conference
  • at your home

They will ask:

  • how the glioblastoma has affected your life
  • how the treatment has affected your life
  • what is important to you, your family and carers

The interview takes about an hour. It is tape recorded. All your details and answers are kept safe and confidential. Only members of the research team can access the recording. 

You don’t have to agree to do the interview if you don’t want to. 

Hospital visits

You see the doctor for tests before taking part. These are:

  • a physical examination Open a glossary item
  • blood tests
  • MRI scan of the brain
  • a test to see how well your brain and nerves work – a neurological examination

You see the doctor regularly during treatment. This is to see how you are and for blood tests.

After treatment you see the doctor every 6 weeks for about 18 months. 

You have an MRI scan every 12 weeks. 

Side effects

The trial team monitor you during treatment and afterwards. Contact your advice line or tell your doctor or nurse if any side effects are bad or not getting better. 
The most common side effects of having radiotherapy again are similar to when you had radiotherapy the first time. These include:

  • tiredness
  • hair loss in patches where you have the radiotherapy
  • feeling or being sick
  • headaches
  • dizziness
  • swelling of the brain 
  • skin redness and irritation on the scalp
  • crustiness or blockage of the ear which could cause temporary hearing problems
  • weakness
  • seizures (fits)
  • dry mouth or taste changes
  • temporary worsening of existing symptoms such as weakness and problems with talking and speech

Radiotherapy might cause damage to the brain tissue. This is radionecrosis. It can happen weeks or months after treatment. Depending on where your glioblastoma is, this may not cause any symptoms. Or it could cause symptoms similar to those listed above. In most cases you can have steroids to treat the symptoms of radionecrosis. Very rarely you might need surgery.

Your doctor, nurse or radiographer will closely monitor you for these side effects during and after treatment.

We have more information about the side effects of having radiotherapy to the brain.

We have information about the chemotherapy drugs and their side effects:

Your doctor will talk to you about the possible side effects of all the treatments before you agree to take part. 


Newcastle upon Tyne

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Louise Murray

Supported by

The Jon Moulton Charity Trust
University of Leeds

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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