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CompletedNCT03376386ADMIREUpdated Jun 27, 2019

Adaptive Dose-Escalated Multi-modality Image-guided RadiothErapy

An interventional study of Adaptive dose-Escalated multi-modality image-guided radiotherapy in Head and Neck Cancer, sponsored by The Netherlands Cancer Institute. Completed at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-06-27.

Sponsored by The Netherlands Cancer Institute · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Patients with primary head and neck squamous cell carcinoma (HNSCC) planned for treatment with radiotherapy with or without chemotherapy in curative setting will be treated with an adaptive radiotherapy scheme. An FDG-PET/CT scan for re-delineation and re-planning will be made at the end of the second and fourth of week of radiotherapy. The non-responding part of the tumor on FDG-PET will receive a mild dose-escalation. Depending on the metabolic response, the entire tumor will receive 70 Gy or the residual FDG-avid area will receive 74 or 78 Gy.

Read the detailed description

If there is a complete metabolic response on the FDG-PET after 2 weeks, the entire tumor will receive 70 Gy. If there is a complete metabolic response after 4 weeks of treatment, the residual FDG-avid area will receive 74 Gy. If there also is no complete metabolic response after 4 weeks of treatment, the residual FDG-avid area will receive 78 Gy.

02

Conditions studied

  • Head and Neck Cancer

Keywords

  • Adaptive
  • Image-guided
  • Radiotherapy
  • Head and Neck cancer
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Histologic biopsy confirmed squamous cell carcinoma of the oral cavity, HPV-negative oropharynx, HPV-positive oropharynx with a minimum of 10 pack-years, hypopharynx or larynx
  • T2-T4
  • Scheduled for radiotherapy or radiotherapy with cisplatin or cetuximab

Exclusion criteria

Exclusion Criteria:

  • GFR\<30
  • Other neoplasms with metastases in the previous 3 years
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (actual)

Study arms

  • Other
    HNSCC receiving (chemo)radiotherapy

    Imaging

    Radiation: Adaptive dose-Escalated multi-modality image-guided radiotherapy

Interventions

  • RadiationAdaptive dose-Escalated multi-modality image-guided radiotherapy

    FDG-PET/CT-scan will be used twice during radiotherapy for a mild dose-escalation to the less-responding parts of the tumor. By adapting the radiotherapy plan, these areas will receive 74-78 Gy.

05

What researchers measure

Primary outcomes

  1. the feasibility of the adaptive radiotherapy scheme estimated by the acute toxicities and implementation of the adaptive treatment plans

    The feasibility of the adaptive radiotherapy schedule will be rejected in case of: Occurrence of intolerable radiation-induced acute toxicities.

    Time frame: 1 year

  2. the feasibility of the adaptive radiotherapy scheme estimated by the implementation of the adaptive treatment plans

    The feasibility of the adaptive radiotherapy schedule will be rejected in case of: The inability to implement 80% of the adaptive treatment plans within 2 days from the intended starting day

    Time frame: 1 year

Secondary outcomes

  1. the toxicity of the adaptive RT scheme

    according to the CTCAE v4.0 scoring system

    Time frame: 1 year

  2. the locoregional tumor control

    Time frame: 1 year

  3. relative response will be calculated for the decrease of the SUV-value

    the prognostic value of the FDG-PET/CT-scans

    Time frame: 1 year

06

Study locations

1 site
  • Netherlands Cancer Institute
    Amsterdam, 1066CX, Netherlands
07

References and documents

Publications

  • Gouw ZAR, La Fontaine MD, Vogel WV, van de Kamer JB, Sonke JJ, Al-Mamgani A. Single-Center Prospective Trial Investigating the Feasibility of Serial FDG-PET Guided Adaptive Radiation Therapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys. 2020 Nov 15;108(4):960-968. doi: 10.1016/j.ijrobp.2020.04.030. Epub 2020 Apr 30. PubMed 32361007 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03376386
Lead sponsor
The Netherlands Cancer Institute
Responsible party
Sponsor
First posted
Dec 18, 2017
Start date
Dec 21, 2017
Primary completion
Apr 25, 2019
Completion
Apr 25, 2019
Last update
Jun 27, 2019

Study contacts

Abrahim Al-Mamgani, MD, PhD
principal investigator · The Netherlands Cancer Institute

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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