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RecruitingNCT06282497Updated May 1, 2024

Xerostomia-optimised IMRT Versus Standard IMRT in NPC

An interventional study of Optimised neck CTV and standard neck CTV in Nasopharyngeal Carcinoma ,Xerostomia,Radiotherapy, sponsored by Zhongshan People's Hospital, Guangdong, China. Recruiting at 1 site in China. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2024-05-01.

Sponsored by Zhongshan People's Hospital, Guangdong, China · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
524
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This is a multi-center, non-inferiority, open-label, randomized controlled phase III clinical trial in primary diagnosed nasopharyngeal carcinoma (NPC) patients without distant metastasis. This study aims to compare the regional control, survival outcomes, radiation-related toxicities, and quality of life (QoL) of xerostomia-optimized intensity-modulated radiotherapy versus standard intensity-modulated radiotherapy in NPC patients

Read the detailed description

Xerostomia remains one of the most common radiation-induced toxicities, and approximately 80% to 90% of NPC patients still experience varying degrees of xerostomia post-IMRT. Among the major salivary glands, the parotid gland is the largest and produces 60% to 65% of the oral saliva output. Studies have revealed that xerostomia post-IMRT is mainly dependent on the irradiation dose of the parotid glands. Clinical target volumes (CTV) for the cervical nodal region starting from skull base have been the standard in nasopharyngeal carcinoma for several decades. Consequently, the parotid glands overlap with the target volumes and irradiation dose reaches 31.7 Gy to 43.9 Gy in most reports. Retrospective studies reveal that the lateral process of C1 is a suitable cranial edge for neck CTV delineation; therefore, the volume of the parotid glands exposed to high radiation doses can be greatly reduced. we conducted this trial comparing outcomes ,toxicities and QoL of xerostomia-optimized intensity-modulated radiotherapy versus standard intensity-modulated radiotherapy in nasopharyngeal carcinoma.

02

Conditions studied

  • Nasopharyngeal Carcinoma ,Xerostomia,Radiotherapy
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Newly histologic diagnosis of nasopharyngeal non-keratinizing carcinoma (WHO II/III);
  • All genders, range from 18-70 years old;
  • ECOG score 0-1;
  • Clinical stage I-IVa (AJCC/UICC 8th);
  • Not received radiotherapy, chemotherapy and other anti-tumor treatment (including immunotherapy);
  • No contraindications to chemotherapy or radiotherapy;
  • Adequate organ function: white blood cell count ≥ 4×109/L, neutrophile granulocyte count ≥ 1.5×109/L, hemoglobin ≥ 90g/L, platelet count ≥ 100×109/L; alanine aminotransferase or aspartate aminotransferase \< 2.5×upper limit of normal; blood urea nitrogen or creatinine ≤ 1.5×upper limit of normal or endogenous creatinine clearance ≥ 60ml/min (Cockcroft-Gault formula);
  • Sign the consent form.

Exclusion criteria

Exclusion Criteria:

  • Level II involvement with extracapsular extension (ECE), and/or had a maximum nodal axial diameter (MAD) of greater than 3cm in level II ;

    -≥4 nodal regions of ipsilateral neck involvement;

  • Radiologically suspicious or confirmed involvement in level II area between skull base and the lateral process of C1;
  • Parotid lymph node and/or parotid gland involvement;
  • History of parotid disease or surgery;
  • Previous malignancy or other concomitant malignant disease;
  • Pregnancy or lactation.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
524 participants (estimated)

Study arms

  • Experimental
    Study Group

    optimised neck CTV delineation

    Radiation: Optimised neck CTV

  • Active comparator
    Control Group

    standard neck CTV delineation

    Radiation: standard neck CTV

Interventions

  • RadiationOptimised neck CTV

    neck CTV delineation extends from the lateral process of C1

  • Radiationstandard neck CTV

    neck CTV delineation extends from skull base

05

What researchers measure

Primary outcomes

  1. Regional recurrence free survival

    From the date of randomization to regional recurrence or any death

    Time frame: 3 years

Secondary outcomes

  1. Overall survival

    From the date of randomization to any death, with patients unavailable for follow-up censored at the date of last follow-up

    Time frame: 3 years

  2. Local recurrence free survival

    From the date of randomization to local recurrence or any death

    Time frame: 3 years

  3. Distant metastasis-free survival

    From the date of randomization to distant metastasis or any death

    Time frame: 3 years

  4. Progression free survival

    From the date of randomization to local or regional recurrence, distant metastasis or any death

    Time frame: 3 years

  5. Acute toxicities

    Assessed with CTCAE v5.0

    Time frame: From the start of treatment until 3 months post treatment

  6. Late toxicities

    Assessed with Radiation Therapy Oncology Group criteria and the CTCAE v5.0

    Time frame: 3 years post treatment

06

Study locations

1 of 1 sites recruiting
  • Zhongshan City People's Hospital
    Zhongshan, Guangdong 528403, China
    Recruiting
07

Registry details

Key details

Study ID
NCT06282497
Lead sponsor
Zhongshan People's Hospital, Guangdong, China
Responsible party
Gui-Qiong Xu (Chief Physician, Zhongshan People's Hospital, Guangdong, China) — Principal investigator
First posted
Feb 28, 2024
Start date
Oct 23, 2023
Primary completion
Oct 23, 2026 (estimated)
Completion
Oct 23, 2029 (estimated)
Last update
May 1, 2024

Study contacts

Gui-qiong Xu, MD
Contact
donna_shee@163.com
+8613528109888
Gui-qiong Xu, MD
principal investigator · Zhongshan People's Hospital, Guangdong, China

Oversight

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

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