- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00592501
Proton Radiotherapy With Chemotherapy for Nasopharyngeal Carcinoma
October 24, 2021 updated by: Annie W. Chan, MD, Massachusetts General Hospital
A Phase II Study of Proton Radiotherapy With Chemotherapy for Nasopharyngeal Carcinoma
Photon beam radiation is the standard type of radiation used to treat nasopharyngeal carcinoma.
Photon beam radiation enters the body and passes through healthy tissue, encounters the tumor and leaves the body through healthy tissue.
Proton beam radiation has been shown to have the same effect on tumors as photon beam radiation but it enters the body, passes through healthy tissue, and encounters the tumor but then stops.
This means less healthy tissue is affected by proton beam treatment than by photon beam treatment.
The purpose of this study is to determine the effectiveness of proton beam radiation in treating nasopharyngeal cancer and reducing the acute and long-term side effects from the treatment.
This study will also test to see if the sparing of the healthy tissue can improve quality of life
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
- Before beginning study treatment, participants will be asked to fill out a Quality of Life (QOL) questionnaires, a Speech Assessment, a ChemoSensory Questionnaire, a Patient Swallowing Diary, A Swallowing Study, Salivary Tests and a Trismus Assessment. Participants will need to go to the Massachusetts Eye and Ear Infirmary (MEEI) or Massachusetts General Hospital (MGH) for these tests.
- Radiation therapy will be given once a day, five days a week, for seven weeks. This will be given as outpatient care at the Northeast Proton Therapy Center (proton component) and Massachusetts General Hospital (photon component).
- During radiation treatments, participants will receive cisplatin intravenously once every three weeks. This three-week period is called a cycle of treatment.
- After the completion of radiation, participants will receive cisplatin intravenously once every 4 weeks along with fluorouracil as a continuous infusion over 4 days starting on the day cisplatin is given, for three cycles.
- Participants will have a physical exam and blood work drawn weekly to monitor their health.
- An MR/CT scan of the head and neck will be done 2 months after the radiation treatment.
- Follow-up visits will occur once every three months for 2 years, then once every 6 months during years 3-5, then annually. During these follow-up visits, participants will have the following tests and procedures: physical examination; blood work; chest CT scan and CT/MRI of the head and neck will be repeated once every 6 months during the first three years; swallow study; salivary study; QOL questionnaires; speech assessment; ChemoSensory Questionnaire; and Trismus Assessment.
Study Type
Interventional
Enrollment (Actual)
25
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Dana-Farber Cancer Institute
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Biopsy proven greater than or equal to T2b and/or node positive non-metastatic, squamous cell carcinoma of the nasopharynx, types WHO I-III.
- No head and neck surgery of the primary tumor or lymph nodes except incisional or excisional biopsies.
- Zubrod performance status 0-1 or Karnofsky 70 or above.
- All patients must undergo pre-treatment evaluation of tumor extent and tumor measurement.
- Nutritional and general physical condition must be considered compatible with the proposed chemoradiation treatment
- Patients must have adequate platelet and renal function as outlined in protocol.
- 18 years of age or above.
- No active alcohol addiction.
- Women of childbearing potential must have a negative pregnancy test.
Exclusion Criteria:
- Stage IVC or evidence of distant metastases
- Previous irradiation for head and neck tumor
- Patient is on other experimental therapeutic cancer treatment
- Other malignancy except non-melanoma skin cancer or carcinomas of head and neck origin and have been controlled for at least 5 years.
- Active untreated infection
- Major medical or psychiatric illness
- Prophylactic use of amifostine or pilocarpine
- Pregnant or breast feeding women
- Symptomatic peripheral neuropathy of grade 2 or greater by NCI CTCAE
- Symptomatic altered hearing > grade 2 by CTCAE
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Proton/Photon Radiotherapy, Cisplatin, Fluorouracil
|
Given once a day, five days a week, for seven weeks.
Given intravenously once every three weeks during radiation treatment, then once every four weeks for three cycles.
Given as continuous infusion over 4 days starting on the day cisplatin is received after radiation therapy.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Acute Toxicity
Time Frame: 54 days of chemoradiation treatment and 90 days after completion, up to 144 days total
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Acute toxicities are side affects that occur during treatment and 90 days after completion.
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54 days of chemoradiation treatment and 90 days after completion, up to 144 days total
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Participant Compliance Rate to Assigned Treatment Intervention
Time Frame: 2 years
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2 years
|
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Sialometry to Evaluate Xerostomia (Dry Mouth)
Time Frame: Baseline and 2 years (24 months)
|
Sialometry is a measure of saliva flow.
The normal daily production of saliva varies between 0.5 and 1.5 liters.
Stimulated saliva is produced in response to a mechanical, gustatory, olfactory, or pharmacological stimulus, contributing to around 40-50% of daily salivary production.
In adults, normal total stimulated salivary flow ranges 1-3 mL/minute, low ranges 0.7-1.0
mL/minute, while hyposalivation is characterized by a stimulated salivary flow <0.7mL/minute.
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Baseline and 2 years (24 months)
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Penetration-aspiration Scale to Evaluate Swallowing Function
Time Frame: Baseline and 12 months
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The videofluoroscopic swallow study (VFSS) is the gold standard diagnostic tool to evaluate oropharyngeal dysphagia.
The penetration-aspiration scale (PAS) is an 8-point scale used to grade the severity of penetration or aspiration observed in a videofluoroscopic swallow study.
Aspiration is defined as the passing of the bolus below the true vocal folds, and penetration is when the bolus enters the airway but not below the true vocal folds. 1 is normal, no penetration or aspiration.
2-5 is penetration.
6-8 is aspiration.
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Baseline and 12 months
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Serial Measurements of Maximal Inter-incisal Distance to Evaluate Trismus (Lockjaw)
Time Frame: Baseline and 2 years
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Serial measures of the changes of the maximal inter-incisal distance in the vertical opening, right lateral, and left lateral jaw movements are used to evaluate trismus (lockjaw).
An average measurement of the three directional areas will be reported.
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Baseline and 2 years
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ChemoSensory Questionnaire (CSQ) to Evaluate Smell and Taste Function
Time Frame: 2 years
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The Chemosensory Questionnaire (CSQ) has four questions each on smell and taste.
A minimum score of 4 and a maximum of 20 for the smell scale and taste scale are possible with a higher score indicating better function.
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2 years
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Number of Participants With Speech Problems Assessed by Head and Neck Health Status Assessment Inventory (HNHSAI)
Time Frame: 2 years
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The Head and Neck Health Status Assessment Inventory (HNHSAI) is a descriptive outcome assessment consisting of 14 yes/no questions to measure number of participants with speech problems.
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2 years
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Health Related Quality-of-Life Outcomes Using Validated Quality-of-Life Instrument EORTC QLQ-C30
Time Frame: 2 years
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General quality of life is measured with the European organization for research and treatment of cancer (EORTC) quality of life questionnaire (QLQ) EORTC QLQ-C30 (cancer 30).
They are self-administered questionnaires.
All of the scales and single-item measures range in score from 0 to 100.
A high scale score represents a higher response level.
A high score for the global health status / QoL represents a high QoL.
|
2 years
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Health Related Quality-of-life Outcomes Using Validated Quality-of-life Instrument EORTC-QLQ-H&N
Time Frame: 2 years
|
General quality of life is measured with the European organization for research and treatment of cancer (EORTC) quality of life questionnaires (QLQ) for head and neck (H&N) (EORTC-QLQ-H&N).
The head & neck cancer module incorporates seven multi-item scales that assess pain, swallowing, senses (taste and smell), speech, social eating, social contact, and sexuality.
There are also eleven single items.
All of the scales and single-item measures range in score from 0 to 100.
For all items and symptom scales, high scores represent a high level of symptomatology/problems.
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2 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rate and Pattern of Locoregional Tumor Recurrence
Time Frame: 3 years
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3 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Annie W Chan, MD, Massachusetts General Hospital
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
October 1, 2006
Primary Completion (Actual)
April 1, 2019
Study Completion (Actual)
April 1, 2019
Study Registration Dates
First Submitted
December 28, 2007
First Submitted That Met QC Criteria
December 28, 2007
First Posted (Estimate)
January 14, 2008
Study Record Updates
Last Update Posted (Actual)
October 26, 2021
Last Update Submitted That Met QC Criteria
October 24, 2021
Last Verified
October 1, 2021
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Pharyngeal Neoplasms
- Otorhinolaryngologic Neoplasms
- Head and Neck Neoplasms
- Nasopharyngeal Diseases
- Pharyngeal Diseases
- Stomatognathic Diseases
- Otorhinolaryngologic Diseases
- Nasopharyngeal Neoplasms
- Carcinoma
- Nasopharyngeal Carcinoma
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Cisplatin
- Fluorouracil
Other Study ID Numbers
- 05-089
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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