The SWOAR Trial Sparing of Swallowing and Aspiration Related Organs at Risk & Submandibular Gland With Intensity Modulated Radiotherapy Versus Standard IMRT in Head and Neck Squamous Cell Carcinomas (SWOAR)
The SWOAR Trial: A Phase III Trial Evaluating Sparing of Swallowing and Aspiration Related Organs at Risk & Submandibular Gland With Intensity Modulated Radiotherapy Versus Standard IMRT in Head and Neck Squamous Cell Carcinomas
The aim of SWOAR TRIAL is to test sparing of Dysphagia/ Aspiration risk structures (DARS) and contra lateral submandibular gland by IMRT. HNSCC of the oropharynx, larynx and the hypopharynx treated with radical concurrent chemoradiotherapy or radiotherapy will be included in the trial. Patients will be randomized to SWOAR IMRT or standard IMRT.
Swallowing function will be evaluated the MD Anderson Dysphagia Inventory (MDADI) scoring. Difference in the mean composite score of MDADI, a patient-reported outcome, at 6 months post radiotherapy is the primary outcome of the trial.
Secondary Objectives include longitudinal assessment of aspiration prevention as evaluated by FEES by the 8 point penetration-aspiration score. Swallowing function, will be assessed by using the MDADI at baseline, at completion of CRT/RT, 3, 6, 12, and 24 months.
Assessment of acute and late toxicity assessed at baseline, weekly during radiotherapy and then at 3, 6, 12, and 24 months post treatment as per RTOG and LENT SOMA score, respectively.
Treatment outcomes will be assessed in terms of loco-regional tumor recurrence and overall survival, assessed at follow-up visits 3, 6, 12, and 24 months post treatment and then annually until 5 years post treatment.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Forventet)
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
- Navn: Aman Sharma, MD
- Telefonnummer: +917018529339
- E-mail: amans757@gmail.com
Studiesteder
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Haryana
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Jhajjar, Haryana, Indien, 124105
- Rekruttering
- Nci, Aiims
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Kontakt:
- Aman Sharma, MD
- Telefonnummer: +917018529339
- E-mail: amans757@gmail.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Aged 18 or above and less than 70 years
- Patient undergoing radiotherapy for HNSCC of the Oropharynx or Larynx or Hypopharynx.
- Stage T1-4, N0-3, M0 disease with histologically confirmed squamous cell carcinoma requiring bilateral neck radiotherapy and where sparing of contra lateral or one submandibular gland is possible
- Radiotherapy with concomitant chemotherapy (unless contraindicated) is the planned treatment
- Karnofsky performance score greater or equal 70
- Available to attend long term follow- up;
- Ability to complete the MD Anderson Dysphagia Inventory (MDADI) and EORTC quality of life questionnaires English or Hindi Version.
- Willingness to undergo FEES.
- Written informed consent for treatment.
- Available to attend long term follow- up
Exclusion Criteria:
- Early Carcinoma Glottis (T1-T2, N0M0)
- Metastatic disease.
- Previous radiotherapy to the head and neck region
- Lateralised tumours, requiring unilateral irradiation
- Patients requiring radiation to both submandibular glands
- Evidence of pre-existing swallowing dysfunction (not related to HNC);
- Major head and neck surgery (excluding biopsies/tonsillectomy);
- Tracheostomy placement
- Previous or concurrent illness, which in the investigator's opinion would interfere with completion of therapy, trial assessments or follow-up
- Any invasive malignancy within previous 2 years (other than non melanomatous skin carcinoma or cervical carcinoma in situ).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Ingen indgriben: Standard IMRT
Standard IMRT with radical CRT/RT
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Eksperimentel: Swallowing Sparing IMRT
Standard IMRT with radical CRT/RT with additional sparing of dysphagia-aspiration related structures & submandibular gland sparing by SWOAR-IMRT
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Standard IMRT with radical CRT/RT with additional sparing of dysphagia-aspiration related structures & submandibular gland sparing by SWOAR-IMRT
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change in swallowing function post radiotherapy
Tidsramme: 6 months
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Primary objective of the SWOAR trial is to determine whether sparing the DARS by SWOAR IMRT, changes swallowing function compared to S- IMRT in advanced HNSCC.
The impact of sparing the DARS with SWOAR-IMRT on late swallowing function will be evaluated the MDADI.
Difference in the mean composite score of MDADI, a patient-reported outcome, at 6 months post radiotherapy is the primary outcome of the trial.
MDADI score ranges from 0-100 where 0 is the worst and 100 is the best score for dysphagia assessment
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6 months
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Swallowing assessment
Tidsramme: longitudinal assessment till 2 years
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Swallowing will be assessed by using the MDADI at baseline, at completion of CRT/RT, 3, 6, 12, and 24 months.
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longitudinal assessment till 2 years
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Aspiration assessment
Tidsramme: longitudinal assessment till 2 years
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Longitudinal assessment of aspiration prevention as evaluated by FEES by the 8 point penetration-aspiration score.
Patients will be subjected to 10 ml of liquid, semi solid and solid meal at baseline, at completion of CRT/RT, 3, 6, 12 and 24 months.6,
12, and 24 months.
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longitudinal assessment till 2 years
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Acute Toxicity
Tidsramme: longitudinal assessment till 2 years
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Assessment of acute weekly during radiotherapy as per RTOG RTOG grading is from 0 to IV where 0 represents no findings and IV being the worst Findings |
longitudinal assessment till 2 years
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Late Toxicity assessment by RTOG
Tidsramme: longitudinal assessment till 2 years
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Assessment of late toxicity at 3, 6, 12, and 24 months post treatment as per RTOG score. RTOG is from 0 to IV where 0 represents no findings and IV being the worst Findings |
longitudinal assessment till 2 years
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Late Toxicity assessment by LENT SOMA
Tidsramme: longitudinal assessment till 2 years
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Assessment of late toxicity at 3, 6, 12, and 24 months post treatment as LENT SOMA score. LENT SOMA score is from 0 to IV where 0 represents no findings and IV being the worst Findings |
longitudinal assessment till 2 years
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Treatment outcome: Loco-regional tumor control
Tidsramme: 2 years
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Loco-regional tumor control at 2 years At follow up of 3, 6, 12, and 24 months post treatment
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2 years
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Treatment outcome: Overall survival
Tidsramme: 2 years
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Overall survival at 2 years At follow up of 3, 6, 12, and 24 months post treatment
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2 years
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Quality of life assessment: EORTC QLQ C-30
Tidsramme: longitudinal assessment till 2 years
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EORTC QLQ C-30 questionnaire At follow up of 3, 6, 12, and 24 months post treatment The QLQ-C30 is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status / QoL scale, and six single items. Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. High score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems. |
longitudinal assessment till 2 years
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Quality of life assessment: EORTC QLQ HN35
Tidsramme: longitudinal assessment till 2 years
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As per the EORTC QLQ HN35 questionnaire At follow up of 3, 6, 12, and 24 months post treatment 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.
For all items and scales, high scores indicate more problems (i.e.
there are no function scales in which high scores would mean better functioning).
The scoring approach for the QLQ-H&N35 is identical in principle to that for the symptom scales / single items of the QLQ-C30.
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longitudinal assessment till 2 years
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Samarbejdspartnere og efterforskere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Forventet)
Studieafslutning (Forventet)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 2021/05/043810
Plan for individuelle deltagerdata (IPD)
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Kliniske forsøg med Swallowing and submandibular sparing IMRT
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)RekrutteringOrofaryngeal cancer | Ondartede neoplasmer i mundhulen i læben og svælgetForenede Stater