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Brachytherapy (Interventional Radiotherapy) for Squamous Cell Carcinomas of the Nasal Vestibule: Optimization of Dose and Technique (BRAVO)

31. August 2026 aktualisiert von: Radboud University Medical Center

Brachytherapy (Interventional Radiotherapy) for Squamous Cell Carcinomas of the Nasal Vestibule: Optimization of Dose and Technique A Multicenter Prospective Registration Study Endorsed by HNS GEC-ESTRO WG

Rationale: Primary brachytherapy (also known as Interventional Radiotherapy, IRT) achieves high cure rates in cancer of the nasal vestibule (CNV) while preserving nasal aesthetics and function. In our recently published nationwide multicenter study, brachytherapy (BT) increased nose preservation probability from 61 to 82 % compared to external beam radiotherapy (EBRT). Although late toxicity was more common following BT, it was predominantly CTCAE grade 1-2 and deemed acceptable given the substantial benefit in local control and nose preservation.

However, a notable finding of our study was the substantial variation in BT practice, including implantation techniques, dose prescriptions, and treatment planning. Although this analysis covers one of the largest series of CNV patients to date, patient numbers were insufficient to reliably compare the efficacy of the different application/implantation techniques and doses. The retrospective design of the study proved inappropriate for a detailed analysis of the dose-volume data, which is necessary to correlate implantation and dose data to outcome. As the integral brachytherapy dose, as well as the dose inhomogeneity in tissue may vary widely depending on how the dose is prescribed, simple prescription doses are insufficient to characterize a brachytherapy plan comprehensively.

Given the excellent disease control achieved with BT, optimizing aesthetic and functional outcomes while minimizing toxicity becomes increasingly important. Therefore, to optimize BT treatment for CNV and facilitate its wider adoption, detailed prospective data collection on treatment parameters, dose plans, toxicity (both physician-reported and patient-reported), oncological outcomes, and functional results is necessary. This study is designed as a non-comparative, descriptive prospective registry aimed at systematically documenting current international practice in brachytherapy for cancer of the nasal vestibule.

Objective: To prospectively describe BT treatment techniques, parameters, oncological outcomes, acute and late toxicity and patient satisfaction; and to correlate these outcomes with treatment parameters. Specifically, to establish dose-response relationships for oncological control, toxicity, and functional outcomes.

Study design: Prospective observational multicentre registration study. Study population: Adults with a squamous cell squamous cell carcinoma of the nasal vestibule, considered suitable for primary brachytherapy.

Main study parameters/endpoints: To describe treatment techniques, dose prescriptions and brachytherapy dose plans in terms of dose-volume parameters. Oncological outcomes include details on recurrence and cancer-specific survival. Toxicity, patient satisfaction, and QoL will be assessed with validated patient questionnaires as through applicable CTCAE (physician based).

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Studientyp

Beobachtungs

Einschreibung (Geschätzt)

300

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

All patients referred for primary brachytherapy for cancer of the nasal vestibule in the participating institutes will be asked to participate.

Beschreibung

Inclusion criteria:

  • Aged 18 years or older
  • Rome stage 1-4 / Wang Stage T1 -T3
  • Staging of the neck by ultrasound/FNAC and/or (FDG-PET)CT and/or MRI is performed
  • Brachytherapy with curative intent as sole treatment for the primary tumor
  • Suitable to undergo brachy procedure, based on clinical judgment

Exclusion criteria

  • Other primary tumor, except bcc skin or curatively treated cancer > 3 years before inclusion
  • Previous radiotherapy to the treated area
  • Distant metastasis
  • Inability to comply with study procedures, including filling out treatment related questionnaires and to comply with scheduled follow-up visits
  • Non-squamous cell histology
  • Combinations with systemic therapy
  • Combination to EBRT and brachytherapy to primary tumor

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Kohorten und Interventionen

Gruppe / Kohorte
ll patients referred for primary brachytherapy for cancer of the nasal vestibule

Newly diagnosed CNV patients, eligible according to the study in- and exclusion criteria. Patients will receive the same treatment and have the same follow-up as patients who do not participate in the study. Eligible patients will be asked to consent to the use of their tumor- and treatment data for the purpose of the study and to fill out QoL- and functional and cosmetic evaluation questionnaires at pre-specified timepoints at start of, during, and after treatment.

Recruitment will be organized through the treating physician, who will obtain written informed consent, given according to standard research procedures.

Patients will be accrued from participating institutions, recruited from the Dutch Head& Neck Cancer Working Party and the GEC-ESTRO H&N brachy workgroup (Groupe Européen de Curiethérapie and the European Society for Radiation Therapy and Oncology)

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
3-year local disease control
Zeitfenster: 3 years
The primary endpoint is 3-year local disease control, defined as absence of histologically or radiologically confirmed local recurrence within the treated nasal vestibule region, measured from start of brachytherapy until recurrence or last follow-up.
3 years
3-year freedom from (partial) nose amputation
Zeitfenster: 3 year
The second primary endpoint is 3-year freedom from (partial) nose amputation, defined as absence of histologically or radiologically confirmed local recurrence requiring (partial) removal of the nose, measured from start of brachytherapy until recurrence or last follow-up
3 year

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
CTCAE toxicity scoring
Zeitfenster: 3 years
CTCAE 5.0 toxicity scoring for skin, mucosa, septum (cartilage) assessed at baseline, end of treatment, 3 months, 6 months and annually up to three years after treatment. These will be assessed by the treating physician during clinical follow-up visits.
3 years
Toxicity scoring by patients
Zeitfenster: 3 years
Pain, dryness/mucous secretion , nasal bleeding , nasal occlusion, synechiae, loss of smell/taste (applicable PRO-CTCAE components: anosmia, dysgeusia, pain, rhinorrhea, skin hyper/hypopigmentation).
3 years
Patient satisfaction
Zeitfenster: 3 years
Patient satisfaction measured using validated questionnaires filled in by the patients at baseline, 3 months, 12, 24 and 36 months (NAFEQ questionnaire).
3 years
3-year regional and distant control
Zeitfenster: 3 years
Defined as absence of histologically or radiologically confirmed regional recurrence (regional lymph node metastasis) or distant recurrence within the treated nasal vestibule region, measured from start of brachytherapy until recurrence or last follow-up.
3 years
Overall survival
Zeitfenster: 3 years
measured from start of brachytherapy until recurrence or last follow-up
3 years
Patient satisfaction (2)
Zeitfenster: 3 years
Patient satisfaction measured using validated questionnaires filled in by the patients at baseline, 3 months, 12, 24 and 36 months (ROE questionnaire).
3 years

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. Oktober 2026

Primärer Abschluss (Geschätzt)

1. Oktober 2029

Studienabschluss (Geschätzt)

1. Oktober 2034

Studienanmeldedaten

Zuerst eingereicht

26. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

31. August 2026

Zuerst gepostet (Tatsächlich)

3. September 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

3. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

31. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 2026-19203

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UNENTSCHIEDEN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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