- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07652489
Surgery Plus Postoperative Radiotherapy for T4 Sinonasal Adenoid Cystic Carcinoma: A Prospective Observational Study (SPORT-SNACC)
SPORT-SNACC: A Prospective, Multicenter, Observational Cohort Study of Surgery Plus Postoperative Radiotherapy in T4 Sinonasal Adenoid Cystic Carcinoma
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
This is a prospective, multicenter, observational cohort study of T4 stage sinonasal adenoid cystic carcinoma (SNACC) patients receiving standard treatment (surgery followed by postoperative intensity-modulated radiotherapy). No experimental intervention is assigned. Approximately 70 patients will be enrolled from six Chinese centers over 18-24 months. Key exclusions include unresectable disease (e.g., bilateral cavernous sinus or carotid artery involvement) and progressive lung metastases.
Endpoints: Primary is 3-year progression-free survival (PFS). Secondary include R0 rate, 3-year overall survival, distant metastasis-free survival, local control, postoperative complications (CTCAE v5.0), radiotherapy toxicity, quality of life (EORTC QLQ-C30/H&N35), and surgery-to-radiotherapy interval. Exploratory analyses by margin status, histologic subtype (solid ≥30%), T4a/T4b, and surgical approach.
Quality & data management: Central pathology/imaging review; EDC with range/logic checks; quarterly remote and biannual on-site monitoring with ≥20% source data verification; data dictionary; MDT requirement; independent DSMB every 6 months.
Statistical methods: Primary PFS estimated by Kaplan-Meier with 95% CI. Secondary time-to-event endpoints similarly analyzed. QoL longitudinal data using MMRM. Missing data: censoring for PFS; no imputation for safety; MMRM for QoL under MAR.
Tipo di studio
Iscrizione (Stimato)
Contatti e Sedi
Contatto studio
- Nome: Quan Liu, MD
- Numero di telefono: +86 15001959681
- Email: liuqent@163.com
Backup dei contatti dello studio
- Nome: Wanpeng Li, MD
- Numero di telefono: +86 13262856870
- Email: 18879117831@163.com
Luoghi di studio
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Heilongjiang
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Harbin, Heilongjiang, Cina, 150001
- Non ancora reclutamento
- The Second Affiliated Hospital of Harbin Medical University
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Contatto:
- Yanan Sun, MD
- Numero di telefono: 0451-86662962
- Email: h04015@hrbmu.edu.cn
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Hunan
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Changsha, Hunan, Cina, 410013
- Non ancora reclutamento
- Third Xiangya Hospital, Central South University
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Contatto:
- Guoling Tang, MD
- Numero di telefono: 0731-88638888
- Email: guolintan@csu.edu.cn
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Liaoning
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Shenyang, Liaoning, Cina, 110001
- Non ancora reclutamento
- The First Affiliated Hospital of China Medical University
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Contatto:
- Hongquan Wei, MD
- Numero di telefono: 024-961200
- Email: hongquanwei@163.com
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Cina, 200031
- Reclutamento
- Eye & ENT Hospital of Fudan University
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Contatto:
- Quan Liu, MD
- Numero di telefono: +86 15001959681
- Email: liuqent@163.com
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Shanxi
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Xi’an, Shanxi, Cina, 710032
- Non ancora reclutamento
- The First Affiliated Hospital of Air Force Medical University
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Contatto:
- Xiaodong Chen, MD
- Numero di telefono: 029-84775507
- Email: xdchen1981@139.com
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Zhejiang
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Wenzhou, Zhejiang, Cina, 325000
- Non ancora reclutamento
- The First Affiliated Hospital of Wenzhou Medical University
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Contatto:
- Kaiquan Zhu, MD
- Numero di telefono: 0577-55578167
- Email: kaiquanzhu@wzhospital.cn
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- Age 18 80 years, any gender; ECOG performance status 0 2; life expectancy ≥6 months.
- Histologically confirmed primary sinonasal adenoid cystic carcinoma (cribriform, tubular, solid, or mixed type). Other malignancies excluded.
- T4 stage (T4a or T4b) according to AJCC 8th edition, based on contrast enhanced MRI/CT.
- N0 2 (operable lymph node metastasis allowed).
- M0 (no distant metastasis on chest CT and abdominal ultrasound) OR M1 with stable limited lung metastases; (c) stable on two CT scans ≥3 months apart; (d) no respiratory symptoms.
- Previously untreated (no radiotherapy, chemotherapy, targeted therapy, immunotherapy, or tumor resection). MDT deems technically resectable (R0/R1 achievable, not diffusely unresectable).
- Adequate organ function within 14 days before enrollment: ANC ≥1.5×10⁹/L, platelets ≥100×10⁹/L, Hb ≥90 g/L; ALT/AST ≤2.5×ULN, TBil ≤1.5×ULN, Cr ≤1.5×ULN or CrCl ≥50 mL/min; LVEF ≥50%, no uncontrolled arrhythmia.
- Willing and able to provide written informed consent for clinical data collection (and optional biospecimen banking). Investigator judges good compliance.
Exclusion Criteria:
- Progressive lung metastases within 6 months (new lesions or >20% increase); extrapulmonary metastases (liver, bone, brain); symptomatic lung metastases.
- MDT judged unresectable, e.g., bilateral cavernous sinus invasion, brain parenchyma invasion, bilateral internal carotid artery encasement.
- Primary tumor outside sinonasal cavity (e.g., major salivary glands, oropharynx); non ACC histology.
- Other active malignancy within 5 years (except cured basal cell carcinoma, cervical carcinoma in situ, etc.).
- Severe comorbidities: NYHA class III/IV heart failure, recent myocardial infarction or unstable angina, uncontrolled hypertension (≥160/100 mmHg); COPD requiring home oxygen or interstitial lung disease; decompensated cirrhosis; active hepatitis B/C without antiviral therapy; nephropathy requiring dialysis; active serious infection; active bleeding or coagulopathy (INR >1.5×ULN without anticoagulation, or platelets <50×10⁹/L).
- Special populations: pregnant or breastfeeding; unwilling to use contraception (if childbearing potential); severe allergy to medications required for surgery/radiotherapy; severe psychiatric or cognitive disorder impairing cooperation; currently participating in another interventional trial.
- Unable to undergo contrast enhanced MRI (metal implants, claustrophobia, gadolinium allergy); investigator judges inability to complete follow up (e.g., living abroad, substance abuse).
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Coorti e interventi
Gruppo / Coorte |
Intervento / Trattamento |
|---|---|
|
T4 Sinonasal Adenoid Cystic Carcinoma: Surgery plus Postoperative Radiotherapy
This single cohort includes patients with previously untreated T4 stage sinonasal adenoid cystic carcinoma (T4a or T4b, any N, M0 or M1 with stable limited lung metastases).
All participants receive standard treatment as per routine clinical practice: radical surgery (aiming for R0/R1 resection, via endoscopic, open, or combined approach) followed by postoperative intensity-modulated radiotherapy (IMRT) starting within 4-6 weeks after surgery.
No experimental intervention is assigned.
The cohort is followed prospectively for 3 years to assess progression-free survival, overall survival, local control, distant metastasis, treatment-related complications, and quality of life.
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Postoperative Radiotherapy
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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3-Year Progression-Free Survival
Lasso di tempo: Up to 3 years after enrollment
|
Time from enrollment to first documented local recurrence, regional recurrence, distant metastasis, or death.
Assessed by contrast-enhanced MRI every 3-6 months; recurrence confirmed by pathology or MDT.
3-year rate estimated by Kaplan-Meier with 95% CI.
Participants without event censored at last follow-up.
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Up to 3 years after enrollment
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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R0 Resection Rate
Lasso di tempo: At time of surgery (postoperative pathological assessment)
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Proportion of surgical patients with negative microscopic margins (R0) based on central pathology review.
R0 defined as no tumor cells at the inked surgical margin.
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At time of surgery (postoperative pathological assessment)
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3-Year Overall Survival
Lasso di tempo: Up to 3 years after enrollment
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Time from enrollment to death from any cause.
Participants alive at last follow-up are censored.
Estimated by Kaplan-Meier method.
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Up to 3 years after enrollment
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3-Year Distant Metastasis-Free Survival
Lasso di tempo: Up to 3 years after enrollment
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Time from enrollment to first documented distant metastasis (lung, bone, liver, etc.), assessed by annual chest CT and other imaging as clinically indicated.
Death without metastasis is censored.
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Up to 3 years after enrollment
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3-Year Local Control Rate
Lasso di tempo: Up to 3 years after enrollment
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Proportion of patients without local recurrence at the primary tumor site.
Local recurrence defined as reappearance of tumor within the nasal cavity, sinuses, or skull base, confirmed by imaging and/or pathology.
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Up to 3 years after enrollment
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Postoperative Complication Rate (CTCAE Grade ≥3)
Lasso di tempo: Within 30 days after surgery
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Incidence of grade 3 or higher postoperative complications according to CTCAE v5.0, including cerebrospinal fluid leak, intracranial infection, hemorrhage, visual loss, palatal defect, and other events within 30 days after surgery.
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Within 30 days after surgery
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Radiotherapy Toxicity Rate (Grade ≥3)
Lasso di tempo: From start of radiotherapy up to 3 years
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Incidence of grade 3 or higher radiation-related adverse events according to CTCAE v5.0, including mucositis, osteoradionecrosis, optic nerve injury, brain necrosis, and hypopituitarism.
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From start of radiotherapy up to 3 years
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Collaboratori e investigatori
Pubblicazioni e link utili
Pubblicazioni generali
- Mavrikios A, Goudjil F, Beddok A, Zefkili S, Bolle S, Feuvret L, Le Tourneau C, Choussy O, Sauvaget E, Herman P, Dendale R, Calugaru V. Proton therapy and/or helical tomotherapy for locally advanced sinonasal skull base adenoid cystic carcinoma: Focus on experience of the Institut Curie and review of literature. Head Neck. 2023 Jul;45(7):1619-1631. doi: 10.1002/hed.27371. Epub 2023 Apr 25.
- Bjorndal K, Krogdahl A, Therkildsen MH, Overgaard J, Johansen J, Kristensen CA, Homoe P, Sorensen CH, Andersen E, Bundgaard T, Primdahl H, Lambertsen K, Andersen LJ, Godballe C. Salivary gland carcinoma in Denmark 1990-2005: a national study of incidence, site and histology. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol. 2011 Jul;47(7):677-82. doi: 10.1016/j.oraloncology.2011.04.020. Epub 2011 May 25.
- Dodd RL, Slevin NJ. Salivary gland adenoid cystic carcinoma: a review of chemotherapy and molecular therapies. Oral Oncol. 2006 Sep;42(8):759-69. doi: 10.1016/j.oraloncology.2006.01.001. Epub 2006 Jun 6.
- Song X, Sun J, Yang G, Wang X, Wang L. Long-term outcomes of platinum-based chemotherapy for T4 stage sinonasal adenoid cystic carcinoma. Front Pharmacol. 2025 Sep 29;16:1623242. doi: 10.3389/fphar.2025.1623242. eCollection 2025.
- Cavalieri S, Mariani L, Vander Poorten V, Van Breda L, Cau MC, Lo Vullo S, Alfieri S, Resteghini C, Bergamini C, Orlandi E, Calareso G, Clement P, Hauben E, Platini F, Bossi P, Licitra L, Locati LD. Prognostic nomogram in patients with metastatic adenoid cystic carcinoma of the salivary glands. Eur J Cancer. 2020 Sep;136:35-42. doi: 10.1016/j.ejca.2020.05.013. Epub 2020 Jul 3.
- Seok J, Lee DY, Kim WS, Jeong WJ, Chung EJ, Jung YH, Kwon SK, Kwon TK, Sung MW, Ahn SH. Lung metastasis in adenoid cystic carcinoma of the head and neck. Head Neck. 2019 Nov;41(11):3976-3983. doi: 10.1002/hed.25942. Epub 2019 Aug 29.
- Jang S, Patel PN, Kimple RJ, McCulloch TM. Clinical Outcomes and Prognostic Factors of Adenoid Cystic Carcinoma of the Head and Neck. Anticancer Res. 2017 Jun;37(6):3045-3052. doi: 10.21873/anticanres.11659.
- Lee TH, Kim K, Oh D, Yang K, Jeong HS, Chung MK, Ahn YC. Clinical Outcomes in Adenoid Cystic Carcinoma of the Nasal Cavity and Paranasal Sinus: A Comparative Analysis of Treatment Modalities. Cancers (Basel). 2024 Mar 21;16(6):1235. doi: 10.3390/cancers16061235.
- Mays AC, Hanna EY, Ferrarotto R, Phan J, Bell D, Silver N, Mulcahy CF, Roberts D, Abdelmeguid ASA, Fuller CD, Frank SJ, Raza SM, Kupferman ME, DeMonte F, Su SY. Prognostic factors and survival in adenoid cystic carcinoma of the sinonasal cavity. Head Neck. 2018 Dec;40(12):2596-2605. doi: 10.1002/hed.25335. Epub 2018 Nov 17.
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- 2026134
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