Cisplatin and RT With or Without Gemcitabine, Carboplatin, and Paclitaxel in Treating Patients With Locally Advanced NPC
A Randomised Phase II/III Study of Concurrent Cisplatin-Radiotherapy With or Without Induction Chemotherapy Using Gemcitabine, Carboplatin and Paclitaxel in Locally Advanced Nasopharyngeal Cancer
RATIONALE: Drugs used in chemotherapy, such as cisplatin, gemcitabine hydrochloride, carboplatin, and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving chemotherapy together with radiation therapy my kill more tumor cells. It is not yet known whether giving cisplatin together with radiation therapy is more effective with or without gemcitabine hydrochloride, carboplatin, and paclitaxel in treating patients with nasopharyngeal cancer.
PURPOSE: This randomized phase II/III trial is studying how well giving cisplatin together with radiation therapy works compared with giving cisplatin and radiation therapy together with gemcitabine hydrochloride, carboplatin, and paclitaxel in treating patients with locally advanced nasopharyngeal cancer.
調査の概要
状態
条件
詳細な説明
OBJECTIVES:
Primary
- To compare the 5-year overall survival of patients with locally advanced nasopharyngeal cancer treated with concurrent cisplatin and radiotherapy with vs without induction chemotherapy comprising gemcitabine hydrochloride, carboplatin, and paclitaxel.
Secondary
- To assess and compare the disease-free survival, distant metastases rate, toxicities, and quality of life of patients treated with these regimens.
OUTLINE: Patients are stratified by N-stage (N0-1 vs N2-3) and are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cisplatin IV over 2 hours once weekly on weeks 1-8 and undergo intensity-modulated radiotherapy once daily, 5 days a week, on weeks 1-7 (6½ weeks for a total of 33 fractions).
- Arm II: Patients receive induction chemotherapy comprising gemcitabine hydrochloride IV over 30 minutes, carboplatin IV over 1 hour, and paclitaxel IV over 1 hour on days 1 and 8. Treatment repeats every 21 days for 3 courses. Beginning at least 3 weeks after the last dose of induction chemotherapy, patients receive cisplatin and undergo radiotherapy as in arm I.
Quality of life is assessed periodically.
After completion of study treatment, patients are followed every 2 months for 1 year, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
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-
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Singapore、シンガポール、169610
- National Cancer Centre - Singapore
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion criteria:
Patients are eligible for inclusion if all of the following criteria are fulfilled:
- Have given written informed consent, with the understanding that consent may be withdrawn at any time without prejudice.
- Loco-regional advanced NPC UICC (1997) Stages T3 - 4 any N, or any Stage T, N2 - 3.
- A histological diagnosis of WHO Type II or III NPC must have been established at some time and the investigator must review and confirm the diagnosis prior to randomization.
- No evidence of distant metastases in staging work up (including lung, liver and bone imaging).
- Cross sectional imaging of the primary and neck disease (MRI preferred)
- Evaluable disease must be present.
- Performance status of ECOG grade 0 or 1 (see Appendix I).
- No prior tumour therapy
Adequate bone marrow, renal and hepatic function:
Bone marrow : WBC > 3000 / mm3 (ANC > 1500 / mm3 ),
- Platelets > 100 000 / mm3,
- Hb > 10 gm/dl Renal : serum creatinine within institutional normal range (or) lower than the lower limit of institutional normal range
- calculated creatinine clearance > 50 ml / min Hepatic : enzymes (SAP, SGOT) < 2x normal
- bilirubin < 24 µmol / l.
- At least 18 years of age, of either sex.
Exclusion criteria:
Patients are to be excluded from the study if any of the following criteria is fulfilled:
- Uncontrolled hypercalcaemia: calcium ≥ 2.7 mmol/L (10.8 mg/dL).
- Second primary malignancy (except in situ carcinoma of the cervix or adequately treated basal cell carcinoma of the skin).
- Other serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator).
- Have serious active infection.
- Hepatitis B carrier
- Prior treatment including chemotherapy or radiotherapy.
- Pregnant or lactating female subjects and subjects with reproductive potential not implementing adequate contraceptive measures.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Arm I
Patients receive cisplatin IV over 2 hours once weekly on weeks 1-8 and undergo intensity-modulated radiotherapy once daily, 5 days a week, on weeks 1-7 (6½ weeks for a total of 33 fractions).
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与えられた IV
Given once daily 5 days a week for 6½ weeks.
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実験的:Arm II
Patients receive induction chemotherapy comprising gemcitabine hydrochloride IV over 30 minutes, carboplatin IV over 1 hour, and paclitaxel IV over 1 hour on days 1 and 8. Treatment repeats every 21 days for 3 courses.
Beginning at least 3 weeks after the last dose of induction chemotherapy, patients receive cisplatin and undergo radiotherapy as in arm I.
|
与えられた IV
与えられた IV
与えられた IV
Given once daily 5 days a week for 6½ weeks.
Given IV
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
---|---|
5年後の全生存率
時間枠:5年
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5年
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二次結果の測定
結果測定 |
時間枠 |
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無病生存
時間枠:10年
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10年
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Metastases-free survival
時間枠:10 years
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10 years
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Tumor recurrence
時間枠:10 years
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10 years
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Toxicity according to the Common Toxicity Criteria
時間枠:10 years
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10 years
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Quality of life as measured by the EORTC QLQ-C30
時間枠:5 years
|
5 years
|
協力者と研究者
捜査官
- 主任研究者:Terence Tan, FRCR、National Cancer Centre, Singapore
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- CDR0000657121
- SINGAPORE-NCC0901 (その他の識別子:National Cancer Centre Singapore)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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