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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)

17 januari 2022 bijgewerkt door: Aman Sharma, All India Institute of Medical Sciences, New Delhi

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.

Studie Overzicht

Studietype

Ingrijpend

Inschrijving (Verwacht)

136

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

    • Haryana
      • Jhajjar, Haryana, Indië, 124105
        • Werving
        • Nci, Aiims
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 70 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Aged 18 or above and less than 70 years
  2. Patient undergoing radiotherapy for HNSCC of the Oropharynx or Larynx or Hypopharynx.
  3. 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
  4. Radiotherapy with concomitant chemotherapy (unless contraindicated) is the planned treatment
  5. Karnofsky performance score greater or equal 70
  6. Available to attend long term follow- up;
  7. Ability to complete the MD Anderson Dysphagia Inventory (MDADI) and EORTC quality of life questionnaires English or Hindi Version.
  8. Willingness to undergo FEES.
  9. Written informed consent for treatment.
  10. Available to attend long term follow- up

Exclusion Criteria:

  1. Early Carcinoma Glottis (T1-T2, N0M0)
  2. Metastatic disease.
  3. Previous radiotherapy to the head and neck region
  4. Lateralised tumours, requiring unilateral irradiation
  5. Patients requiring radiation to both submandibular glands
  6. Evidence of pre-existing swallowing dysfunction (not related to HNC);
  7. Major head and neck surgery (excluding biopsies/tonsillectomy);
  8. Tracheostomy placement
  9. Previous or concurrent illness, which in the investigator's opinion would interfere with completion of therapy, trial assessments or follow-up
  10. Any invasive malignancy within previous 2 years (other than non melanomatous skin carcinoma or cervical carcinoma in situ).

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Geen tussenkomst: Standard IMRT
Standard IMRT with radical CRT/RT
Experimenteel: Swallowing Sparing IMRT
Standard IMRT with radical CRT/RT with additional sparing of dysphagia-aspiration related structures & submandibular gland sparing by SWOAR-IMRT
Standard IMRT with radical CRT/RT with additional sparing of dysphagia-aspiration related structures & submandibular gland sparing by SWOAR-IMRT

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in swallowing function post radiotherapy
Tijdsspanne: 6 months
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
6 months

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Swallowing assessment
Tijdsspanne: longitudinal assessment till 2 years
Swallowing will be assessed by using the MDADI at baseline, at completion of CRT/RT, 3, 6, 12, and 24 months.
longitudinal assessment till 2 years
Aspiration assessment
Tijdsspanne: longitudinal assessment till 2 years
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.
longitudinal assessment till 2 years
Acute Toxicity
Tijdsspanne: longitudinal assessment till 2 years

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
Late Toxicity assessment by RTOG
Tijdsspanne: longitudinal assessment till 2 years

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
Late Toxicity assessment by LENT SOMA
Tijdsspanne: longitudinal assessment till 2 years

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
Treatment outcome: Loco-regional tumor control
Tijdsspanne: 2 years
Loco-regional tumor control at 2 years At follow up of 3, 6, 12, and 24 months post treatment
2 years
Treatment outcome: Overall survival
Tijdsspanne: 2 years
Overall survival at 2 years At follow up of 3, 6, 12, and 24 months post treatment
2 years
Quality of life assessment: EORTC QLQ C-30
Tijdsspanne: longitudinal assessment till 2 years

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
Quality of life assessment: EORTC QLQ HN35
Tijdsspanne: longitudinal assessment till 2 years
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.
longitudinal assessment till 2 years

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

11 juli 2021

Primaire voltooiing (Verwacht)

1 juni 2023

Studie voltooiing (Verwacht)

1 juni 2025

Studieregistratiedata

Eerst ingediend

18 augustus 2021

Eerst ingediend dat voldeed aan de QC-criteria

22 december 2021

Eerst geplaatst (Werkelijk)

11 januari 2022

Updates van studierecords

Laatste update geplaatst (Werkelijk)

31 januari 2022

Laatste update ingediend die voldeed aan QC-criteria

17 januari 2022

Laatst geverifieerd

1 januari 2022

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Nee

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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