Predictive-Model Based Individualized Carbon-Ion Radiotherapy for Patients With Locally Recurrent Nasopharyngeal Carcinoma: A Phase 2 Randomized Trial
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Locally Recurrent Nasopharyngeal Carcinoma
- Sponsor
- Shanghai Proton and Heavy Ion Center
- Enrollment
- 96
- Locations
- 1
- Primary Endpoint
- Progression-free survival
- Status
- Not yet recruiting
- Last Updated
- 5 years ago
Overview
Brief Summary
This is a randomized phase 2 trial with 2 groups (control group vs experimental group). Patients with locally recurrent nasopharyngeal carcinoma (LR-NPC) assigned to the control group will receive standardized carbon-ion radiotherapy (CIRT). For patients assigned to the experimental group, a predictive model will be used to predict the chance of developing mucosal necrosis after salvage carbon-ion radiotherapy, and individualized dose prescription will be given. The primary endpoint of the study is to compare the 2-year progression-free survival (PFS) between 2 groups.
Detailed Description
This is a randomized phase 2 trial with 2 groups (control group vs experimental group). Patients with locally recurrent nasopharyngeal carcinoma (LR-NPC) assigned to the control group will receive standardized CIRT with a dose of 63 gray equivalent (GyE) in 21 fractions (fx). This regimen was obtained from our previous phase 1 (dose escalation) study. For patients assigned to the experimental group, a predictive model will be used to predict the chance of developing mucosal necrosis after salvage carbon-ion radiotherapy, and individualized dose prescription will be given. A dose of 60 GyE/20 fx, 63 GyE/21 fx and 66 GyE/22 fx will be given to patients with high, moderate and low risk of developing mucosal necrosis, respectively. The primary endpoint of the study is to compare the 2-year progression-free survival (PFS) between 2 groups. The secondary endpoints include 2-year overall survival (OS), local progression-free survival, regional progression-free survival, distant metastasis-free survival, toxicities and quality of life.
Investigators
Jiade J. Lu
Prof. Jiade J. Lu
Shanghai Proton and Heavy Ion Center
Eligibility Criteria
Inclusion Criteria
- •Aged between 17-70 years.
- •Pathologically diagnosed as WHO type 2/3 nasopharyngeal carcinoma.
- •Failed previous definitive radiotherapy at least 6 months ago.
- •Only had 1 previous course of radiotherapy.
- •Eastern Cooperative Oncology Group score: 0-
- •Adequate laboratory values within 30 dyas of enrollment to study defined as follows: 1) neutrophil \> 2000/mm\^3; 2) platelet \> 100,000/mm\^3; 3) total bilirubin \< 1.5mg/dl; 4) alanine aminotransferase/aspartate aminotransferase \< 1.5 upper limit of normal; 5) SCr \< 1.5mg/dl; creatinine clearance rate \> 60ml/min.
- •Willing to accept adequate contraception for women with childbearing potential.
- •Willing to sign the written informed consent; Informed consent must be signed before the enrollment in the trial.
Exclusion Criteria
- •Presence of distant metastasis.
- •Without measurable lesion.
- •Previous history of malignant tumor (within 5 years) or simultaneous existence of multiple primary tumors.
- •Accompanied with severe major organ dysfunction.
- •Presence of mental disease that may influence the understanding of informed consent.
Outcomes
Primary Outcomes
Progression-free survival
Time Frame: From randomization to death or disease progression, a median of 2 years
Secondary Outcomes
- Regional progression-free survival(From randomization to regional failure, a median of 2 years)
- Distant metastasis-free survival(From randomization to distant metastasis, a median of 2 years)
- Quality of life by questionnaires evaluated using EORTC-H&N35 questionnaire.(Throughout the study, an average of 2 years)
- Incidence of radiation-induced late toxicity evaluated by CTCAE 5.0(Three months after initiation of radiation therapy)
- Quality of life by questionnaires evaluated using EORTC-Q30 questionnaire.(Throughout the study, an average of 2 years)
- Overall survival(From randomization to death, a median of 2 years)
- Local progression-free survival(From randomization to local failure, a median of 2 years)
- Incidence of radiation-induced acute toxicity evaluated by CTCAE 5.0(Within 3 months after initiation of radiation therapy)