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Beta-carotene and Alpha-tocopherol Chemoprevention of Second Primary Malignancies in Head and Neck Cancer Patients

Phase 3
Completed
Conditions
Neoplasms
Interventions
Dietary Supplement: Alpha-Tocopherol and Beta-Carotene
Dietary Supplement: Placebo
Registration Number
NCT00169845
Lead Sponsor
Laval University
Brief Summary

Epidemiologic studies suggest that low dietary intakes and low plasma concentrations of antioxidant vitamins and minerals are associated with increased risks of cancer, especially for epidermoid tumors. Patients with stage I or II head and neck cancer have a good prognosis, with a 5-year relative survival of 60% to 90%, depending of the tumor site. However, the benefit of treatment is often compromised by the occurrence of second primary cancers, which develop in 20% of patients during the first 5 years after diagnosis. We conducted a randomized chemoprevention trial among patients with head and neck cancer treated by radiation therapy to determine whether supplementation combining two antioxidants, alpha-tocopherol and beta-carotene, could reduce the incidence of second primary cancers in this patient population (primary objective of the trial). This study was conducted with funds from the NCIC (#008176,004738,013211) and was completed.

In this cohort of head and neck cancer patients, we evaluated whether nine potential prognostic serum markers measured at the time of diagnosis were related to recurrence, occurence of second primary cancers and survival. This study was conducted with funds from the NCIC (#018100) and was completed.

Presently, we evaluate genetic polymorphisms(GWAS) associated with prognosis (NCIC grant #019502). We also assess the relationship between vitamin D (dietary intake, serum level, and genetic polymorphisms of key vitamin D-related genes) and head and neck long-term outcomes (NCI grant #1R03CA141615-01).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
540
Inclusion Criteria
  • Histologically documented stage I or II head and neck cancer
Exclusion Criteria
  • Karnofsky performance score of less than 60
  • Multiple primary head and neck cancer
  • History of cancer
  • Severe cardiovascular disease
  • Inadequate renal, hepatic or hematologic function
  • Anticoagulant therapy
  • Pregnancy
  • Average daily supplement intake of beta-carotene or vitamin E in the preceding year greater than 6.0 mg and 50 IU, respectively.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Alpha-Tocopherol and Beta-CaroteneAlpha-Tocopherol and Beta-CarotenePatients received a daily supplementation of alpha-tocopherol (one capsule of 400 IU dl-alpha-tocopherol) and beta-carotene (one capsule of 30 mg) for 3 years after the end of radiation therapy. Due to ethical concerns, the beta-carotene supplementation was stopped during the trial (after the randomization of 156 patients). See details in JNCI, 2005: 97 (7), 481-8.
PlaceboPlaceboPatients received two capsules of placebos per day during 3 years. When the beta-carotene was stopped, they received only one capsule.
Primary Outcome Measures
NameTimeMethod
Second primary cancersImmediately and 1 month after radiation therapy, every 6 months during the 3 years following the end of radiation therapy, and then once a year until June 30, 2003
Secondary Outcome Measures
NameTimeMethod
Survival until death from first cancerevery year
Survival until death from second primary cancerEvery year
Survival until death from non-cancer causesEvery year
Disease free survivalImmediately and 1 month after radiation therapy, every 6 months during the 3 years following the end of radiation therapy, and then once a year until June 30, 2003

Alive and without recurrence

Acute and late side-effects of radiation therapyDuring radiation therapy (RT), at the end of RT, one month after RT, six months after RT and 1 year after RT
Overall survivalEvery year
Quality of lifeBaseline, at the end of radiation therapy (RT), 1, 6,12,24 and 36 months after RT
Cancer free survivalImmediately and 1 month after radiation therapy, every 6 months during the 3 years following the end of radiation therapy, and then once a year until June 30, 2003

Without recurrence and without second primary cancer

RecurrenceImmediately and 1 month after radiation therapy, every 6 months during the 3 years following the end of radiation therapy, and then once a year until June 30, 2003

Trial Locations

Locations (1)

Laval University Cancer Research Center

🇨🇦

Quebec City, Quebec, Canada

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