Prospective Randomized Pilot Clinical Trial of Margin-Based Vs. Robust Photon Radiotherapy Planning in Intensity-Modulated Radiation Therapy of Squamous-Cell Carcinoma of the Head and Neck
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Squamous Cell Carcinoma of the Head and Neck
- Sponsor
- University of Arkansas
- Enrollment
- 23
- Locations
- 1
- Primary Endpoint
- Grade of Xerostomia
- Status
- Completed
- Last Updated
- 8 months ago
Overview
Brief Summary
This is a research study to evaluate the quality of life and amount of dry mouth experienced as a result of radiotherapy in subjects who have squamous cell carcinoma of the head and neck (HN-SQCC). This study will compare the side effects experienced based on the method to plan radiotherapy, Margin Based or Robust.
Detailed Description
This is a prospective randomized pilot clinical trial, stratified by primary tumor site, to evaluate the degree of xerostomia and quality of life (QOL) in subjects with HN-SQCC treated with radiation therapy under margin-based and robust radiotherapy treatment plans. Margin-based plans will use both biological (biological optimization) and physical objectives whereas robust planning will use physical objectives for sparing of the parotid glands. Intensity-modulated radiation therapy (IMRT) and standard chemotherapy will be used. QOL (quality of life) will be measured using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 questionnaire and EORTC QLQ-H\&N35 (head and neck) module before radiotherapy (baseline) and then 3, 6, 9 and 12 months after radiotherapy. Xerostomia will be measured in study subjects using two patient-reported scoring systems completed by each subject before radiotherapy and then 3, 6, 9, and 12 months after radiotherapy: Late Effects Normal Tissue Task Force (LENT)-Subjective, Objective, Management, Analytic (SOMA) LENT/SOMA grading system and the University of Michigan's Xerostomia Questionnaire (XQ). The data collected by this randomized pilot clinical trial will be used to inform the design of, and decision-making for, future larger studies that seek to compare different methods of radiotherapy planning in the treatment of HN-SQCC.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Histological documentation of Squamous-Cell Carcinoma of the Head and Neck (HN-SQCC)
- •Older than 21 years of age
- •Subject is eligible for routine chemo-radiotherapy for treatment of HN-SQCC
- •Informed consent is obtained
- •Karnofsky performance of at least 70 points
Exclusion Criteria
- •Women with a positive urine pregnancy test are excluded from this study; women of childbearing potential must agree to refrain from breast feeding and practice adequate contraception
- •Unable to comply with study procedures
- •Use of saliva stimulating prescription drugs such as Evoxac or Salagen
- •Unable to receive standard chemotherapy
Outcomes
Primary Outcomes
Grade of Xerostomia
Time Frame: Month 12 (i.e., 12 months (+/- 30 days) after baseline visit)
Self reported dry mouth using Late Effects Normal Tissue Task Force -Subjective, Objective, Management, Analytic (LENT/SOMA) scale. LENT/SOMA measures xerostomia in 4 stages. This ranges from Stage 1 "occasional dryness" through Stage 4 "complete dryness, debilitating". Lower stage values indicate a more favorable outcome than higher stage values.
Prevalence of Xerostomia
Time Frame: Month 12 (i.e., 12 months (+/- 30 days) after baseline visit)
Self reported dry mouth using University of Michigan's Xerostomia Questionnaire (XQ). This questionnaire has 8 questions that measure the degree to which xerostomia is affecting quality of life. Patients rate each item on a scale from 0 to 10. Higher score denotes worse xerostomia. To analyze the XQ, scores on its 8 items will be summed for each subject at each time point to produce an overall XQ score whose values theoretically can range from 0 to 80; it will be treated as a continuous variable. Lower values indicate a more favorable outcome than higher values.