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Stereotactic Body Radiation Therapy Using HyperArc in Treating Patients With Recurrent Head and Neck Cancer

Not Applicable
Completed
Conditions
Recurrent Head and Neck Carcinoma
Interventions
Other: Quality-of-Life Assessment
Other: Questionnaire Administration
Radiation: Stereotactic Body Radiation Therapy
Registration Number
NCT03892720
Lead Sponsor
Jonsson Comprehensive Cancer Center
Brief Summary

This phase II trial studies how well stereotactic body radiation therapy with HyperArc software technology works in treating patients with head and neck cancer that has come back. Stereotactic body radiation therapy uses special equipment to position a patient and deliver radiation to tumors with high precision. This method can kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue.

Detailed Description

PRIMARY OBJECTIVES:

I. To evaluate local control and toxicity of patients who receive escalated dose stereotactic body radiation therapy (SBRT) reirradiation with HyperArc for recurrent head and neck cancer (rHNC).

SECONDARY OBJECTIVES:

I. To evaluate the clinical benefit of HyperArc through the analysis of overall survival (OS), progression-free survival (PFS) and locoregional progression-free survival (LPFS).

EXPLORATORY OBJECTIVES:

I. To evaluate dosimetric data including dose to target and organs at risk (OAR).

OUTLINE:

Patients undergo treatment planning with both standard radiation treatment software and HyperArc software technology. The most optimal plan will be delivered to a total dose of 55 Gy in 5 fractions, given 2-3 times weekly.

After completion of study treatment, patients are followed up periodically for 1 year.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  • Histologically confirmed recurrent head and neck cancer; either unresectable or status post salvage surgery.
  • History of radiation therapy for head and neck cancer with minimum 50% overlap of the 50% isodose line from prior treatment to the proposed treatment volume.
  • Estimated life expectancy > 12 weeks.
  • Karnofsky performance status >= 70 (Eastern Cooperative Oncology Group [ECOG] 0-2).
  • Maximum tumor, or tumor bed, diameter < 5 cm.
  • If a woman is of childbearing potential, a negative serum pregnancy test must be documented. Women of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; or abstinence) for duration of study participation and for up to 4 weeks following the study treatment.
  • Ability to understand and willingness to sign a written informed consent.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment (SBRT)Questionnaire AdministrationPatients undergo stereotactic body radiation therapy with either standard radiation treatment software or HyperArc software technology for 2-3 fractions per week over a 2-week period for 5 fractions.
Treatment (SBRT)Quality-of-Life AssessmentPatients undergo stereotactic body radiation therapy with either standard radiation treatment software or HyperArc software technology for 2-3 fractions per week over a 2-week period for 5 fractions.
Treatment (SBRT)Stereotactic Body Radiation TherapyPatients undergo stereotactic body radiation therapy with either standard radiation treatment software or HyperArc software technology for 2-3 fractions per week over a 2-week period for 5 fractions.
Primary Outcome Measures
NameTimeMethod
Local control rate of the treated tumor target per Response Evaluation Criteria in Solid Tumors version 1.1, magnetic resonance imaging (MRI) response or positron emission tomography (PET) responseAt 1 year

Will calculate the percentage and construct 95% exact confidence interval for local control rate.

Percent of patients with acute or chronic grade >= 3 treatment-related toxicity per Common Terminology Criteria for Adverse Events version 4.0At 1 year

Data will be tabulated and summarized. Incidence of adverse events (AEs) will be summarized overall and with separate summaries for serious adverse events (SAEs), AEs leading to discontinuation, AEs leading to death, etc. The overall safety and tolerability will be assessed throughout the study period. All AE data will be listed individually by patient identifier.

Secondary Outcome Measures
NameTimeMethod
Overall survival (OS)The time between the first dose of stereotactic body radiation therapy (SBRT) and death, assessed at 1 year

The Kaplan-Meier method will be used to provide an estimate of OS. The corresponding 95% confidence interval will also be presented.

OSThe time between the first dose of SBRT and death, assessed at 2 years

The Kaplan-Meier method will be used to provide an estimate of OS. The corresponding 95% confidence interval will also be presented.

PFSFrom the first dose of SBRT to the first objectively documented disease progression or death due to any cause, assessed at 2 years

The Kaplan-Meier method will be used to provide an estimate of PFS. The corresponding 95% confidence interval will also be presented.

Median PFSFrom the first dose of SBRT to the first objectively documented disease progression or death due to any cause, assessed up to 2 years

The Kaplan-Meier method will be used to provide an estimate of median PFS. The corresponding 95% confidence interval will also be presented.

LPFSFrom the first dose of SBRT to the first objectively documented disease progression in either the primary tumor, adjacent to the primary tumor, or in the surrounding lymph node areas, assessed at 2 years

The Kaplan-Meier method will be used to provide an estimate of LPFS. The corresponding 95% confidence interval will also be presented.

Median LPFSFrom the first dose of SBRT to the first objectively documented disease progression in either the primary tumor, adjacent to the primary tumor, or in the surrounding lymph node areas, assessed up to 2 years

The Kaplan-Meier method will be used to provide an estimate of median LPFS. The corresponding 95% confidence interval will also be presented.

Median OSThe time between the first dose of SBRT and death, assessed up to 2 years

The Kaplan-Meier method will be used to provide an estimate of median OS. The corresponding 95% confidence interval will also be presented.

Progression-free survival (PFS)From the first dose of SBRT to the first objectively documented disease progression or death due to any cause, assessed at 1 year

The Kaplan-Meier method will be used to provide an estimate of PFS. The corresponding 95% confidence interval will also be presented.

Locoregional progression-free survival (LPFS)From the first dose of SBRT to the first objectively documented disease progression in either the primary tumor, adjacent to the primary tumor, or in the surrounding lymph node areas, assessed at 1 year

The Kaplan-Meier method will be used to provide an estimate of LPFS. The corresponding 95% confidence interval will also be presented.

Trial Locations

Locations (1)

UCLA / Jonsson Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

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