A Phase II Study Of Intensity Modulated Radiation Therapy (IMRT) +/- Chemotherapy For Nasopharyngeal Cancer
Overview
- Phase
- Phase 2
- Intervention
- cisplatin
- Conditions
- Head and Neck Cancer
- Sponsor
- Radiation Therapy Oncology Group
- Enrollment
- 68
- Locations
- 17
- Primary Endpoint
- Protocol Compliance of Intensity-modulated Radiotherapy Treatment Delivered
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation therapy in different ways may cause less damage to normal tissue, prevent or lessen mouth dryness, and may help patients live more comfortably. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with radiation therapy may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of specialized radiation therapy techniques with or without chemotherapy in reducing mouth dryness in patients who have nasopharyngeal cancer.
Detailed Description
OBJECTIVES: * Determine the transportability of IMRT to a multi-institutional setting. * Determine the rate of late xerostomia in patients with nasopharyngeal cancer treated with intensity-modulated radiotherapy (IMRT) with or without chemotherapy. * Correlate reduction of side effects on salivary flow with compliance in patients treated with these regimens. * Determine the rate of local-regional control, distant metastasis, and disease-free and overall survival of patients treated with these regimens. * Determine the acute and late toxicity of these regimens in these patients. * Determine chemotherapy compliance in patients treated with these regimens. OUTLINE: Patients undergo daily intensity-modulated radiotherapy (IMRT) 5 days a week for approximately 6.5 weeks (total of 33 fractions) in the absence of disease progression or unacceptable toxicity. Patients with stage T2b or greater and/or node-positive disease receive cisplatin IV over 20-30 minutes on days 1, 22, and 43 concurrently with IMRT followed by cisplatin IV over 20-30 minutes and fluorouracil IV over 96 hours starting on days 71, 99, and 127. Quality of life is assessed through saliva measurement at baseline and then at 3, 6, and 12 months after IMRT. Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 64 patients will be accrued for this study within 36-40 months.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
IMRT +/- chemotherapy
Intensity modulated radiation therapy (IMRT) for all patients and chemotherapy (cisplatin and fluorouracil) for patients with stage ≥ T2b and/or N+
Intervention: cisplatin
IMRT +/- chemotherapy
Intensity modulated radiation therapy (IMRT) for all patients and chemotherapy (cisplatin and fluorouracil) for patients with stage ≥ T2b and/or N+
Intervention: fluorouracil
IMRT +/- chemotherapy
Intensity modulated radiation therapy (IMRT) for all patients and chemotherapy (cisplatin and fluorouracil) for patients with stage ≥ T2b and/or N+
Intervention: Intensity modulated radiation therapy
Outcomes
Primary Outcomes
Protocol Compliance of Intensity-modulated Radiotherapy Treatment Delivered
Time Frame: From start of treatment to end of treatment
Patients scored by the study chairs as no variation or minor variation were considered compliant, while patients scored as major variation or inevaluable were considered non-compliant. The number being reported is the number non-compliant. A compliance rate of 90% was targeted with 75% or lower being considered unacceptable. Fifty-seven patients were required with types I and II error rates both 0.10. If 10 or more patients out of 57 were non-compliant, the treatment would be unacceptable, per a two-stage Fleming multiple testing procedure.
Secondary Outcomes
- Other Acute and Late Toxicities(From start of treatment to last follow-up)
- Chemotherapy Compliance(From start of treatment to end of treatment)
- Rate of Xerostomia at 1 Year (Grade ≥ 2)(From start of treatment to 1 year)
- Rate of Locoregional Control at 2 Years(From registration to 2 years)
- Whole Mouth Saliva Output Relative to Pretreatment Measurements(From start of treatment to 1 year)