A Multicenter Randomized Controlled Clinical Study on the Treatment of T3N1M0 High Risk Nasopharyngeal Carcinoma With or Without Induction Chemotherapy Before Concurrent Radiotherapy and Chemotherapy
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 236
- 试验地点
- 1
- 主要终点
- Failure Free Survival
研究概览
简要总结
The goal of this clinical trial is to compare the efficacy and safety of curative radiotherapy with or without induction chemotherapy in patients with T3N1M0 nasopharyngeal carcinoma. The main question[s] it aims to answer are:
- Whether induction chemotherapy confers a survival benefit in patients with T3N1M0 nasopharyngeal carcinoma with high risks factors.
- Whether induction chemotherapy worsens adverse effects in patients with T3N1M0 nasopharyngeal carcinoma.
Participants in experimental group will receive 3 cycles induction chemotherapy (GP or TPF) followed by concurrent chemoradiotherapy.Participants in control group will receive concurrent chemoradiotherapy only.
Researchers will compare FFS, OS and AE or SAE to see if patients can benefit from induction chemotherapy or screen out high-risk factors associated with survival benefits.
详细描述
In this study, 236 patients with pathologically diagnosed nasopharyngeal carcinoma and clinical stage of T3N1M0 will be randomly divided into two groups, 118 in the experimental group (induction chemotherapy + concurrent chemoradiotherapy) and 118 in the control group (concurrent chemoradiotherapy). The experimental group received 3 courses of induction chemotherapy followed by radical radiotherapy for the nasopharynx and neck, and 2-3 courses of cisplatin (100mg/m2, Q3W) treatment during radiotherapy. The control group received radical radiotherapy for the nasopharynx and neck, and 2-3 courses of cisplatin (100mg/m2, Q3W) during radiotherapy. Since there have been clinical trials to prove that GP or TPF induction chemotherapy is effective in locally advanced nasopharyngeal carcinoma, the induction chemotherapy regimen in this study can be selected by the investigator with GP or TPF. During treatment and within 3 years after treatment, the efficacy and safety of patients in both groups were followed up and evaluated.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1.Pathologically diagnosed with stage T3N1M0 nasopharyngeal cancer according to 2017 AJCC Cancer Staging Manual-8th Edition; not received anticancer treatment.
- •2.18-70 years old.
- •One or more of the following prognostic factors exist:
- •MRI showed extravasation of lymph node capsule,
- •MRI showed lymph node necrosis,
- •The maximum diameter of positive lymph nodes in the three-dimensional direction on MRI is ≥ 3cm,
- •2 or more positive lymph nodes,
- •Peripheral blood EBV-DNA ≥ 4000 copies/ml,
- •The maximum SUV value of lymph nodes on PET/CT ≥ 9.
- •4.ECOG Score (PS score) 0 or
- •5.Neutrophil count > 1.5*10^9/L, hemoglobin > 90g/L, and platelet count > 100*10^9/L.
- •6.ALT or AST level < 2.5 times upper normal limit (upper limit of normal, ULN), bilirubin level < 1.5 times ULN.
- •7.Creatinine clearance level > 60 ml/min. (Calculated according to Cockcroft Gault formula).
- •8.Patients must sign an informed consent and must be willing and able to comply with the visit, treatment protocol, laboratory tests and other requirements specified in the study protocol.
排除标准
- •Patients who have other malignant tumors within 5 years, excluding carcinoma in situ, well treated non melanoma skin cancer and papillary thyroid cancer.
- •Other conditions that may affect the safety or test compliance of the subject as judged by the investigator, including symptomatic heart failure, unstable angina, myocardial infarction, active infection requiring systemic treatment, mental illness or family and social factors.
研究组 & 干预措施
IC plus CC plus IMRT
Induction chemotherapy followed by Intensity-modulated radiotherapy plus concurrent chemotherapy
干预措施: Induction chemotherapy plus Concurrent chemotherapy (Drug)
IC plus CC plus IMRT
Induction chemotherapy followed by Intensity-modulated radiotherapy plus concurrent chemotherapy
干预措施: IMRT (Radiation)
CC plus IMRT
Intensity-modulated radiotherapy plus concurrent chemotherapy alone
干预措施: Concurrent chemotherapy (Drug)
CC plus IMRT
Intensity-modulated radiotherapy plus concurrent chemotherapy alone
干预措施: IMRT (Radiation)
结局指标
主要结局
Failure Free Survival
时间窗: Two years
The absence of relapse, non-relapse mortality or addition of another systemic therapythe last follow-up if there is no disease progression.
次要结局
- Overall survial(Two years)
研究者
Fang-Yun Xie
Sun Yat-sen University Cancer Center
Sun Yat-sen University