Randomized Controlled Trial to Test the Efficacy of Trans-tympanic Injections of a Sodium Thiosulfate Gel to Prevent Cisplatin-induced Ototoxicity in Patients With Head and Neck Cancer
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 发起方
- 入组人数
- 13
- 试验地点
- 1
- 主要终点
- Hearing loss at high frequencies
研究概览
简要总结
This study evaluates whether a gel containing sodium thiosulfate deposited via a trans-tympanic injection on the round window of the middle ear could reduce the ototoxicity caused by the drug Cisplatin among patients with head and neck cancer treated by chemoradiation. One ear selected randomly will be treated while the other will serve as control.
详细描述
Background
Cisplatin (cis-DiammineDichloridoPlatinum, DDP) is an antineoplastic agent used in the treatment of solid malignant tumors in adults and is also a key part of treatment for many children and adolescents with cancer. However, treatment with Cisplatin carries the risk of serious dose-limiting adverse effects. Ototoxicity is of major concern since the associated hearing loss greatly impairs patients' quality of life and no preventive treatment is presently available. Cisplatin ototoxicity is an important problem for patients treated for head and neck squamous cell carcinoma (HNSCC) who receive repeatedly high doses.
Cisplatin causes an accumulation of reactive oxygen species (ROS) in the cochlea, triggering damage to the outer hair cells of the organ of Corti. Sulfur-containing antioxidants can neutralize ROS following Cisplatin intoxication, and thus represent a potential preventive measure. A few sulfur-containing molecules have been studied. Experimental and human studies have shown that sodium thiosulfate (STS) can protect against Cisplatin-induced ototoxicity. However, when administered through the blood stream, STS interfere with Cisplatin treatment efficacy. To counter the ototoxic effects of Cisplatin treatment without impairing its efficacy, a local pharmacology approach directly aiming at the cochlea, would represent a powerful clinical strategy.
The proposed study is the first to test the efficacy of STS administered locally in the middle ear to prevent Cisplatin-induced ototoxicity in humans.
Objective
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with newly diagnosed locally advanced (stage III or IV) squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx scheduled to be treated with concomitant chemoradiation including Cisplatin100 mg/m2 3 times
- •Normal otoscopic findings and symmetrical hearing
排除标准
- •Karnofsky below 70
研究组 & 干预措施
Treated ear
Trans-tympanic injection of a sodium thiosulfate gel
干预措施: Trans-tympanic injection of a sodium thiosulfate gel (Drug)
结局指标
主要结局
Hearing loss at high frequencies
时间窗: One month after Cisplatin treatment
Hearing loss defined by the difference between the average permanent threshold shift (PTS) in dB (decibel) at four pure tone high frequencies (9, 10, 12.5 and 14 kHz) using the data from the audiograms done before and one month after Cisplatin therapy, for each patient and for each ear.
次要结局
- Cochlear damage(One month after Cisplatin treatment)
- Hearing loss at lower frequencies(One month and one year after Cisplatin treatment)
- Adverse effects of trans-tympanic injections(One month after Cisplatin treatment)
研究者
François Meyer
Researcher
CHU de Quebec-Universite Laval