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NCT Number: NCT00580983

Optimized Intensity Modulated Irradiation for Head and Neck Cancer

The purpose of this study is to test whether the use of advanced radiation therapy delivery techniques can spare a patient's normal tissue, including salivary glands, from radiation. This study is being done to try to reduce radiation side effects, especially mouth dryness, which happens with standard radiation methods. In order to reduce these side effects, other normal tissues may receive a different radiation dose (sometimes more) than what would have been received using standard radiation therapy. A secondary goal of this study is to determine if the type of tumor a patient has can be controlled at least as well (or better) using this advanced radiation therapy delivery technique as it would be if the patient was treated with standard radiation therapy.

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Key information

Conditions

Head and Neck Cancer Head and Neck Neoplasms Neoplasms Neoplasms by Site

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Michigan

Ann Arbor, Michigan, 48109-5010, United States

About this study

Studies show that a dose response relationship in the salivary glands exists and that it may be possible to improve significantly post-radiation xerostomia and quality of life if radiation techniques can be devised that would spare the salivary glands while adequately treating the targets. A new treatment modality (computer-optimized IMRT) facilitates increased sparing of noninvolved tissue, specifically the sparing of both parotid glands, and more conformal high-dose delivery to the bilateral neck targets in patients with head and neck cancer. This study will evaluate the benefits regarding xerostomia-specific and general QOL in patients receiving head and neck RT using this modality. Assessment of swallowing dysfunction and aspiration will be made using videofluoroscopy. In addition, this study will evaluate the pattern of local/regional tumor recurrence, to assess whether sparing both parotid glands may cause tumor recurrence in spared neck areas.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All patients must have histologically confirmed invasive cancer of the head and neck.
  • Irradiation to both neck sides is required.
  • Standard radiation techniques would irradiate most of both parotid glands to a high dose (>50 Gy). Patients with oropharyngeal, oral, nasopharyngeal, hypopharyngeal and advanced laryngeal cancer are expected to fulfill this requirement.
  • Patients with resectable disease that is either measurable, evaluable or non-measurable disease (post-operative) will be eligible.
  • Karnofsky performance status >60
  • Patients receiving or not receiving chemotherapy are eligible.
  • All patients must sign an informed consent.
  • Pre-treatment laboratory criteria:
  • WBC (White Blood Cell) > 3500/ul, granulocyte > 1500/ul.
  • Platelet count > 100,000/ul.
  • Creatinine clearance > 60 cc/min. to receive cisplatin; creatinine clearance 30-59 cc/min to receive carboplatin.
  • Bilirubin < 1.5 mg% with no evidence of obstructive liver disease.
  • AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) equal to or less than 2.5 x upper limit of normal.

Exclusion criteria

  • Patients who received past irradiation to the head and neck are not eligible.
  • Prior head and neck malignancy or history of other prior non-head and neck malignancy within the past 3 years.
  • Prior head and neck radiation or prior chemotherapy.
  • Documented evidence of distant metastases.
  • Active infection.
  • Pregnancy or lactation; patients must use effective contraception during the course of the clinical trial.
  • Any medical or psychiatric illness which in the opinion of the principal investigator would compromise the patients ability to tolerate this treatment.
  • Patients residing in prison.
  • Age < 18 years.

Treatment and study plan

IMRT

Radiation

paclitaxel

Drug

carboplatin

Drug

Cisplatin

Drug

5-fluorouracil

Drug

Primary outcomes

  1. Percentage of Participants With Grade 0-1 Observer-rated Dysphagia

    Time frame: 12 months

    To objectively assess dysphagia and aspiration in patients receiving dysphagia/aspiration-sparing IMRT concurrent with chemotherapy, the percentage of participants with observer-rated dysphagia was calculated.

Secondary outcomes

  1. The Mean Esophageal Radiotherapy Dose in Patients With Strictures and Without Strictures

    Time frame: 5 years

    To assess the relationships between the mean radiotherapy dose delivered and objectively measured dysphagia.

Sponsors and collaborators

Lead sponsor

University of Michigan Rogel Cancer Center

Other

Registry information

Important dates

Study start
2003
Primary completion
2010
Study completion
2010
First posted
Dec 27, 2007
Registry last updated
Sep 7, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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