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NCT Number: NCT07327216

Sapylin Versus Dexamethasone Inhalation for CCRT-Induced Oral Mucositis in Nasopharyngeal Carcinoma

Radiation therapy is the main treatment for nasopharyngeal carcinoma (NPC), and standard care for advanced NPC often includes combination chemotherapy and radiation (CCRT). However, many patients experience serious side effects, such as painful mouth sores (Radiation-Induced Oral Mucositis, RTOM). These side effects can be so severe that they lower a patient's ability to adhere to treatment, potentially making the CCRT less effective. Studies have shown that a significant number of patients stop treatment early due to this toxicity.

Current clinical guidelines from organizations like MASCC/ISOO and ESMO agree that preventing RTOM is crucial, but there is currently no specific drug that works for everyone.

This study aims to investigate a new approach: using Sapylin, a biological immune regulator, delivered through an atomized inhaler. Preliminary research suggests Sapylin delivered this way may enhance the effectiveness of chemotherapy and boost the body's immunity.

The main purpose of this study is to determine the effect of Sapylin inhalation on the incidence and severity of RTOM, and to evaluate its safety and impact on the overall success of CCRT.

By participating, you will help researchers find a high-efficiency, low-toxicity method to improve CCRT outcomes and manage RTOM for future NPC patients and specialists.

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Key information

Conditions

Nasopharyngeal Carcinoma (NPC) Carcinoma Head and Neck Neoplasms Nasopharyngeal Carcinoma Nasopharyngeal Diseases Nasopharyngeal Neoplasms Neoplasms Neoplasms by Histologic Type Neoplasms by Site Neoplasms, Glandular and Epithelial Otorhinolaryngologic Diseases Otorhinolaryngologic Neoplasms Pharyngeal Diseases Pharyngeal Neoplasms Stomatognathic Diseases

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Affiliated Hospital of Guangdong Medical University

Zhanjiang, Guangdong, China

Location status: Recruiting

Who can participate

Healthy volunteers accepted: No

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

  • Inclusion Criteria:
  • Stage III-IVa NPC (AJCC 8th edition) diagnosed via pathology in a tertiary hospital;
  • No previous radiotherapy, chemotherapy, surgery, immunization, or targeted therapy;
  • Karnofsky Performance Status score ≥80;
  • Intact and normal oral mucosa before treatment;
  • Age 18-75 years;
  • Voluntary participation and provision of informed consent in person;
  • Routine blood examination: white blood cell count ≥4.0×109/L, hemoglobin ≥100g/L, neutrophil count ≥1.5×10^9/L, and platelet count ≥100×10^9/L;
  • Biochemical examination: total bilirubin ≤1.5×the upper limit of the normal range (ULN), alanine aminotransferase and aspartate aminotransferase ≤2×ULN, and estimated glomerular filtration rate ≥60 mL/min.
  • Exclusion Criteria:
  • With other malignant tumors in the past or present and/or distant metastasis during treatment;
  • Who have undergone surgery, chemoradiotherapy, and targeted immunotherapy;
  • With a history of asthma, rash, urticaria, and other allergic diseases;
  • With a history of autoimmune diseases, connective tissue diseases, and diabetes mellitus that significantly affect the healing of the oral mucosa;
  • With concomitant diseases, such as heart disease, kidney disease, and acute infectious diseases, which are judged by the investigator to seriously endanger the safety of patients or affect the completion of the study;
  • Who are breastfeeding, pregnant, or planning to become pregnant during the study;
  • With known allergies to the therapeutic agents and penicillin used in the trial;
  • Mental or nervous system diseases or poor compliance.

Treatment and study plan

Sapylin

Drug

Atomized inhalation, 1 KE/time, QD from day 1 of CCRT until the end of radiotherapy.

Dexamethasone

Drug

Dexamethasone (10 mg per administration) via atomized inhalation once daily (QD).

CCRT with Cisplatin

Combination Product

Patients receive cisplatin-based CCRT: cisplatin 80-100mg/m2, Q3W, three times during CCRT. Radiation dose: PTVnx: 69.96Gy/33F, PTV1: 60.06Gy/33F, PTV2: 54.12Gy/33F.

Primary outcomes

  1. Incidence of Radiation-Induced Oral Mucositis (RIOM)

    Time frame: From the start of Concurrent Chemoradiotherapy (CCRT) through the completion of radiotherapy, assessed weekly for approximately 7 weeks.

    Incidence of RIOM is defined as the number of participants developing oral mucositis of any grade. Assessment is based on the World Health Organization (WHO) Oral Toxicity Scale. Scores range from 0 to 4 for ulceration, where higher scores indicate worse outcome.

  2. Severity of Radiation-Induced Oral Mucositis (RIOM)

    Time frame: From Week 1 of Concurrent Chemoradiotherapy (CCRT) until the end of Radiotherapy (Week 7).

    To compare the severity of RlOM between the Sapylin and Dexamethasone groups using the World Health Organization (WHO) Oral Toxicity Scale. Scores range from 0 to 4 for ulceration, where higher scores indicate worse outcome.

Secondary outcomes

  1. Duration of Radiation-Induced Oral Mucositis (RIOM)

    Time frame: Daily assessment during CCRT, and up to 1 month after the completion of treatment (assessed up to 3 months).

    Time from the first diagnosis of RIOM (any grade) until the symptoms resolve to Grade 0 or return to baseline level.

  2. Rate of Completion of Treatment Measures

    Time frame: Measured at the end of the concurrent chemoradiotherapy (CCRT) regimen (Week 7).

    Determined by comparing the actual dose and cycle count of Concurrent Chemoradiotherapy (CCRT) administered versus the planned total treatment regimen. Includes: 1) Actual dose divided by planned total dose (%); 2) Actual completed cycles divided by planned total cycles (%).

  3. Incidence and Severity of Adverse Events (AEs)

    Time frame: Daily recording during treatment; Follow-up every 3 months for one year after treatment completion.

    All observed adverse events will be recorded and graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

  4. Change in Body Mass Index (BMI)

    Time frame: Baseline (before CCRT starts) and at the end of treatment (End of Radiotherapy, approximately Week 7).

    Change is defined as the difference between BMI (kg/m2) at the end of treatment and baseline BMI (Baseline BMI: before CCRT starts).

Study contacts

Contact information is provided by the study sponsor or research team.

Haiqing Luo, PhD

CONTACT

[email protected]

+8613729196345

Sponsors and collaborators

Lead sponsor

Affiliated Hospital of Guangdong Medical University

Other

Registry information

Official study title

Efficacy and Safety of Sapylin Versus Dexamethasone Atomized Inhalation for Concurrent Chemoradiotherapy-Induced Oral Mucositis in Patients With Nasopharyngeal Carcinoma: A Randomized, Parallel, Non-inferiority Clinical Trial

Important dates

Study start
2022
Primary completion
2026
Study completion
2027
First posted
Jan 8, 2026
Registry last updated
Mar 4, 2026

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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