HYPORT: A Phase I/II Study of Hypofractionated Post-operative Radiation Therapy for Head and Neck Cancer

  • STATUS
    Recruiting
  • End date
    Aug 5, 2027
  • participants needed
    98
  • sponsor
    University of Texas Southwestern Medical Center
Updated on 19 February 2024
psychiatric disorder
cancer
squamous cell carcinoma
carcinoma
unstable angina
angina pectoris
head and neck cancer
neck cancer
congestive heart failure
intensity-modulated radiation therapy
squamous cell carcinoma of the oral cavity
caries
stem cell transplant
complete resection
carcinoma of oral cavity
feeding tube
perineural invasion

Summary

There is a strong radiobiological and economic rationale for hypofractionated radiation therapy in head and neck cancer. Phase 1 of the trial aims to assess the acute toxicity and tolerability of hypofractionated radiation therapy in the post-operative setting, and to determine the dose/fractionation for Phase 2. Phase 2 aims to establish non-inferiority of swallowing-related quality of life and to assess the toxicity and efficacy of hypofractionated radiation therapy compared to conventionally fractionated radiation therapy in the post-operative setting.

Description

The trial will assess the effects of aggressive hypofractionated radiation therapy in patients with oral cavity, oropharynx, hypopharynx, or larynx cancer after surgical resection with pathology showing intermediate risk factors requiring post-operative radiation therapy without concurrent chemotherapy. During Phase 1, the maximum tolerated dose/fractionation and tolerability will be determined. During Phase 2, patients will be randomized between conventionally fractionated radiation therapy (6 weeks) vs. hypofractionated radiation therapy (3-4 weeks depending on Phase 1 results) to establish non-inferiority of hypofractionated radiation therapy.

Details
Condition Head and Neck Squamous Cell Carcinoma
Age 18years - 100years
Treatment Intensity-modulated radiation therapy (IMRT)
Clinical Study IdentifierNCT04403620
SponsorUniversity of Texas Southwestern Medical Center
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Inclusion criteria will be the same for Phase I and Phase II
Pathologically proven diagnosis of stage I-IVB squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx status post gross total resection with pathology showing one or more of the following intermediate risk factors: T3/4 disease, positive lymph node(s), close margin(s), perineural invasion, and/or lymphovascular invasion
Age 18 years
ECOG performance status 0-2
Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy
Negative serum or urine pregnancy test within 2 weeks before registration for women of childbearing potential
Ability to understand and the willingness to sign a written informed consent

Exclusion Criteria

Phase I
Distant metastasis
Stage I and II glottic squamous cell carcinoma
High risk factors following surgical resection requiring concurrent chemotherapy: positive margin(s) and/or extranodal extension
Feeding tube dependence at baseline assessment
Synchronous non-skin cancer primaries outside of the oropharynx, oral cavity, larynx, and hypopharynx except for low- and intermediate-risk prostate cancer and synchronous well-differentiated thyroid cancer. For thyroid cancer, surgery may occur before or after treatment, provided all other eligibility criteria are met
Prior invasive malignancy with an expected disease-free interval of less than 3 years
Prior radiotherapy to the region of the study cancer that would result in overlap of radiation fields
Subjects may not be receiving any other investigational agents for the treatment of the cancer under study
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that, in the opinion of the investigator, would limit compliance with study requirements
Subjects must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants
History of severe immunosuppression, including HIV, and organ or autologous or allogeneic stem cell transplant
Phase II
The exclusion criteria will be the same as Phase I except for feeding tube
dependence. Patients who are feeding tube dependent are excluded from Phase I
to accurately assess treatment associated toxicity affecting swallowing and
oral intake. During Phase II, patients who are feeding tube dependent will be
eligible to enroll and stratified at randomization
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