Therapeutic Gain by Induction-concurrent Chemoradiotherapy and/or Accelerated Fractionation for Nasopharyngeal Carcinoma

NCT ID: NCT00379262

Last Updated: 2019-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

803 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-09-30

Study Completion Date

2018-12-31

Brief Summary

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The objectives of this clinical study are threefold:

1. To compare the benefits in cancer control and survival obtained from adding induction-concurrent chemotherapy to radiation with those from adding concurrent-adjuvant chemotherapy to radiation.
2. To test whether replacing fluorouracil with Xeloda in combining with cisplatin in the chemotherapy plan will maintain or improve further the chemotherapy benefits while reducing the duration of hospital stay.
3. To see if accelerated fractionation radiotherapy can improve the outcome of patients as compared with conventional fractionation radiotherapy.

Detailed Description

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1. primary objectives include

1. comparing induction chemotherapy with Cisplatin + 5-Fluorouracil versus adjuvant chemotherapy with Cisplatin + 5-Fluorouracil(PF-Pvs P-PF)
2. comparing induction chemotherapy with Cisplatin + Capecitabine versus adjuvant chemotherapy with Cisplatin + 5-Fluorouracil(PX-P vs P-PF)
3. comparing accelerated fractionation versus conventional fractionation (AF vs CF)radiotherapy.
2. secondary objectives include

1. comparing induction chemotherapy with Cisplatin + Capecitabine versus induction chemotherapy with Cisplatin + 5-Fluorouracil(PX-P vs PX-P)
2. Comparing concurrent-adjuvant (CA) versus induction-concurrent (IC) chemotherapy sequence.

Conditions

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Nasopharyngeal Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1A

Concurrent-Adjuvant CRT using P-PF regimen and conventional fractionation radiotherapy

Group Type EXPERIMENTAL

Adjuvant chemotherapy using PF (5-Fluorouracil )

Intervention Type DRUG

Cisplatin 80 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 96 hr every 28 days for 3 cycles

1B

Concurrent-Adjuvant CRT using P-PF regimen and accelerated fractionation radiotherapy

Group Type EXPERIMENTAL

Adjuvant chemotherapy using PF (5-Fluorouracil )

Intervention Type DRUG

Cisplatin 80 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 96 hr every 28 days for 3 cycles

2A

Induction-Concurrent CRT using PF-P regimen and conventional fractionation radiotherapy

Group Type EXPERIMENTAL

Induction chemotherapy using PF (5-Fluorouracil)

Intervention Type DRUG

Cisplatin 100 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 120 hr every 21 days for 3 cycles

2B

Induction-Concurrent CRT using PF-P regimen and accelerated fractionation radiotherapy

Group Type EXPERIMENTAL

Induction chemotherapy using PF (5-Fluorouracil)

Intervention Type DRUG

Cisplatin 100 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 120 hr every 21 days for 3 cycles

3A

Induction-Concurrent CRT using PX-P regimen and conventional fractionation radiotherapy

Group Type EXPERIMENTAL

Capecitabine

Intervention Type DRUG

Dose:1000 mg/m2, BD, Day 1-Day 14 Interval: 21 days Cycles: 3 cycles

3B

Induction-Concurrent CRT using PX-P regimen and accelerated fractionation radiotherapy

Group Type EXPERIMENTAL

Capecitabine

Intervention Type DRUG

Dose:1000 mg/m2, BD, Day 1-Day 14 Interval: 21 days Cycles: 3 cycles

Interventions

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Capecitabine

Dose:1000 mg/m2, BD, Day 1-Day 14 Interval: 21 days Cycles: 3 cycles

Intervention Type DRUG

Adjuvant chemotherapy using PF (5-Fluorouracil )

Cisplatin 80 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 96 hr every 28 days for 3 cycles

Intervention Type DRUG

Induction chemotherapy using PF (5-Fluorouracil)

Cisplatin 100 mg/m2 IV + 5-Fluorouracil 1000 mg/m2/day IV infusion for 120 hr every 21 days for 3 cycles

Intervention Type DRUG

Other Intervention Names

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Xeloda

Eligibility Criteria

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Inclusion Criteria

* histologically proven nasopharyngeal carcinoma for primary treatment with radical intent
* non-keratinizing or undifferentiated type
* stage III-IVB (by AJCC/UICC 6th edition)
* ECOG Performance status less or equal to 2
* Marrow: WBC \>= 4 and platelet \>=100
* Renal: creatinine clearance \>=60
* Informed consent

Exclusion Criteria

* Primary treatment with palliative intent
* WHO type I squamous cell carcinoma or adenocarcinoma
* Evidence of distant metastases
* Patient is pregnant or lactating
* Prior malignancy except adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer or other cancer for which the patient has been disease-free for 5 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Hong Kong Anti-Cancer Society

OTHER

Sponsor Role collaborator

hong Kong Cancer Fund

UNKNOWN

Sponsor Role collaborator

Hong Kong Nasopharyngeal Cancer Study Group Limited

OTHER

Sponsor Role lead

Responsible Party

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Dr. ANNE W M LEE

Consultant, Dept of Clinical Oncology, PYNEH

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anne W.M. Lee, F.R.C.R.

Role: PRINCIPAL_INVESTIGATOR

Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong

Roger K.C. Ngan, F.R.C.R

Role: PRINCIPAL_INVESTIGATOR

Department of Clinical Oncology, Quen Elizabeth Hospital, Hong Kong

Locations

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Cancer Center, Sun Yat Sen University

Guangzhou, , China

Site Status

Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital

Hong Kong, , China

Site Status

Department of Clinical Oncology, Prince of Wales Hospital

Hong Kong, , China

Site Status

Department of Clinical Oncology, Princess Margaret Hospital

Hong Kong, , China

Site Status

Department of Clinical Oncology, Queen Elizabeth Hospital

Hong Kong, , China

Site Status

Department of Clinical Oncology, Queen Mary Hospital

Hong Kong, , China

Site Status

Department of Clinical Oncology, Tuen Mun Hospital

Hong Kong, , China

Site Status

Countries

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China

References

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Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, Ensley JF. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998 Apr;16(4):1310-7. doi: 10.1200/JCO.1998.16.4.1310.

Reference Type BACKGROUND
PMID: 9552031 (View on PubMed)

Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, Siu L, Sze WM, Leung TW, Sham JS, Ngan RK, Law SC, Yau TK, Au JS, O'Sullivan B, Pang ES, O SK, Au GK, Lau JT; Hong Kong Nasopharyngeal Cancer Study Group. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005 Oct 1;23(28):6966-75. doi: 10.1200/JCO.2004.00.7542.

Reference Type BACKGROUND
PMID: 16192584 (View on PubMed)

Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, Akazawa P, Weinberg V, Fu KK. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys. 2002 May 1;53(1):12-22. doi: 10.1016/s0360-3016(02)02724-4.

Reference Type BACKGROUND
PMID: 12007936 (View on PubMed)

Le QT, Tate D, Koong A, Gibbs IC, Chang SD, Adler JR, Pinto HA, Terris DJ, Fee WE, Goffinet DR. Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):1046-54. doi: 10.1016/s0360-3016(03)00117-2.

Reference Type BACKGROUND
PMID: 12829140 (View on PubMed)

Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, Kwong DL, Al-Sarraf M, Chi KH, Hareyama M, Leung SF, Thephamongkhol K, Pignon JP; MAC-NPC Collaborative Group. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006 Jan 1;64(1):47-56. doi: 10.1016/j.ijrobp.2005.06.037.

Reference Type BACKGROUND
PMID: 16377415 (View on PubMed)

Hoff PM, Ansari R, Batist G, Cox J, Kocha W, Kuperminc M, Maroun J, Walde D, Weaver C, Harrison E, Burger HU, Osterwalder B, Wong AO, Wong R. Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 2001 Apr 15;19(8):2282-92. doi: 10.1200/JCO.2001.19.8.2282.

Reference Type BACKGROUND
PMID: 11304782 (View on PubMed)

Twelves C, Boyer M, Findlay M, Cassidy J, Weitzel C, Barker C, Osterwalder B, Jamieson C, Hieke K; Xeloda Colorectal Cancer Study Group. Capecitabine (Xeloda) improves medical resource use compared with 5-fluorouracil plus leucovorin in a phase III trial conducted in patients with advanced colorectal carcinoma. Eur J Cancer. 2001 Mar;37(5):597-604. doi: 10.1016/s0959-8049(00)00444-5.

Reference Type BACKGROUND
PMID: 11290435 (View on PubMed)

Chua DT, Sham JS, Au GK. A phase II study of capecitabine in patients with recurrent and metastatic nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Oral Oncol. 2003 Jun;39(4):361-6. doi: 10.1016/s1368-8375(02)00120-3.

Reference Type BACKGROUND
PMID: 12676255 (View on PubMed)

Greene FL, et al. AJCC Cancer Staging Handbook from the AJCC cancer staging manual, 6th ed. New York: Springer, 2002.

Reference Type BACKGROUND

Lee AW, Tung SY, Chan AT, Chappell R, Fu YT, Lu TX, Tan T, Chua DT, O'sullivan B, Xu SL, Pang ES, Sze WM, Leung TW, Kwan WH, Chan PT, Liu XF, Tan EH, Sham JS, Siu L, Lau WH. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006 Sep 1;66(1):142-51. doi: 10.1016/j.ijrobp.2006.03.054.

Reference Type BACKGROUND
PMID: 16904519 (View on PubMed)

Freedman J, Furberg, C, DeMets D. Fundamentals of clinical trials. Springer-Verlag, NY, 1998.

Reference Type BACKGROUND

Other Identifiers

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NPC-0501 Trial

Identifier Type: -

Identifier Source: org_study_id

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