Reduced Dose Radiotherapy vs Standard Dose Radiotherapy for Early Stage Nasopharyngeal Carcinoma

NCT ID: NCT06912698

Last Updated: 2025-04-22

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

342 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-22

Study Completion Date

2033-03-19

Brief Summary

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This study investigates whether administering reduced dose is non-inferior to standard dose radiotherapy in terms of 3-year locoregional relapse-free survival (LRRFS) rate for stage I nasopharyngeal carcinoma patients who are sensitive to radiotherapy.

Detailed Description

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All the patients receive intensity-modulated radiotherapy. If patients receive CR and EBV DNA undetectable when completing 50.88Gy radiation, they will continue to receive radiotherapy until 61.48Gy, then the patients would be randomised assigned ( 1:1 ) to reduced dose group (observation) or standard dose group (continue to receive radiotherapy until 69.96Gy). Patients with stage IA will receive radiotherapy alone, and patients with stage IB will receive concurrent chemoradiotherapy. For patients with stage IB, those assigned to reduced dose group will receive a total of 2 cycles cisplatin concurrent chemotherapy, with 100mg/m2 per cycle; those assigned to standard dose group will receive a total of 3 cycles cisplatin concurrent chemotherapy, with 100mg/m2 per cycle. This study investigates whether administering reduced dose is non-inferior to standard dose radiotherapy in terms of 3-year locoregional relapse-free survival (LRRFS) rate for stage I nasopharyngeal carcinoma patients who are sensitive to radiotherapy. The primary endpoint is 3-year locoregional relapse-free survival.

Conditions

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Nasopharyngeal Cancinoma (NPC)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Reduced dose group

Patients receive reduced dose radiotherapy.

Group Type EXPERIMENTAL

Reduced dose radiation

Intervention Type RADIATION

Reduced dose group would receive 61.48Gy radiation.

Standard dose group

Patients receive standard dose radiotherapy.

Group Type ACTIVE_COMPARATOR

Standard dose radiation

Intervention Type RADIATION

Standard dose group would receive 69.96Gy radiation.

Interventions

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Reduced dose radiation

Reduced dose group would receive 61.48Gy radiation.

Intervention Type RADIATION

Standard dose radiation

Standard dose group would receive 69.96Gy radiation.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. Age 18-70, regardless of sex.
2. Patients with newly histologically confirmed non-keratinizing nasopharyngeal carcinoma, type of WHO II or III, clinical stage I (according to the 9th American Joint Committee on Cancer\[AJCC\] edition).
3. Patients with CR according to RECIST and EBV DNA undetectable after received 50.88Gy radiation.
4. ECOG (Eastern Cooperative Oncology Group) score: 0-1.
5. Women in their reproductive years should ensure that they use contraception during the study period.
6. Hemoglobin (HGB) ≥90 g/L, white blood cell (WBC) ≥4×109 /L, platelet (PLT) ≥100×109 /L.
7. Liver function: Alanine transaminase(ALT), Aspartate aminotransferase(AST)\< 1.5 times the upper limit of normal value (ULN), total bilirubin \<1.5×ULN.
8. Renal function: serum creatinine \<1.5×ULN or creatinine clearance rate≥60mL/min.
9. Patients must sign informed consent and be willing and able to comply with the requirements of visits, treatment, laboratory tests and other research requirements stipulated in the research schedule.

Exclusion Criteria

1. Histologically confirmed keratinizing squamous cell carcinoma (WHO I).
2. Patients with PR/SD/PD according to RECIST and/or EBV DNA detectable after received 50.88Gy radiation.
3. Receiving radiotherapy or chemotherapy or targeted therapy previously.
4. Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the preparative chemotherapy on the fetus or infant.
5. Suffered from other malignant tumors (except the cure of basal cell carcinoma or uterine cervical carcinoma in situ) previously.
6. Patients with significantly lower heart, liver, lung, kidney and bone marrow function.
7. Severe, uncontrolled medical conditions and infections.
8. At the same time using other test drugs or in other clinical trials.
9. Refusal or inability to sign informed consent to participate in the trial.
10. Other treatment contraindications.
11. Emotional disturbance or mental illness, no civil capacity or limited capacity for civil conduct.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hai-Qiang Mai,MD,PhD

OTHER

Sponsor Role lead

Responsible Party

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Hai-Qiang Mai,MD,PhD

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Hai-Qiang MD, Dr.

Role: STUDY_CHAIR

Sun Yat-sen University

Locations

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Sun Yat-sen University Cancer Centre

Guangzhou, Guangdong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Hai-Qiang Mai, Dr.

Role: CONTACT

+8602087343380

Qiu-Yan Chen, Dr.

Role: CONTACT

+8602087343380

Facility Contacts

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Shan-Shan Guo

Role: primary

00862087343643

References

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Mayr NA, Magnotta VA, Ehrhardt JC, Wheeler JA, Sorosky JI, Wen BC, Davis CS, Pelsang RE, Anderson B, Doornbos JF, Hussey DH, Yuh WT. Usefulness of tumor volumetry by magnetic resonance imaging in assessing response to radiation therapy in carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys. 1996 Jul 15;35(5):915-24. doi: 10.1016/0360-3016(96)00230-1.

Reference Type BACKGROUND
PMID: 8751400 (View on PubMed)

Miao J, Di M, Chen B, Wang L, Cao Y, Xiao W, Wong KH, Huang L, Zhu M, Huang H, Huang S, Han F, Deng X, Xiang Y, Lv X, Xia W, Tan SH, Wee JTS, Guo X, Chua MLK, Zhao C. A Prospective 10-Year Observational Study of Reduction of Radiation Therapy Clinical Target Volume and Dose in Early-Stage Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys. 2020 Jul 15;107(4):672-682. doi: 10.1016/j.ijrobp.2020.03.029. Epub 2020 Apr 6.

Reference Type BACKGROUND
PMID: 32272183 (View on PubMed)

Pan JJ, Mai HQ, Ng WT, Hu CS, Li JG, Chen XZ, Chow JCH, Wong E, Lee V, Ma LY, Guo QJ, Liu Q, Liu LZ, Xu TT, Gong XC, Qiang MY, Au KH, Liu TC, Chiang CL, Xiao YP, Lin SJ, Chen YB, Guo SS, Wong CHL, Tang LQ, Xu ZY, Jia YZ, Peng WS, Hu LP, Lu TZ, Jiang F, Cao CN, Xu W, Ma J, Blanchard P, Williams M, Glastonbury CM, King AD, Patel SG, Seethala RR, Colevas AD, Fan DM, Chua MLK, Huang SH, O'Sullivan B, Lydiatt W, Lee AWM. Ninth Version of the AJCC and UICC Nasopharyngeal Cancer TNM Staging Classification. JAMA Oncol. 2024 Oct 10;10(12):1627-35. doi: 10.1001/jamaoncol.2024.4354. Online ahead of print.

Reference Type BACKGROUND
PMID: 39388190 (View on PubMed)

Rischin D, Corry J, Smith J, Stewart J, Hughes P, Peters L. Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation. J Clin Oncol. 2002 Apr 1;20(7):1845-52. doi: 10.1200/JCO.2002.07.011.

Reference Type BACKGROUND
PMID: 11919243 (View on PubMed)

Songthong AP, Kannarunimit D, Chakkabat C, Lertbutsayanukul C. A randomized phase II/III study of adverse events between sequential (SEQ) versus simultaneous integrated boost (SIB) intensity modulated radiation therapy (IMRT) in nasopharyngeal carcinoma; preliminary result on acute adverse events. Radiat Oncol. 2015 Aug 8;10:166. doi: 10.1186/s13014-015-0472-y.

Reference Type BACKGROUND
PMID: 26253488 (View on PubMed)

Related Links

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Other Identifiers

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2024-FXY-129

Identifier Type: -

Identifier Source: org_study_id

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