Phase II Study of Daily Adaptive Radiotherapy for Submandibular Gland-sparing in Head and Neck Cancer

NCT ID: NCT07348887

Last Updated: 2026-01-16

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

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-15

Study Completion Date

2029-10-01

Brief Summary

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This is a randomized, single centre, single blinded prospective study comparing the standard of care imaging guided radiation therapy and daily adaptive radiotherapy (ART) for submandibular gland-sparing in head and neck cancer

Detailed Description

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This study will recruit up to 50 patients planned to receive curative (chemo) radiotherapy for (head and neck squamous cell carcinoma) HNSCC with at least one level 1b lesion not being treated electively and with no high dose structure \<1cm to spared (submandibular gland) SMG. The effect of daily ART with SMG dose sparing will be studied using both doimetric analysis and externally-validated quantitative metrics of unstimulated salivary flow as an object assessment for submandibular gland function. Patient report outcomes will assess the effect of the intervention on self-reported quality of life following treatment.

Patients, at the time of enrollment, will be randomized into one of the two treatment arms. The patients will be blinded to prevent bias in their quality of life assessments.

Patients in both arms will undergo a baseline functional CT scan along with other assessments including oral and dental assessment, PSS-HNC swallow assessment, unstimulated salivary flow rate test, DMFS160 index, and quality of life questionnaire. The radiation treatment will take approximately 7 weeks to complete. The follow up visits will be at 1.5, 6, 12, and 24 months with assessments similar to baseline.

Conditions

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Squamous Cell Cancer of Head and Neck (SCCHN)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Image guided radiation therapy

This arm will proceed as per the standard of care. The pre-treatment reference plan will be delivered daily for 35 fractions. If a notable change in anatomy is identified, a dose of the day calculation may be performed as per current standard head and neck workflow

Group Type ACTIVE_COMPARATOR

Image guided radiation therapy

Intervention Type RADIATION

The pre-treatment reference plan will be delivered daily for 35 fractions.

Daily Adaptive Radiation Therapy

Structures of daily adaptive radiation therapy organ at risk will be AI generated in the Ethos platform on the daily CBCT and then edited by radiation therapy team as required. A rigid registration of CTV targets to the CBCT replicating the current radiation therapy led IGRT process.

Group Type EXPERIMENTAL

Daily adaptive radiation therapy

Intervention Type RADIATION

Adaptive radiotherapy (ART) is the modification of the radiotherapy plan during treatment to account of changes from the original anatomy and set up. Reduction in treatment volume can be achieved through ART by:

1. adjusting for gradual longitudinal changes in tumour and anatomy
2. adjusting to account for uncertainty in set up and anatomy via daily online

Interventions

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Daily adaptive radiation therapy

Adaptive radiotherapy (ART) is the modification of the radiotherapy plan during treatment to account of changes from the original anatomy and set up. Reduction in treatment volume can be achieved through ART by:

1. adjusting for gradual longitudinal changes in tumour and anatomy
2. adjusting to account for uncertainty in set up and anatomy via daily online

Intervention Type RADIATION

Image guided radiation therapy

The pre-treatment reference plan will be delivered daily for 35 fractions.

Intervention Type RADIATION

Other Intervention Names

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Daily ART DART IGRT

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Histologically proven Squamous Cell carcinoma of head and neck
* At least one level 1b not being treated electively and with no high dose structure \<1cm to spared SMG
* ECOG PS 0-2
* Planned for curative (chemo)radiotherapy
* Able to receive and understand verbal and written information regarding study and able to give written informed consent
* Be able to lie comfortably on back and to wear immobilization for up to 1 hour

Exclusion Criteria

* As judged by investigator evidence of systemic disease that makes unsuitable for study
* Pregnancy
* Underlying salivary dysfunction prior to treatment judged by investigator to affect likelihood of benefit from ART
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Princess Margaret Cancer Centre

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Andrew McPartlin, MD

Role: CONTACT

416-946-2132

Facility Contacts

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Andrew McPartlin, MD

Role: primary

416-946-4501 ext. 4855

Other Identifiers

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25-5273

Identifier Type: -

Identifier Source: org_study_id

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