RecruitingPhase 3NCT04178174

Stereotactic Boost and Short-course Radiation Therapy for Oropharynx Cancer

Stereotactic Boost and SHOrt-course Radiation Therapy for HPV-associated OroPharynx Cancer Trial: A Randomized Multicentric Phase III Trial


Sponsor

Centre hospitalier de l'Université de Montréal (CHUM)

Enrollment

360 participants

Start Date

Feb 23, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

This is a randomized clinical trial comparing the outcomes of short-course chemoradiation consisting in stereotactic boost to the gross tumor and de-esclalated chemoradiation to the elective neck in human papilloma associated oropharynx cancer vs. the current standard 7-week course chemoradiation.


Eligibility

Min Age: 18 Years

Inclusion Criteria9

  • Age ≥18 years
  • Ability to provide written informed consent.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
  • Biopsy proven diagnosis of squamous cell carcinoma of the oropharynx.
  • Positive for HPV by p16 immunohistochemistry (IHC) or HPV in-situ hybridization (ISH)
  • Clinical stage T1-3, N1 M0 (Stage I-II) as per AJCC 8th edition.
  • Primary tumor \< 30 cc
  • Planned for curative chemoradiation
  • For females of child-bearing age, a negative pregnancy test

Exclusion Criteria9

  • Clinical N3 classification, as per AJCC 8th edition
  • Clinically overt extranodal extension (ENE). As per AJCC 8th edition, clinically overt ENE is defined as invasion of the skin, infiltration of musculature/fixation to adjacent structures on clinical examination, cranial nerve, brachial plexus, sympathetic trunk or phrenic nerve invasion with dysfunction).
  • Previous irradiation of the head and neck region
  • Previous surgery of the HNC region (except for incisional or excisional biopsies)
  • Pregnancy or breastfeeding
  • Connective tissue disease
  • Any medical condition that could, in the opinion of the investigator, prevent follow-up after radiotherapy.
  • Non-Cisplatin concurrent chemotherapy
  • Prior induction chemotherapy

Interventions

RADIATIONSABR boost and de-escalated chemoradiation

Stereotactic body radiotherapy boost to the gross tumor volume to a dose of 14 Gy in 2 fractions, followed by cisplatin-based chemoradiation to a dose of 40 Gy in 20 fractions

RADIATIONStandard chemoradiation

Standard Cisplatin-based chemoradiation to a dose of 70 Gy in 33 fractions


Locations(2)

London Health Sciences Center

London, Ontario, Canada

Centre Hospitalier de l'Université de Montréal

Montreal, Quebec, Canada

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NCT04178174


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