Postoperative Management for HNSCC Based on Pathological Response of Induction Chemotherapy and Immunotherapy
Pathological Response Adapted Decision-making of Postoperative Management for HNSCC Receiving Induction Immunotherapy and Chemotherapy
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
84 participants
Jan 1, 2023
INTERVENTIONAL
Conditions
Summary
To develop postoperative stratification treatment for patients who have received induction chemotherapy and immunotherapy in locally advanced head and neck cancers. Risk stratification is based on clinical characteristics and pathological responses. In order to achieve no inferior survival rate and a lower treatment-related toxicity rate than the standard treatment.
Eligibility
Inclusion Criteria8
- The subjects are not limited by gender, age from 18 to 75 years old;
- Histopathologically confirmed squamous cell carcinoma of the head and neck cancer;
- Locally advanced squamous cell carcinoma diagnosed as T3-4 or N+ stage according to AJCC 8th edition staging;
- ECOG score 0-1;
- without distant metastasis;
- received induction chemotherapy plus immunotherapy, followed by surgery
- The expected survival is expected to be no less than 6 months.
- No contraindications to chemotherapy, immunotherapy, and radiotherapy;
Exclusion Criteria6
- Past malignancies history (except for stage I non-melanoma skin cancer or cervical carcinoma in situ)
- Received any systemic anti-tumor therapy for target lesions before induction chemotherapy and immunotherapy;
- Previously experienced head and neck radiation therapy;
- Subjects who have used corticosteroids (\>10 mg/day prednisone or other equivalent hormones) or other immunosuppressive agents for systemic treatment within 1 month before enrollment. In the absence of active autoimmune disease, inhaled or topical corticosteroids and adrenal hormone replacement therapy at therapeutic doses of prednisone ≤10 mg/day are permitted;
- Patients with pleural effusion, pericardial effusion or ascites that need to be drained with clinical symptoms, or who have received serous cavity effusion drainage for the purpose of treatment within 2 weeks before enrollment;
- Severe comorbidities including myocardial infarction, arrhythmia, cerebral vascular disease, ulceration disease, mental disease and uncontrolled diabetes
Interventions
immunotherapy maintenance with anti-PD-1 or PD-L1 antibody every three weeks for 13 cycles after radiotherapy
postoperative radiotherapy (60Gy or 50Gy)
Locations(1)
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NCT05777824