Robust vs. Margin-Based Radiotherapy for Head and Neck Cancer

RP
AH
Overseen ByAaron Holley
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how two methods of planning radiotherapy affect quality of life and dry mouth in people with squamous cell carcinoma of the head and neck. It compares Margin-Based Radiotherapy, which includes a buffer area around the target, with Robust Radiotherapy, which minimizes radiation to healthy tissue. People diagnosed with this type of cancer and eligible for standard chemo-radiotherapy may be a good fit. The goal is to determine which method leads to fewer side effects, improving patients' daily lives. As an unphased trial, this study allows patients to contribute to research that could enhance future treatment options.

Do I need to stop my current medications for the trial?

The trial requires that you stop using saliva-stimulating prescription drugs like Evoxac or Salagen. Other medications are not specifically mentioned, so it's best to discuss with the trial team.

What prior data suggests that these radiotherapy planning methods are safe for head and neck cancer patients?

Research has shown that both robust and margin-based radiotherapy are generally safe for treating head and neck cancer. Early results suggest that robust radiotherapy, such as intensity-modulated radiation therapy (IMRT), effectively controls tumors and results in fewer long-term side effects than expected. This method reduces radiation exposure to normal tissues, helping to minimize side effects.

Studies on margin-based radiotherapy indicate it effectively targets cancer while adjusting for changes in tumor size or position during treatment. It uses a planning margin to ensure sufficient radiation reaches the cancer while protecting nearby healthy tissues.

Both methods prioritize precision and safety. Research supports their tolerance by patients with head and neck cancer. However, like any treatment, some side effects can occur, so discussing potential risks with a doctor is important.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores two innovative approaches to radiotherapy for head and neck cancer. Unlike traditional methods that often risk exposing healthy tissue to radiation, the robust radiotherapy planning technique is designed to minimize radiation exposure to normal tissues, potentially reducing side effects. Meanwhile, the margin-based radiotherapy planning involves adding a margin around the target area, which could improve accuracy in targeting cancer cells. This trial aims to find out which method is more effective at delivering precise treatment while sparing healthy tissue, offering hope for more efficient and safer treatment options.

What evidence suggests that this trial's radiotherapy planning methods could be effective for head and neck cancer?

This trial will compare Robust Radiotherapy Planning with Margin-Based Radiotherapy Planning for head and neck cancer. Research has shown that a strong radiotherapy plan, like the robust method, can effectively control head and neck cancer by ensuring even distribution of the radiation dose. This approach improves tumor coverage by 5.8% and reduces unnecessary radiation to healthy tissues. Studies indicate that this type of planning reliably targets the cancer while minimizing harm to surrounding areas, potentially leading to better outcomes.

In this trial, the Margin-Based Radiotherapy Planning arm will use a slightly different method. This approach involves adding extra space around the tumor to ensure it receives the necessary dose, even with slight movement. While it provides good coverage, it may not reduce radiation to healthy tissues as effectively as the robust planning method. Both methods aim to treat cancer effectively, but they differ in managing radiation exposure to nearby healthy tissues.16789

Who Is on the Research Team?

Mausam A. Patel, M.D. | Radiation ...

Mausam Patel, MD

Principal Investigator

University of Arkansas

Are You a Good Fit for This Trial?

This trial is for adults over 21 with a type of cancer called HN-SQCC, who are fit enough for standard chemo-radiotherapy. They must be able to follow the study procedures and not use certain saliva-stimulating drugs. Pregnant or breastfeeding women cannot participate unless they agree to use contraception.

Inclusion Criteria

I am able to care for myself but cannot do normal activities or work.
I am eligible for standard chemo-radiotherapy for head and neck cancer.
My cancer is a type of squamous-cell carcinoma located in the head or neck.
See 2 more

Exclusion Criteria

Women with a positive urine pregnancy test are excluded from this study; women of childbearing potential must agree to refrain from breast feeding and practice adequate contraception
Unable to comply with study procedures
I cannot undergo standard chemotherapy.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Intensity-Modulated Radiation Therapy (IMRT) with either margin-based or robust radiotherapy planning, along with standard chemotherapy

6-8 weeks

Follow-up

Participants are monitored for xerostomia and quality of life using questionnaires at 3, 6, 9, and 12 months after radiotherapy

12 months
4 visits (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Margin-Based Radiotherapy planning
  • Robust Radiotherapy planning
Trial Overview The study compares two radiotherapy planning methods for treating head and neck cancer: Margin-Based and Robust planning. It aims to see which method results in better quality of life and less dry mouth after treatment.
How Is the Trial Designed?
2Treatment groups
Active Control
Group I: Robust Radiotherapy PlanningActive Control1 Intervention
Group II: Margin-Based Radiotherapy PlanningActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Arkansas

Lead Sponsor

Trials
500
Recruited
153,000+

Published Research Related to This Trial

A study involving 100 patients with head-and-neck cancer used cine MR imaging to measure tumor motion during radiotherapy, revealing that the average maximum tumor motion was less than 3.0 mm, but varied significantly among patients (0.1-12.0 mm).
Based on the quantified tumor motion, population-based planning target volume (PTV) margins were established, with specific margins of 2.8 mm for nasopharyngeal tumors, 3.2 mm for oropharyngeal tumors, and 4.3 mm in the inferior-superior direction for laryngeal tumors, ensuring more accurate targeting during treatment.
Intrafraction motion quantification and planning target volume margin determination of head-and-neck tumors using cine magnetic resonance imaging.Bruijnen, T., Stemkens, B., Terhaard, CHJ., et al.[2019]

Citations

Planning target volume margin in head and neck cancer ...This study was conducted to determine the 3-dimensional PTV (PTV 3D ) margins for head and neck cancer (HNC) at our center.
Intensity-modulated radiotherapy in patients with head and ...The purpose of this study was to analyse retrospectively the intensity-modulated radiotherapy (IMRT) results in patients with head and neck cancer (HNC)
Dose accumulation to assess the validity of treatment plans ...This study agrees with previous literature that PTV/PRV margin reduction did not significantly reduce CTV coverage during treatment, but also ...
Robust vs. Margin-Based Radiotherapy for Head and Neck ...This trial compares two radiotherapy planning methods in head and neck cancer patients to see which one causes fewer side effects like dry mouth. The results ...
Adaptive radiotherapy in locally advanced head and neck ...This study retrospectively assessed the technical feasibility and potential benefits of daily ART in combination with reduced planning target volume (PTV) ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/24044789/
An in silico comparison between margin-based and ...Conclusion: The TPP approach was evaluated in HNC patients, and proven to be an efficient tool for managing uncertainties. Keywords: Head and neck cancer; ...
Head and Neck Margin Reduction With Adaptive Radiation ...Volumetric modulated arc therapy head and neck cancer treatment plans with 5-mm margins are robust for anatomy changes and show a modest increase in OAR dose.
In silico evaluation and feasibility of near margin-less head ...We explore the potential dosimetric benefits of reducing treatment volumes through daily adaptive radiation therapy for head and neck cancer (HNC) patients.
Comparison of Safety Margin Generation Concepts in ...Intensity modulated radiation therapy (IMRT) of head and neck tumors allows a precise conformation of the high-dose region to clinical ...
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