Status:

COMPLETED

Image-guided Proton Therapy for the Treatment of Locally Advanced Unresectable Head and Neck Cancer

Lead Sponsor:

M.D. Anderson Cancer Center

Collaborating Sponsors:

National Cancer Institute (NCI)

Conditions:

Locally Advanced Head and Neck Squamous Cell Carcinoma

Locally Advanced Hypopharyngeal Squamous Cell Carcinoma

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

This phase I trial studies the side effects of image-guided hyper-fractioned proton therapy in treating patients with head and neck cancer that has spread to nearby tissue or lymph nodes (locally adva...

Detailed Description

PRIMARY OBJECTIVE: I. To assess the safety \& feasibility of image guided mid-treatment hyper-fractioned dose-escalation with proton therapy and identify the maximum tolerable dose (MTD) for the trea...

Eligibility Criteria

Inclusion

  • Biopsy proven diagnosis of squamous cell carcinoma of head and neck cancer originating in the oropharynx, hypopharynx, larynx, oral cavity (base of tongue) or nasopharynx. Clinical evidence should be documented, and may consist of imaging, endoscopic evaluation, palpation, and should be sufficient to estimate the image tumor characteristic of the primary tumor
  • Negative for HPV by p16 immunohistochemistry (IHC) or in situ hybridization (ISH)
  • Inoperable locally advances disease, i.e. stage \>= III and T stage \>= 2
  • The primary radiotherapy, either in combination with chemotherapy or not, with curative intent
  • No head and neck surgery of the primary tumor or lymph nodes except for incisional or excisional biopsies
  • Eastern Cooperative Oncology Group (ECOG) = 0, 1, or 2
  • For females of child-bearing age, a negative pregnancy test

Exclusion

  • Patients who have undergone definitive resection of their primary or nodal disease as well as any chemotherapy or radiation therapy for their head and neck squamous cell carcinoma (HNSCC)
  • Patient that refuse or are unable to stop smoking and/or consuming alcohol during and after radiotherapy. In addition, patients that refuse or fail tobacco and alcohol blood test
  • Patients that have no detectable no tumor in both the primary site and lymph nodes at week 4 in treatment, because there will not be a volume to boost
  • Patients unable or unwilling to give written, informed consent or to undergo magnetic resonance imaging (MRI) imaging
  • Women of childbearing potential (a woman of child-bearing potential is a sexually mature woman who has not undergone a hysterectomy or who has not been naturally postmenopausal for at least 24 consecutive months \[i.e., who has had menses at any time in the preceding 24 consecutive months\]). Male partners must practice effective contraception (oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner) throughout the study
  • Patients unable to tolerate intravenous contrast for both computed tomography (CT) and MRI, having an estimated glomerular filtration rate (GFR) \< 60 ml/min/1.73 m\^2 or any contraindications to gadolinium-based contrast agents
  • Contraindications to iron supplementation include hemochromatosis, colitis, history of gastrointestinal (GI) bleeds, alcoholism, or liver disease. Ferumoxytol is contraindicated in patients with evidence of iron overload and/or known hypersensitivity to Feraheme or any of its components. Consequently, we will plan to exclude patients who have symptoms or signs that might be caused by iron overload. These include patients with (unexplained): arthritis (including premature osteoarthritis), congestive heart failure or cardiomyopathy, adult-onset diabetes, secondary hypogonadism, increased skin pigmentation, or patients with persistently elevated serum ferritin not explained by an underlying inflammatory/systemic disease, unless these patients demonstrate a fasting transferrin saturation =\< 0.45
  • Patients with any evidence of iron overload on pre-imaging laboratory studies

Key Trial Info

Start Date :

October 19 2020

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

July 11 2023

Estimated Enrollment :

3 Patients enrolled

Trial Details

Trial ID

NCT04870840

Start Date

October 19 2020

End Date

July 11 2023

Last Update

October 29 2024

Active Locations (1)

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M D Anderson Cancer Center

Houston, Texas, United States, 77030