About this trial
This study is a prospective, open-label, multicenter, cohort, phase III non-inferiority clinical trial comparing proton therapy with photon radiotherapy for nasopharyngeal carcinoma. It intends to enroll histologically confirmed newly diagnosed nasopharyngeal carcinoma patients without distant metastasis (M0). Through a prospective 1:1 matched cohort study design, patients will be divided into the intensity-modulated proton therapy (IMPT) group and the intensity-modulated radiation therapy (IMRT) group. Systemic treatment regimens are formulated according to clinical guidelines.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial design
Parallel
Treatments tested in this trial
Intensity-Modulated Proton Therapy (IMPT)
RadiationThis is the experimental arm intervention. Patients receive Intensity-Modulated Proton Therapy (IMPT) for primary nasopharyngeal carcinoma. The subjects are patients with histologically confirmed, previously untreated, non-metastatic (M0) nasopharyngeal carcinoma. Radiotherapy target volumes and doses: GTV (gross tumor volume of primary tumor and metastatic lymph nodes); CTV70Gy (GTVp + 0-5mm margin, GTVn + 0-3mm margin, reducible near organs at risk) at a dose of 69.6-70Gy; CTV50-54Gy (GTVp + 8-10mm margin + entire nasopharyngeal mucosa + adjacent high/intermediate risk structures and intermediate-risk subclinical lymph node regions) at a dose of 50-54Gy, delivered at 2Gy/(RBE) per fraction. The protocol notes that proton therapy does not use a PTV (Planning Target Volume). The systemic therapy plan is formulated according to clinical guidelines.
Intensity-Modulated Radiotherapy (IMRT)
RadiationThis is the control arm intervention. Patients receive Intensity-Modulated Radiotherapy (IMRT) for primary nasopharyngeal carcinoma; IMRT is one of the current standard and widely used treatment techniques. The subjects are patients with histologically confirmed, previously untreated, non-metastatic (M0) nasopharyngeal carcinoma. Radiotherapy target volumes and doses: GTV (gross tumor volume of primary tumor and metastatic lymph nodes); CTV70Gy (GTVp + 0-5mm margin, GTVn + 0-3mm margin); PTV70 (CTV70 + 3-5mm margin, reducible near organs at risk) at a dose of 70Gy; CTV50-54Gy (GTVp + 8-10mm margin + entire nasopharyngeal mucosa + adjacent high/intermediate risk structures and intermediate-risk subclinical lymph node regions); PTV50-54 (CTV50-54 + 3-5mm margin, reducible near organs at risk) at a dose of 50-54Gy, delivered at 2Gy/(RBE) per fraction. The systemic therapy plan is formulated according to clinical guidelines.
Treatment groups
Trial outcomes
Primary outcomes
2-year Locoregional Recurrence-Free Survival (LRFS)
Defined as the time from group allocation to local-regional recurrence, including recurrence at the primary site and lymph node regions, or death from any cause.
Secondary outcomes
2-year Overall Survival (OS)
Time from group allocation to death from any cause
2-year Progression-Free Survival (PFS)
Defined as the time from enrollment to documented disease progression or recurrence, or death from any cause.
2-year Distant Metastasis-Free Survival (DMFS)
Time from group allocation to the occurrence of distant metastasis or death from any cause
Radiation-related adverse reactions
The severity of acute and late radiation-related adverse reactions (e.g., mucosal reactions, skin reactions, gastrointestinal reactions, myelosuppression, xerostomia, hearing loss, temporal lobe injury, etc.) will be graded and assessed according to NCI CTCAE Version 5.0
Sponsors and contacts
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Man Hu
Lead sponsor
Shandong Cancer Hospital and Institute
Sponsor institution