Radiation Therapy Using Helical Tomotherapy IMRT for Head and Neck Cancer

Titre officiel

Helical Tomotherapy Intensity Modulated Radiation Therapy:A Phase I/II Pilot Study to Determine the Toxicity Profile, Pattern of Failures and Quality of Life of Patients With Squamous Cell Carcinoma of the Head and Neck

Sommaire:

Dans le passé, les patients atteints du cancer de la tête et du cou de stade III ou IV étaient traités par chirurgie ou radiothérapie. Par suite des résultats de récents essais cliniques, la chimiothérapie combinée à la radiothérapie a été adoptée comme norme de traitement actuelle pour les patients hospitalisés qui ne peuvent pas être traités par chirurgie. La chimioradiothérapie entraîne cependant une augmentation importante des effets toxiques liés au traitement, ce qui limite la mesure dans laquelle ce traitement peut être offert aux patients. Cet essai vise à déterminer si un nouveau type de radiothérapie, appelé radiothérapie par modulation d’intensité, provoque moins d’effets toxiques causés par l’irradiation.

Description de l'essai

Primary Outcome:

• 1) To determine the toxicity profile of patients with head and neck cancer treated with helical tomotherapy-IMRT

Secondary Outcome:

• 1) To compare the dose distributions generated by HT-IMRT with those generated using three-dimensional conformal radiation, 2) To determine the pattern of relapse in the primary site and neck within the first 2 years following treatment, 3) To access the

The mechanisms of action to explain the radiation-induced toxic effects resulting from the more aggressive radiation therapy treatments of head and neck cancer include the additive and synergistic increase in mucositis from the combination of chemotherapy and radiation therapy. The severe toxicity associated with more aggressive radiation therapy treatments for locoregional head and neck cancer limits the extent to which these treatments can be offered since many patients present with nutritional deficiencies and consequent general debility. Intensity Modulated Radiation Therapy (IMRT) is a technology has the potential for exquisite dose painting and structuring in such a manner that it can permit exclusion of normal tissues and sensitive structures from the high dose radiation volume without compromising primary tumour or nodal target coverage. In this phase I/II feasibility trial, radical radiation therapy will be delivered using Helical Tomotherapy Intensity Modulated Radiation Therapy (HT-IMRT) to a dose of 66-70 Gy to involved areas and to at least 50 Gy to un-involved sites, treated prophylactically. It is hypothesized that the pattern of failure and toxicity profiles of patients treated with helical tomotherapy will demonstrate the greater efficacy of helical tomotherapy, as compared with conventional radiation therapy, in the treatment of cancers of the head and neck.

Voir cet essai sur ClinicalTrials.gov