Malignancy, Salivary Glands, Tumor
Conditions
Keywords
cancer of the salivary glands, radiation, carbon ion therapy
Brief summary
The COSMIC trial is a prospective, mono-centric, phase II trial evaluating toxicity and efficacy in the combined treatment with intensity-modulated radiation therapy (IMRT) and carbon ion (C12) boost. Primary endpoint is mucositis ≥ CTC°3, secondary endpoints are local control, disease-free survival, and toxicity. Planned accrual of the trial includes 54 patients with histologically proved (≥R1-resected, inoperable or Pn+) salivary gland malignancies. Treatment consists of 24 GyE carbon ions (8 fractions) and 50 Gy IMRT (2.0 Gy/ fraction).
Detailed description
Local control in malignant salivary gland tumours is dose dependent. High local control rates in adenoid cystic carcinomas could be achieved by highly conformal radiotherapy techniques and particle (neutron/ carbon ion) therapy. Considering high doses are needed to achieve local control, all malignant salivary gland tumours probably profit from the use of particle therapy, which in case of carbon ion treatment, has been shown to be accompanied by only mild side-effects. Methods/ design: The COSMIC trial is a prospective, mono-centric, phase II trial evaluating toxicity in the combined treatment with intensity-modulated radiation therapy (IMRT) and carbon ion (C12) boost in 54 patients with histologically proved (≥R1-resected, inoperable or Pn+) salivary gland malignancies. Patients receive 24 GyE carbon ions (8 fractions) and IMRT (2.0 Gy/ fraction). Study objectives: Incidence of mucositis ≥ CTC°3 will be assessed as the primary endpoint of the trial, local control, disease-free survival, toxicity (incl. mucositis CTC °I-II and late toxicity at 3 years post RT)
Interventions
RADIATIONcarbon ion boost
8 fractions carbon ion (8 x 3 GyE C12) therapy followed by 25 fractions of IMRT corresponding to a total dose of approximately 74 GyE. Treatment duration is approximately 61/2-7 weeks
Sponsors
Heidelberg University
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Histologically confirmed or surgically removed malignant tumour of the salivary glands (head and neck) * Inoperable tumour * G2/3 * Macroscopic or microscopic residual tumour (R2/ R1) or * ≥T3/T4 or * perineural invasion (Pn+) * written informed consent * pts aged 18 - 80 years * effective contraception for pts in childbearing age (\<12 months post beginning of menopause)
Exclusion criteria
* Prior radio- or chemotherapy for tumours of the head and neck * Other previous malignancy within the past 5 years except prior, adequately treated basal cell carcinoma of the skin or pre-invasive carcinoma of the cervix * Significant neurological or psychiatric condition including dementia or seizures or other serious medical condition prohibiting the patient's participation in the trial by judgement of the investigators * Legal incapacity or limited legal capacity * Positive serum/ urine beta-HCG/ pregnancy * Drug abuse
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| mucositis ≥ CTC°3 | 6-8 weeks post completion of treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| local control | 3 years post RT | to evaluate local control at 3 years post RT |
| acute toxicity | 6-8 weeks post completion of treatment | evaluation of acute radiation effects (other than mucositis CTC°C) 6-8 weeks post completion of treatment |
| late toxicity | 3 years post radiotherapy | to evaluate radiation late effects |
| disease-free survival | 3 years post treatment | to evaluate disease-free survival at 3 years post radiotherapy |
Countries
Germany
Outcome results
None listed