Head and Neck Neoplasms
Conditions
Brief summary
This phase II trial studies the safety and effectiveness of an induction chemotherapy (ACF) consisting of paclitaxel albumin-stabilized nanoparticle formulation (nab-paclitaxel), cisplatin and fluorouracil followed by chemoradiation therapy in treating patients with stage III-IV squamous cell cancer of the head and neck. ACF may be an effective way to reduce or downgrade locally aggressive tumors, and improve the chance of eradication by chemoradiation.
Detailed description
Compared to the standard induction regimen of TPF (docetaxel, cisplatin, and 5-FU), the ACCF (nab-paclitaxel, cisplatin, cetuximab, and 5-FU) regimen included two therapeutic changes: nab-paclitaxel was substituted for docetaxel and cetuximab was added. The investigators propose to eliminate cetuximab from the ACCF regimen to isolate the treatment effects of nab-paclitaxel when given with cisplatin and 5-FU. The primary objective of the ACF proposal is to determine the complete (CR) rate by clinical examination at the primary tumor site following two cycles of ACF. An important secondary objective will be to compare the tumor response rates at the primary site following two cycles of ACF to our historical experience following two cycles of ACCF (protocol # ABX 218/HRPO# 08-0911). In addition, the investigators will compare adverse events (AEs) between patients who receive ACF to the historical group given ACCF. From these two comparisons, we aim to determine if either ACF or ACCF is superior based on a balance of efficacy (using the surrogate prognostic endpoint of CR rate at primary tumor site) and toxicity.
Interventions
DRUGpaclitaxel albumin-stabilized nanoparticle formulation
DRUGCisplatin
DRUGFluorouracil
RADIATIONIntensity modulated radiation therapy
DRUGCetuximab
PROCEDUREQuality-of-life assessment
ACF baseline, IMRT baseline, Day 7, Week 12, months 6 and 12
Sponsors
Celgene
Washington University School of Medicine
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient must have selected stage III or IVa/b head and neck squamous cell carcinoma (HNSCC); all patients must have T2-T4 primary tumors; (patients with T1 tumors will be excluded); although most of these patients will have regional nodal disease, patients with no nodal disease will also be eligible * Patient must have disease at the oropharynx, hypopharynx, larynx, or oral cavity sub-sites * Patient must have measurable disease defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as \>= 10 mm with CT scan * Patient must be \>= 18 years of age. * Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 * Patient must have adequate bone marrow and organ function as defined below: * Absolute neutrophil count (ANC) \>= 1500/mcL * Platelets \> 100,000/mcL * Hemoglobin \> 9.0 g/dL * Total bilirubin =\< 1.5 mg/dL * Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 2.5 x upper limit of normal (ULN) * Alkaline phosphatase =\< 2.5 x ULN * Serum creatinine \< 1.8 mg/dL * Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry, for the duration of study participation, and for 3 months after completing treatment. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately * Patient must be able to understand and willing to sign an Institutional Review Board (IRB)-approved written informed consent document * Patient with uncontrolled diabetes or fasting blood glucose level of greater than 200 mg/dL will be eligible for enrollment but will not be evaluable for PET imaging
Exclusion criteria
* Patient must not have had prior chemotherapy, prior epidermal growth factor receptor (EGFR) targeted therapy, or prior radiation therapy for HNSCC * Patient must not have disease at the nasopharyngeal, sinus, or other sub-site not specified in the inclusion criteria; patient must not have unknown primary squamous cell carcinoma of the head and neck * Patient must not have a history of prior invasive malignancy diagnosed within 3 years prior to study enrollment other than local stage non-melanoma skin cancer * Patient must not be receiving any other investigational agents * Patient must not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to any of the agents used in this study * Patient must not be taking cimetidine or allopurinol. If currently taking either of these medications, patient must discontinue for one week before receiving treatment with nab-paclitaxel * Patient must not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active serious infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or serious psychiatric illness/social situations that would limit compliance with study requirements * Patient must not be pregnant and/or breastfeeding; a negative serum or urine pregnancy test is required at screening for all female patients of childbearing potential * Patient must not be known to be human immunodeficiency virus (HIV)-positive on combination antiretroviral therapy because of the potential for pharmacokinetic interactions with the study agents; in addition, these patients are at increased risk of lethal infections when treated with marrow suppressive therapy; appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated * Patient must not have peripheral neuropathy \> grade 1
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Complete Response (CR) by Clinical Exam at Primary Tumor Site | 6 weeks (2 cycles of therapy) | * Response will be assessed by laryngoscopy. * CR: disappearance of all lesions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Per Anatomic Tumor Response by CT Scan | 6 weeks (2 cycles of therapy) | * Response assessed using RECIST criteria version 1.0 * Complete response: disappearance of all target lesions * Partial response: at least 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum longest diameter * Non-complete response/non-progression: persistence of one or more non-target lesion and/or maintenance of tumor marker level above the upper limits of normal. * Progression: at least a 20% increase in the sum of the LD of target lesions taking as references the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
| Metabolic Tumor Responses as Measured by FDG-PET/CT | 6 weeks (2 cycles of therapy) | * Complete metabolic response (CMR): Complete resolution of all metabolically active target and non-target lesions, and no interval development of new lesions * Partial metabolic response (PMR): 20% or greater decrease in max SUV from baseline, no metabolic progression of non-target lesions and no new lesions and/or decrease in total number of non-target lesions, no new lesions * Stable metabolic disease (SMD) - does not qualify for CMR, PMR, or PMD * Progressive metabolic disease (PMD): development of one or more metabolically active lesions or 20% or greater increased in max SUV from baseline, new metabolically active lesions |
| Overall Survival Rate | 2 years | -Overall survival rate is the percentage of participants who are alive at 2 years. |
| Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | From start of treatment through 30 days after end of treatment | Assessed by NCI-CTCAE version 3 |
| Changes in Secreted Protein Acidic and Rich in Cysteine (SPARC) Expression by Immunohistochemistry (IHC) in Primary Tumor Tissue | 6 weeks (2 cycles of therapy) | SPARC and Ki-67 expression will be assessed at this institution by IHC stains performed on clinically available tumor specimens (paraffin blocks). The specimens will be collected retrospectively from prior biopsies (pre treatment and following 2 cycles of ACF) that will have consisted of a minimum of two needle cores (16-18 gauge) or two small incisional/excisional pieces of tumor. These will have been placed in 2% buffered formalin and transported to the surgical pathology processing lab. |
| Complete Response (CR) or Partial Response (PR) at Regional (Neck) Nodes as Measured by Clinical Exam | 6 weeks (2 cycles of therapy) | — |
| Percentage of Participants With Partial Response (PR) at Primary Tumor Site | 6 weeks (2 cycles of therapy) | * Response will be assessed by laryngoscopy. * PR: at least 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum longest diameter |
| Disease-free Survival (DFS) Rate | 2 years | — |
| Progression-free Survival (PFS) | 2 years | -Progression: at least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as references the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
| Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | Through one year after completion of treatment | * Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-H&N Total Score (range 0-148) measures the sum of the physical, social, emotional, functional, and HNCS domains * The maximum score of 148 reflects the best quality of life. |
| Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) FACT-G Total Score | Through end of chemoradiation | * Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-G Total Score (range 0-108) measures the sum of the physical, social, emotional, and functional domains but excludes the HNCS domain * The maximum score of 108 reflects the best quality of life. |
| Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI) | Through end of chemoradiation | * Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-H&N TOI (range 0-96) measures the total score for the physical, functional, and HNCS domains but excludes the emotional and social domains * The maximum score of 96 reflects the best quality of life. |
| Changes in Ki-67 Expression by Immunohistochemistry (IHC) in Primary Tumor Tissue | 6 weeks (2 cycles of therapy) | Ki-67 expression will be assessed at this institution by IHC stains performed on clinically available tumor specimens (paraffin blocks). The specimens will be collected retrospectively from prior biopsies (pre treatment and following 2 cycles of ACF) that will have consisted of a minimum of two needle cores (16-18 gauge) or two small incisional/excisional pieces of tumor. These will have been placed in 2% buffered formalin and transported to the surgical pathology processing lab. |
Countries
United States
Participant flow
Recruitment details
The study opened to participant enrollment on 08/09/2012 and closed to participant enrollment on 11/07/2013.
Participants by arm
| Arm | Count |
|---|---|
| Arm 1-ACF Induction Therapy Followed by Chemoradiation Therapy ACF Induction Therapy (Cycle 1 and Cycle 2 - each cycle is every 3 weeks)
1. nab-Paclitaxel 100 mg/m2 on Days 1, 8, and 15
2. Cisplatin 75 mg/m2 on Day 1
3. 5-FU 750 mg/m2 on Days 1-3
If patient has complete or partial response, he/she will receive an additional ACF cycle (cycle 3). If patient has stable disease or progressive disease will not receive the third cycle of ACF.
Definitive Therapy
1. Cisplatin 100 mg/m2 IV on Days 1, 22, and 43
2. Intensity modulated radiation therapy (IMRT) 7000 cGy in 35 fractions of 200 cGy each over 7 weeks. A dose of 6300 cGy in 35 fractions is optional and may be delivered to area considered to be at intermediate risk. Additional regions in the ipsilateral and contralateral neck at risk for microscopic disease in the cervical lymph nodes will receive 5600 cGy in 35 fractions.
3. If patient cannot receive cisplatin then he/she will receive cetuximab 250 mg/m2 IV week for 8 weeks | 30 |
| Total | 30 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| ACF Definitive Chemoradiation-cisplatin | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | Arm 1-ACF Induction Therapy Followed by Chemoradiation Therapy |
|---|---|
| Age, Continuous | 58.8 years |
| HPV Status HPV-related OPSCC | 17 participants |
| HPV Status HPV-unrelated HNSCC | 13 participants |
| Overall stage of disease III | 3 participants |
| Overall stage of disease IVA | 18 participants |
| Overall stage of disease IVB | 9 participants |
| Primary tumor site Hypopharynx | 3 participants |
| Primary tumor site Larynx | 9 participants |
| Primary tumor site Oropharynx | 18 participants |
| Region of Enrollment United States | 30 participants |
| Sex: Female, Male Female | 5 Participants |
| Sex: Female, Male Male | 25 Participants |
| Smoking history No | 7 participants |
| Smoking history Yes | 23 participants |
| T Stage T2 | 8 participants |
| T Stage T3 | 13 participants |
| T Stage T4 | 9 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 30 / 30 | 27 / 27 | 2 / 2 |
| serious Total, serious adverse events | 15 / 30 | 4 / 27 | 0 / 2 |
Outcome results
Primary
Percentage of Participants With Complete Response (CR) by Clinical Exam at Primary Tumor Site
* Response will be assessed by laryngoscopy. * CR: disappearance of all lesions
Time frame: 6 weeks (2 cycles of therapy)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Arm 1 (ACF) | Percentage of Participants With Complete Response (CR) by Clinical Exam at Primary Tumor Site | 76.7 percentage of participants |
Secondary
Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy
Assessed by NCI-CTCAE version 3
Time frame: From start of treatment through 30 days after end of treatment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Neutropenia | 9 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Neutropenia | 7 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Thrombocytopenia | 11 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades1/2 Anemia | 24 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Anemia | 2 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Tinnitus | 3 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Tinnitus | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Rash | 5 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Diarrhea | 9 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Diarrhea | 3 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Mucositis | 8 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Mucositis | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Febrile Neutropenia | 4 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Edema: Limb | 5 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Creatinine | 7 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 ALT | 4 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 ALT | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 AST | 2 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 AST | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Sensory Neuropathy-peripheral | 4 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Sensory Neuropathy - peripheral | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Fatigue | 13 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Fatigue | 1 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 1/2 Weight Loss | 7 participants |
| Arm 1 (ACF) | Adverse Events as Measured by Number of Participants That Experienced Each Common Adverse Event During ACF Induction Therapy | Grades 3/4 Weight Loss | 6 participants |
Secondary
Changes in Ki-67 Expression by Immunohistochemistry (IHC) in Primary Tumor Tissue
Ki-67 expression will be assessed at this institution by IHC stains performed on clinically available tumor specimens (paraffin blocks). The specimens will be collected retrospectively from prior biopsies (pre treatment and following 2 cycles of ACF) that will have consisted of a minimum of two needle cores (16-18 gauge) or two small incisional/excisional pieces of tumor. These will have been placed in 2% buffered formalin and transported to the surgical pathology processing lab.
Time frame: 6 weeks (2 cycles of therapy)
Population: The data was not collected for this outcome measure.
Secondary
Changes in Secreted Protein Acidic and Rich in Cysteine (SPARC) Expression by Immunohistochemistry (IHC) in Primary Tumor Tissue
SPARC and Ki-67 expression will be assessed at this institution by IHC stains performed on clinically available tumor specimens (paraffin blocks). The specimens will be collected retrospectively from prior biopsies (pre treatment and following 2 cycles of ACF) that will have consisted of a minimum of two needle cores (16-18 gauge) or two small incisional/excisional pieces of tumor. These will have been placed in 2% buffered formalin and transported to the surgical pathology processing lab.
Time frame: 6 weeks (2 cycles of therapy)
Population: The data was not collected for this outcome measure.
Secondary
Complete Response (CR) or Partial Response (PR) at Regional (Neck) Nodes as Measured by Clinical Exam
Time frame: 6 weeks (2 cycles of therapy)
Population: 2 participants were not evaluable for this outcome measure.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Arm 1 (ACF) | Complete Response (CR) or Partial Response (PR) at Regional (Neck) Nodes as Measured by Clinical Exam | Partial response | 7 participants |
| Arm 1 (ACF) | Complete Response (CR) or Partial Response (PR) at Regional (Neck) Nodes as Measured by Clinical Exam | Complete response | 19 participants |
Secondary
Disease-free Survival (DFS) Rate
Time frame: 2 years
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Arm 1 (ACF) | Disease-free Survival (DFS) Rate | 97.0 percentage of participants |
Secondary
Metabolic Tumor Responses as Measured by FDG-PET/CT
* Complete metabolic response (CMR): Complete resolution of all metabolically active target and non-target lesions, and no interval development of new lesions * Partial metabolic response (PMR): 20% or greater decrease in max SUV from baseline, no metabolic progression of non-target lesions and no new lesions and/or decrease in total number of non-target lesions, no new lesions * Stable metabolic disease (SMD) - does not qualify for CMR, PMR, or PMD * Progressive metabolic disease (PMD): development of one or more metabolically active lesions or 20% or greater increased in max SUV from baseline, new metabolically active lesions
Time frame: 6 weeks (2 cycles of therapy)
Population: 29 participants out of 30 participants were evaluable for this outcome measure.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Arm 1 (ACF) | Metabolic Tumor Responses as Measured by FDG-PET/CT | Complete metabolic response | 3 participants |
| Arm 1 (ACF) | Metabolic Tumor Responses as Measured by FDG-PET/CT | Partial metabolic response rate | 25 participants |
| Arm 1 (ACF) | Metabolic Tumor Responses as Measured by FDG-PET/CT | Stable or Progressive Metabolic Disease | 1 participants |
Secondary
Number of Participants Per Anatomic Tumor Response by CT Scan
* Response assessed using RECIST criteria version 1.0 * Complete response: disappearance of all target lesions * Partial response: at least 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum longest diameter * Non-complete response/non-progression: persistence of one or more non-target lesion and/or maintenance of tumor marker level above the upper limits of normal. * Progression: at least a 20% increase in the sum of the LD of target lesions taking as references the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: 6 weeks (2 cycles of therapy)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Arm 1 (ACF) | Number of Participants Per Anatomic Tumor Response by CT Scan | Complete response | 23 participants |
| Arm 1 (ACF) | Number of Participants Per Anatomic Tumor Response by CT Scan | Partial response | 5 participants |
| Arm 1 (ACF) | Number of Participants Per Anatomic Tumor Response by CT Scan | Non-complete response/Non-progression/Progression | 2 participants |
Secondary
Overall Survival Rate
-Overall survival rate is the percentage of participants who are alive at 2 years.
Time frame: 2 years
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Arm 1 (ACF) | Overall Survival Rate | 93.0 percentage of participants |
Secondary
Percentage of Participants With Partial Response (PR) at Primary Tumor Site
* Response will be assessed by laryngoscopy. * PR: at least 30% decrease in the sum of the longest diameter of target lesions taking as reference the baseline sum longest diameter
Time frame: 6 weeks (2 cycles of therapy)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Arm 1 (ACF) | Percentage of Participants With Partial Response (PR) at Primary Tumor Site | 16.7 percentage of participants |
Secondary
Progression-free Survival (PFS)
-Progression: at least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as references the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: 2 years
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Arm 1 (ACF) | Progression-free Survival (PFS) | 97 percentage of participants |
Secondary
Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) FACT-G Total Score
* Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-G Total Score (range 0-108) measures the sum of the physical, social, emotional, and functional domains but excludes the HNCS domain * The maximum score of 108 reflects the best quality of life.
Time frame: Through end of chemoradiation
Population: Questionnaires were not collected at some time points due to various reasons including patient decision, death, lost to follow-up, and missed by staff.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) FACT-G Total Score | Baseline | 83.8 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) FACT-G Total Score | End of induction | 79.1 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) FACT-G Total Score | End of chemoradiation treatment | 62.3 score on a scale |
Secondary
Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score
* Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-H&N Total Score (range 0-148) measures the sum of the physical, social, emotional, functional, and HNCS domains * The maximum score of 148 reflects the best quality of life.
Time frame: Through one year after completion of treatment
Population: Questionnaires were not collected at some time points due to various reasons including patient decision, death, lost to follow-up, and missed by staff.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | Baseline | 109.7 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | End of induction | 105.8 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | End of chemoradiation treatment | 74.2 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | 3 months after completion of treatment | 98.4 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | 6 months after completion of treatment | 107.4 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Total Score | 12 months after completion of treatment | 114.6 score on a scale |
Secondary
Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI)
* Includes 39 questions: 7 in physical well-being, 6 in emotional well-being, 7 in functional well-being, and 12 in head & neck * Scored from 0 (not at all) to 4 (very much) * Higher scores indicated worse physical and emotional well-being and better social/family and functional well-being * The FACT-H&N TOI (range 0-96) measures the total score for the physical, functional, and HNCS domains but excludes the emotional and social domains * The maximum score of 96 reflects the best quality of life.
Time frame: Through end of chemoradiation
Population: Questionnaires were not collected at some time points due to various reasons including patient decision, death, lost to follow-up, and missed by staff.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI) | Baseline | 69.7 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI) | End of induction | 62.3 score on a scale |
| Arm 1 (ACF) | Quality of Life (QOL) as Measured by Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI) | End of chemoradiation treatment | 34.2 score on a scale |