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A phase III randomized controlled trial comparing palliative stereotactic body radiotherapy vs. palliative standard radiotherapy in patients with advanced head and neck cancer (NCT06641791)

I. Poon, I. Karam, H. Bahig, B. Debenham, A. Mutsaers, Murali Rajaraman, C. J. Tsai, L. Chin et al.

Journal of Clinical Oncology, 2025

196 participants · 1 citation

Abstract

TPS6118

Background:

The optimal radiotherapy (RT) treatment regimen for patients with advanced head and neck cancer (AHNC) unsuitable to receive curative intent RT is undefined. Stereotactic body radiotherapy (SBRT) is a promising technique but rigorous multicentre evaluation is required prior to adoption.

Methods:

This is a Phase III randomized controlled trial comparing palliative SBRT to palliative standard RT (SRT) in participants with advanced mucosal, squamous cell head and neck cancer unable to tolerate curative intent RT. Key eligibility criteria: Unsuitable for curative intent therapy, no evidence of metastatic disease, stages TX or T0-T4/N0-N3, geriatric 8 score [1] ≤14. Treatment arms: (Experimental) SBRT 4500 cGy/ 5fr (twice a week to primary and nodal GTV (BED

10

85) OR 4000 cGy /5 fr twice a week if organs at risk (BED

10

-72) versus (standard) 2400 cGy/ 3fr (day 0/7/21 (BED

10

43) or 2500 cGy/ 5fr over 1 week (BED

10

38). Primary objective: To compare OS between arms. Secondary objectives evaluate progression-free survival (PFS), locoregional failure-free survival, distant metastases-free survival, response rates, acute and long-term toxicity (CTCAE v5.0), treatment compliance, patient-reported outcomes (PRO-CTCAE, FACT-HN), resource utilization, and health utilities. Statistical design

:

The trial aims to enroll 196 patients with a 2:1 randomization ratio (SBRT:SRT). The study is powered at 80% with a two-sided alpha of 0.05 to detect a difference in 1-year…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 196 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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