SBRT for Oligo-metastatic Lesions After Systemic Treatment of Primary Metastatic Nasopharyngeal Carcinoma

Study Overview
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Brief Summary
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Primary metastatic NPC patients received chemotherapy± immunotherapy, radiation for primary tumors and SBRT for metastatic lesions.

Detailed Description
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The eligible patients will receive 4-6 cycles chemotherapy±immunotherapy and radical radiotherapy for nasopharyngeal tumors. Then, SBRT for oligometastatic lesions will be assigned to eligible patients. The efficacy and side-effect will be evaluated and analyzed. The relation of liquid biopsy data with treatment outcome（such as EBV DNA, CTCs, CTC subtype，PD-L1 and so on）will be valued.

Official Title
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SBRT for Oligo-metastatic Lesions After Systemic Treatment of Primary Metastatic Nasopharyngeal Carcinoma

Conditions
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Nasopharyngeal Carcinoma, Metastasis, Stereotactic Body Radiation Therapy

Intervention / Treatment
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* Radiation: SBRT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically conformed initial metastatic non-keratinizing nasopharyngeal carcinoma (according to the 8th edition of AJCC/UICC stage system) and no PD was observed in eligible patients after comprehensive treatment (chemotherapy±immunotherapy+radiotherapy to primary tumor). Then, the metastic lesions were PR/SD, and met the following requirement: the metastatic lesions ≤5 and metastatic organs ≤2, no more than 3 metastastic lesions for a single organ (diameter ≤ 5cm) age 18-70 years old Karnofsky scores ≥70 Estimated life ≥ 6 months Adequate organ function including the following: Absolute neutrophil count (ANC) >= 2.0 * 109/l; Platelets count >= 100 * 109/l ;Hemoglobin >= 90 g/dl; Creatinine clearance >= 60 ml/min; For patients without liver metastasis, AST and ALT <= 1.5 times institutional upper limit of normal (ULN), Total bilirubin <= 1.5 times institutional ULN; For patients with liver metastasis, AST and ALT <= 3 times institutional upper limit of normal (ULN), Total bilirubin <= 3 times institutional ULN, with normal coagulation function, child-pugh grade A or B, normal liver tissue volume >700 mL Signed written informed consent Exclusion Criteria: Patients who achieve complete remission after comprehensive treatment Pathology confirmed as second primary tumor Received radiotherapy at the corresponding site before, and overlapped with the site of this radiotherapy Femoral bone metastasis With serious medical complications and contraindications of radiotherapy With uncontrollable malignant pleural effusion Positive pregnancy test for women of childbearing age or lactating women Uncontrolled or active infections, such as immunodeficiency or HIV infection Active mental disorder or other mental disorder that affects the patient's ability to sign informed consent and understanding.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SBRT<br>4-6 cycles of chemotherapy±immunotherapy and radical radiotherapy for nasopharyngeal tumors were given. SBRT for oligometastatic lesions will be assigned to those who got PR,SD after systemic treatment. | Radiation: SBRT<br>* SBRT for oligometastatic lesions will be assigned to those who got PR,SD after systemic treatment.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival | From date of diagnosis until the date of death from any cause | up to 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progress free survival | From date of diagnosis until the date of first documented progression or date of death from any cause, whichever came first | up to 3 years | 
| Previous Metastatic Progression Free Survival | From date of diagnosis until the date of first documented previous metastatic progression or date of death from any cause, whichever came first | up to 3 years | 
| New Metastatic Free Survival | From date of diagnosis until the date of first documented new metastasis | up to 3 years | 
| Adverse Event | Number of Participants with acute or late toxicities | up to 3 years |