Clincal Study of Reduced Target Radiotherapy in Nasopharyngeal Carcinoma

Study Overview
=================
Brief Summary
-----------------
To determine whether subtractive radiotherapy can significantly reduce the acute side effects of radiotherapy and improve the quality of life of patients on the basis of ensuring the existing curative effect.

Official Title
-----------------
Clincal Study of Reduced Target Radiotherapy Based on The Law and Distribution Characteristics of Cervical Lymph Nodes Metastasis in Nasopharyngeal Carcinoma

Conditions
-----------------
Toxicity Due to Radiotherapy, Nasopharyngeal Carcinoma

Intervention / Treatment
-----------------
* Radiation: Target range


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Histopathologically confirmed nasopharyngeal nonkeratologic carcinoma (differentiated or undifferentiated, i.e., WHO type II or Type III). The clinical stage is TanyN2-3M0, III-IVa (AJCC 8th edition stage). Patients who have not received radiation therapy before. After induction chemotherapy, CR or PR were evaluated by radiography. Age 18-65 years old. ECOG score of 0-1. Good organ function The patient has signed an informed letter and is willing and able to comply with the planned visits, treatment plans, laboratory tests and other research programs. Exclusion Criteria: Patients with keratinizing squamous cell carcinoma account for only about 5% of the total pathological types, and the sensitivity of radiotherapy is poor compared with the other two types heterogeneous, so nasopharyngeal carcinoma with pathology of keratinizing squamous cells (WHO type I) is excluded. Patients with relapsed and distant metastases. The metastatic lymph nodes are located in the target area (Ib zone, the lateral group of the retropharyngeal lymphatic drainage area (VII), and the cervical lymphatic rainage area The medial border moves from top to bottom from the medial border of the common carotid artery to the lateral border, from the annular cartilage to the superior sternal border, sternoclavicular.The triangular area between the anterior and posterior edges of the medial mastoid muscle and the anterior and lateral border of the jugular arteriovenous sheath and lateral border of the thyroid glanddomain). Nasopharyngeal primary tumor or retropharyngeal metastatic lymph node invasion of oropharynx. Severe heart disease, lung dysfunction, heart function, lung function lower than grade 3 (including grade 3). Those whose laboratory test values do not meet the relevant criteria within 7 days before enrollment. Those who have participated in clinical trials of other drugs within 3 months before treatment. Pregnant or lactating women. Patients assessed by investigators to be unable to cooperate with regular follow-up due to psychological, social, family and geographical reasons.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Reduced target radiotherapy<br>According to our institutional guidelines, GTVnx included the primary tumor volume and the enlarged retropharyngeal nodes, while GTVnd was the volume of involved gross cervical lymph nodes. The clinical tumor volume (CTV) includes the primary tumor with potential subclinical disease. The high-risk clinical target volume (CTV1) was defined as the GTVnx plus a 5-mm margin to encompass the high-risk sites of microscopic extension, the whole nasopharynx, retropharyngeal nodal regions and . The low-risk clinical target volume (CTV2) was defined as the whole neck area.(Ib, VIIb, and the commom carotid artery are not included). | Radiation: Target range<br>* Compared with conventional radiotherapy, the target dose is unchanged and the CTV2 volume is reduced.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Regional recurrence-free survival | The time from date of treatment until date of first documented disease recurrence at a regional site, assessed up to 1 years. | up to 1 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival | The time from date of treatment until date of death due to any cause, assessed up to 1 years. | up to 1 years | 
| Distant metastasis-free survival | The time from date of treatment until date of death due to any cause, assessed up to 1 years. | up to 1 years | 
| Progress Free Survival | The time from date of treatment until date of death due to any cause, assessed up to 1 years. | up to 1 years | 
| Acute radiation toxicity | The injuries after the beginning of radiotherapy include skin, mucosa, pharynx and esophagus, eyes, ears, nervous system, blood system and other organs and tissues，assessed up to 3 months. | up to 3 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Reduced target, Nasopharyngeal Carcinoma, Radiotherapy