Positronic Emission Tomography (PET) Imaging in Post Radiation Evaluation of Head and Neck Tumours (PET PREVENT Trial) - Full Text View

Purpose

The purpose of this trial is to determine the ability of positron emission tomography (PET) to detect residual cancer in neck lymph nodes of patients following curative treatment with radiation therapy for squamous cell cancer arising in the head and neck.

Patients with head and neck cancer (HNC) undergo treatment of curative intent; patients who are node positive (N2 N3 stages) undergo standard management which includes post-radiation planned neck dissection but two thirds of patients end up not having evidence of residual disease in neck dissection specimens; these patients could have avoided surgery. However, currently used standard tests, like computed tomography (CT) and/or magnetic resonance imaging (MRI) cannot reliably predict who is post-radiation disease free.

Condition	Intervention	Phase
Cancer of the Head and Neck	Other: PET scan in addition to conventional CT imaging	Phase III

MedlinePlus related topics:

Cancer Head and Neck Cancer

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Diagnostic, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study

Official Title:	A Prospective Cohort Study to Determine the Sensitivity of Positron Emission Tomography (PET) in Detecting Metastatic Cancer in Neck Lymph Nodes in Patients With Squamous Cell Head & Neck Cancer Managed With Primary Radiation Therapy

Further study details as provided by Ontario Clinical Oncology Group (OCOG):

Primary Outcome Measures:

Ability of PET compared to CT in identifying the presence of tumour in neck nodes [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Tumour at the primary site 8-10 weeks following radiation; [ Time Frame: 2 years ] [ Designated as safety issue: No ]
The change in PET signal (standard uptake value; [ Time Frame: 2 years ] [ Designated as safety issue: No ]
Local recurrence, distant metastases and survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Estimated Enrollment:	400
Study Start Date:	May 2004
Estimated Study Completion Date:	May 2011
Estimated Primary Completion Date:	May 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
PET All patients receive PET scan and conventional CT imaging.	Other: PET scan in addition to conventional CT imaging PET scans, Pre and post radiation treatment

Detailed Description:

PET-Fluorodeoxyglucose scanning is an imaging test based on the increased uptake of radiolabelled glucose by tumour cells. PET might detect neck tumours better than other imaging tests. This is a cohort study in which patients with N2 N3 squamous cell carcinoma of the head and neck undergo a PET and a CT scan at baseline and then post-radiation therapy and chemotherapy. Then, they undergo neck dissection surgery. The PET and CT results are compared with the presence or absence of tumours in the neck nodes. If PET is sufficiently accurate in predicting the presence or absence of tumours in the neck nodes, then a neck dissection could be avoided.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

All of the following criteria must be satisfied:

Histological evidence of squamous cell carcinoma of the head & neck (T1-T4 arising in either the oral cavity, larynx & pharynx, except Nasopharyngeal carcinoma);OR patients with histological evidence of squamous cell carcinoma metastatic to the neck and an unknown primary site after conventional workup without any of the following: i). Clinically suspected skin primary or previous diagnosis of skin cancer arising in the head and neck area; ii). Patients of Asian or African decent -possible nasopharynx primary; iii). Patients whose malignant adenopathy is confined to zone V -possible nasopharynx primary; and iv). Patients whose malignant adenopathy is confined to zone IV (supraclavicular)-possible lung primary.
Presence of advanced N2 or N3 neck disease.
Planned for primary curative radiation therapy (± chemotherapy) followed by neck dissection eight to twelve weeks after completion of treatment.

Exclusion Criteria:

Presence of distant metastasis
Recurrent tumour
Prior neo-adjuvant chemotherapy
Previous radiation therapy to intended treatment volumes
Other active malignancy
Surgically inoperable neck disease
Unable to remain supine for 60 minutes
Unfit to undergo general anesthetic or neck dissection for medical reasons
Known hypersensitivity to CT contrast
Pregnancy

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00147472

Contacts


Contact: Denise H Julian, M.Sc.	905 527 2299 ext 42797	juliand@mcmaster.ca

Contact: Sharon Nason	905 527 2299 ext 42622	nasons@mcmaster.ca

Locations


Canada, Ontario
	Princess Margaret Hospital	Recruiting
	Toronto, Ontario, Canada, M5G 2M9
	Contact: John Waldron, MD 416 -946-6522 John.Waldron@rmp.uhn.on.ca
	Principal Investigator: John Waldron, MD
	Principal Investigator: Ralph Gilbert, MD
	Sub-Investigator: Anne Keller, MD
	Sub-Investigator: Aaron Hendler, MD
	Principal Investigator: Bayardo Perez-Ordonez, MD
	London Regional Cancer Centre	Recruiting
	London, Ontario, Canada, N6A 4L6
	Contact: Alex Hammond, MD 519 685 8650 Alex.Hammond@lrcc.on.ca
	Principal Investigator: Alex Hammond, MD
	Juravinski Cancer Centre	Recruiting
	Hamilton, Ontario, Canada, L8V 5C2
	Contact: Ian Hodson, MD 905 387 9711 ext 64702 ian.hodson@hrcc.on.ca
	Principal Investigator: Ian Hodson, MD
	Sub-Investigator: Jim Wright, MD
	Ottawa Regional Cancer Centre	Recruiting
	Ottawa, Ontario, Canada, K1H 1C4
	Contact: Libni Eapen, MD 613 737 7700 ext 70199 leapen@ottawahospital.on.ca
	Principal Investigator: Libni Eapen, MD

Sponsors and Collaborators

Ontario Clinical Oncology Group (OCOG)

Ontario Ministry of Health and Long Term Care

Investigators


Study Chair:	John Waldron, MD	Princess Margaret Hospital, Canada

Principal Investigator:	Ralph Gilbert, MD	Princess Margaret Hospital, Canada

Principal Investigator:	Libni Eapen, MD	Ottawa Regional Cancer Centre

Principal Investigator:	Anne Keller, MD	Princess Margaret Hospital, Canada

Principal Investigator:	Mark N Levine, MD	Ontario Clinical Oncology Group

Principal Investigator:	Bayardo Perez-Ordonez, MD	Princess Margaret Hospital, Canada

Principal Investigator:	Chu-Shu Gu, M.Sc.	Ontario Clinical Oncology Group

More Information

Responsible Party:	Ontario Clinical Oncology Group ( Dr Mark Levine )
Study ID Numbers:	CTA-Control-088421
First Received:	September 1, 2005
Last Updated:	September 11, 2008
ClinicalTrials.gov Identifier:	NCT00147472
Health Authority:	Canada: Health Canada

Keywords provided by Ontario Clinical Oncology Group (OCOG):

Head and neck

Cancer

Diagnosis

Fluorodeoxyglucose

Positron-Emission Tomography

PET

Oncology

Study placed in the following topic categories:

Head and Neck Neoplasms

Neoplasm Metastasis

Additional relevant MeSH terms:

Neoplasms

Neoplasms by Site

ClinicalTrials.gov processed this record on October 10, 2008

Sponsors and Collaborators:	Ontario Clinical Oncology Group (OCOG) Ontario Ministry of Health and Long Term Care
Information provided by:	Ontario Clinical Oncology Group (OCOG)
ClinicalTrials.gov Identifier:	NCT00147472