Trial of Proton Versus Carbon Ion Radiation Therapy in Patients With Chordoma of the Skull Base (HIT-1)
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ClinicalTrials.gov Identifier: NCT01182779 |
Recruitment Status :
Recruiting
First Posted : August 17, 2010
Last Update Posted : August 17, 2010
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Chordoma Tumor Treatment | Radiation: Carbon ion Radiation: Protons | Phase 3 |
The study is a prospective randomised clinical phase III trial. The trial will be carried out at Heidelberger Ionenstrahl-Therapie (HIT) centre as monocentric trial.
Proton therapy is the gold standard in the treatment of skull base chordomas. However, high-LET beams such as carbon ions theoretically offer biologic advantages by enhanced biologic effectiveness in slow-growing tumors. Up until now it was impossible to compare two different particle therapies, i.e. proton and carbon ion therapy directly with each other. The aim of this study is to find out, whether the biological advantages of carbon ion therapy mentioned above can also be clinically confirmed.
Patients with skull base chordoma will be randomised to either proton or carbon ion radiation therapy. As a standard, patients will undergo non-invasive, rigid immobilization and target volume delineation will be carried out based on CT and MRI data. The biologically isoeffective target dose to the PTV in carbon ion treatment (accelerated dose) will be 63 Gy E ± 5% and 72 Gy E ± 5% (standard dose) in proton therapy respectively. Local-progression free survival (LPFS) will be analysed as primary end point. Toxicity and survival are the secondary end points. Also matters of interest are patterns of recurrence, prognostic factors and plan quality.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 319 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Randomised Trial of Proton vs. Carbon Ion Radiation Therapy in Patients With Chordoma of the Skull Base -Clinical Phase III Study- |
Study Start Date : | July 2010 |
Estimated Primary Completion Date : | August 2015 |
Estimated Study Completion Date : | August 2023 |

Arm | Intervention/treatment |
---|---|
Experimental: A
Arm A (carbon ion therapy): Total dose to the PTV2 - 45 Gy E in 3 Gy E /d, 4-6 days a week, 15 fractions Total dose to the PTV1 - 63 Gy E ± 5%, further 5-7 fractions a 3 Gy E. |
Radiation: Carbon ion
Arm A (carbon ion therapy): Total dose to the PTV2 - 45 Gy E in 3 Gy E /d, 4-6 days a week, 15 fractions Total dose to the PTV1 - 63 Gy E ± 5%, further 5-7 fractions a 3 Gy E. |
Active Comparator: B
Arm B (proton therapy): Total dose to the PTV2 - 50 to 56 Gy E in 2 Gy E /d, 4-6 days a week, 28 fractions Total dose to the PTV1 - 72 Gy E ± 5%, further 6-9 fractions a 2 Gy E. |
Radiation: Protons
Arm B (proton therapy): Total dose to the PTV2 - 50 to 56 Gy E in 2 Gy E /d, 4-6 days a week, 28 fractions Total dose to the PTV1 - 72 Gy E ± 5%, further 6-9 fractions a 2 Gy E. |
- local-progression free survival (LPFS) [ Time Frame: 8-years ]The primary objective of this study is to evaluate, if the innovative therapy (carbon ion irradiation) in chordomas is superior to the standard proton treatment with respect to the LPFS defined as time from the randomisation to observed local reccurrence or death from any cause in the absence of documented local disease progression. Lo-cal recurrence defined as MRT or CT - morphological tumor progress in the former irradiated region. A 10% increase in the LPFS is considered clinically relevant as-suming that the LPFS rate for the proton therapy is 70%.
- Survival [ Time Frame: 8-years ]Assessment of overall survival, progression free and metastasis free survival.
- Local control and patterns of recurrence [ Time Frame: 8 years ]Local recurrences will be confirmed radiologically and histologically whenever possible. At least two medical doctors (radiation oncologist and/or radiologist) will be required to judge of the recurrence.
- Toxicity [ Time Frame: 8 years ]Acute and late toxicity will be analysed due to Common Terminology Criteria for Adverse Events: CTCAE V4.0 for acute reaction and RTOG/EORTC for late effects.

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Ages Eligible for Study: | 18 Years to 80 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Karnofsky Performance Score ≥60%
- Age >18 years and <80 years
- Informed consent signed by the patient
- Histological confirmation of chordoma with infiltration of the skull base.
Exclusion Criteria:
- Inability to understand the aims of the study, no informed consent
- Prior RT of skull base region
- Other malignancies with disease-free interval < 5 years (excepting pre- cancerous lesions)
- Participation in another trial
- Pregnancy
- Simultaneous CHT or Immunotherapy.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01182779
Contact: Anna V. Nikoghosyan, MD | +496221568202 | anna.nikoghosyan@med.uni-heidelberg.de | |
Contact: Juergen Debus, MD, PhD | +496221568202 | juergen.debus@med.uni-heidelberg.de |
Germany | |
University of Heidelberg | Recruiting |
Heidelberg, Germany, 69120 | |
Principal Investigator: Juergen Debus, MD, PhD | |
Sub-Investigator: Anna V. Nikoghosyan, MD |
Principal Investigator: | Juergen Debus, MD PhD | Heidelberg University |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Juergen Debus, MD PhD, Dept. of Radiation Oncology, INF 400, 69120 Heidelberg, University of Heidelberg |
ClinicalTrials.gov Identifier: | NCT01182779 |
Other Study ID Numbers: |
HIT-1 |
First Posted: | August 17, 2010 Key Record Dates |
Last Update Posted: | August 17, 2010 |
Last Verified: | July 2010 |
base of skull chordoma radiation carbon ions protons |
Chordoma Neoplasms, Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms |