The purpose of this study is to test the hypothesis that radiotherapy of head and neck carcinoma can be improved by hypoxic modification of radiotherapy using nimorazole as a hypoxic radiosensitizer in association with accelerated fractionation, in an unselected patient population in a global environment.
Squamous cell carcinoma in the head \& neck region (HNSCC) accounts for approximately 7% of all cancers worldwide \& around 75% of all HNSCC cases are seen in the less developed countries. Significant improvement in loco-regional control \& disease specific survival by radiation therapy could be achieved by reducing the overall treatment time by "Accelerated Fractionation" schedule. Modification of hypoxia by Nimorazole demonstrated significant improved local effect of radiation with neither serious nor lasting side effects. So, it is expected that the optimal treatment option is reducing the overall treatment time with concomitant use of Nimorazole. Such treatment principle is optimal for testing in developing countries. The aim of the study: * To determine the possible therapeutic gain of using nimorazole given as a hypoxic radiosensitizer in conjunction with accelerated fractionated radiotherapy of invasive squamous cell carcinoma of the larynx, pharynx and oral cavity, and * To determine whether the addition of Nimorazole to primary curative radiotherapy is feasible and tolerable on a worldwide scale. * To evaluate the tolerance, compliance and toxicity of using nimorazole.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
104
Accelerated Radiotherapy: Radiotherapy 66-70 Gy, 2Gy/fx, 6fx/week
Radiation: Radiotherapy 66-70 Gy, 2Gy/fx, 6fx/week plus Nimorazole (tablets or powder) 1.2 g/m2 body surface in connection with the first daily radiation treatments
Radiation Oncology Department, National Cancer Institute
Cairo, Egypt
Radiation Oncology Center
Tallinn, Estonia
Nuclear Medicine, Oncology & Radiotherapy Institute, Radiation Oncology Department G-8/3
Islamabad, Pakistan
Karachi Institute of Radiotherapy and Nuclear Medicine
Karachi, Pakistan
Locoregional control after curative intended radiotherapy +/- Nimorazole
Time frame: 5-years
Disease specific survival
Time frame: 5.years
Overall survival
Time frame: 5-years
Treatment related morbidity
Treatment related acute and late morbidity releted to radiotherapy and/or nimorazole treatment
Time frame: 5-years
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Institute of Radiotherapy and Nuclear Medicine (IRNUM) Hospital Peshawar
Peshawar, Pakistan
Institute of Oncology Department of Radiation Oncology
Ljubljana, Slovenia