Adjuvant Protontherapy of Cervical and Endometrial Carcinomas

NCT03184350UNKNOWNNAINTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Heidelberg University

Enrollment

25

Start Date

2017-06-01

Completion Date

2019-06-01

Study Type

INTERVENTIONAL

Official Title

Adjuvant Protontherapy of Cervical and Endometrial Carcinomas - A Phase-II-study

Interventions

Adjuvant pelvic proton radiation

Conditions

Uterine Cervical NeoplasmsEndometrial Neoplasms Malignant

Eligibility

Age Range

18 Years – 80 Years

Sex

FEMALE

Inclusion Criteria:

* Histologically confirmed cervical or endometrial cancer
* Indication for postoperative radiotherapy
* Karnofsky Index ≥ 70
* Age between 18 and 80 years
* Written informed consent

Exclusion Criteria:

* patient refusal or patient incapable of consent
* implanted active medical devices with no approval for ion beam radiation
* metallic implantations in the radiation field like hip prothesis
* prior pelvic irradiation
* participation in another clinical trial which might influence the results of the APROVE trial

Outcome Measures

Primary Outcomes

Incidence of acute treatment-associated adverse events ≥ grade 3 [Safety and Tolerability]

Assessment of toxicity according to the CTC AE v4.0 (Common Toxicity Criteria for adverse events)

Time frame: 3 months

Secondary Outcomes

clinical symptoms according to the CTC AE v4.0. criteria

clinical symptoms of any grade will be assessed

Time frame: 2 years

Quality of life of all patients included in the study

assessed by the EORTC questionnaires QLQ-C30

Time frame: 2 years

Quality of life of cervical cancer patients included in the study

assessed by the EORTC questionnaires QLQ-CX24

Time frame: 2 years

Quality of life of endometrial cancer patients included in the study

assessed by the EORTC questionnaires QLQ-EN24

Time frame: 2 years

Progression-free survival

regular MRI-scans

Time frame: 2 years

Locations

Department of radiation oncology, University Hospital Heidelberg, Heidelberg, Germany

Linked Papers

2023-01-09

Health-related quality of life and patient-reported symptoms after postoperative proton beam radiotherapy of cervical and endometrial cancer: 2-year results of the prospective phase II APROVE-trial

Abstract Introduction The APROVE-trial investigated the tolerability of postoperative proton beam therapy in women with cervical or endometrial cancer. The present analysis evaluated the secondary endpoints of health-related quality of life (HRQOL) and patient-reported symptoms. Methods 25 patients were included in this prospective phase-II-trial and treated with postoperative radiotherapy using protons alone or in combination with chemotherapy. To attain general and gynecologic-specific HRQOL measures, the EORTC-QLQ-C30 questionnaires combined with -QLQ-CX24 for cervical and -QLQ-EN24 for endometrial cancer were assessed at baseline, at the end of RT and up to 2 years after radiotherapy. The results were compared to an age-matched norm reference population. Symptoms were assessed using Common Terminology Criteria for Adverse Events (CTCAE) and institutional patient-reported symptoms grading. Results Scores regarding global health status were markedly impaired at baseline (mean: 58.0 ± 20.1) compared to reference population data, but significantly (p = 0.036) improved and evened out to comparable norm values 2 years after proton therapy (mean: 69.9 ± 19.3). Treatment caused acute and long-term worsening of pain (p = 0.048) and gastrointestinal symptoms (p = 0.016) for women with endometrial cancer, but no higher-grade CTCAE ≥ 3° toxicity was observed. Dosimetric evaluation of rectum, sigmoid, large and small bowel showed no correlation with the reported gastrointestinal symptoms. After 2 years, fatigue had significantly improved (p = 0.030), whereas patients with cervical cancer experienced more often lymphedema (p = 0.017). Scores for endometrial cancer pertaining to sexual activity (p = 0.048) and body image (p = 0.022) had improved post treatment; in the latter this effect persisted after 2 years. Conclusion Proton beam therapy in the adjuvant setting was well tolerated with only low-grade side effects concerning gastrointestinal symptoms, lymphedema and pain. Overall quality of life was impaired at baseline, but patients were able to recover to values comparable to norm population 2 years after proton therapy. Larger studies are needed to confirm whether the benefit of proton therapy translates into a clinical effect. Sexual dysfunction remains an important issue. Trial registration: The trial was registered at https://clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT03184350, 09th June 2017).