Scheduled IV Fluids in the Supportive Management of Patients Undergoing Chemo-radiotherapy for Head and Neck Cancer

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorWest Virginia University

About this trial

Patients undergoing concurrent chemoradiotherapy (CCRT) for head and neck squamous cell carcinoma frequently experience treatment-related toxicities including mucositis, dysphagia, acute kidney injury, pain, constipation, dermatitis, xerostomia, and trismus. Many of these toxicities may be exacerbated by dehydration and are commonly managed with clinician-directed intravenous (IV) hydration. This study will evaluate whether scheduled IV hydration reduces the incidence and severity of treatment-related toxicities compared with clinician assessment-based hydration. Participants will be randomized 1:1 to scheduled IV hydration or clinician assessment-based IV hydration beginning in Week 3 of concurrent chemoradiotherapy and continuing through one week following completion of chemoradiotherapy.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

ECOG 0-2

Non-nasopharyngeal squamous cell carcinoma of oral cavity, oropharynx, hypopharynx, larynx primary

Planned for concurrent chemoradiotherapy (CCRT) with standard-of-care cisplatin-based regimen (IV cisplatin 100mg/m2 once every three weeks for up to three doses or IV cisplatin 40mg/m2 weekly) with concurrent radiotherapy (treatment duration approximately 6-7 weeks, per institutional standards).

The use of immunotherapy in combination with CCRT is permitted and does not affect eligibility or group assignment.

Disqualifiers

Nasopharyngeal squamous cell carcinomas, nasal cavity and paranasal sinus squamous cell carcinomas.

History of congestive heart failure.

Dependency on enteral nutrition and hydration prior to enrollment.

Use of diuretics that cannot be safely held during study treatment (participants who are able to temporarily discontinue diuretics during treatment are eligible).

Trial design

Design model

Parallel

Treatments tested in this trial

  • Scheduled IV Hydration

    Other intervention

    Normal saline (0.9% sodium chloride) 1L of saline will be administered at each hydration visit. Participants will receive IV fluids on a planned schedule of twice a week, starting in Week 3 of chemoradiation treatment and continuing for one week after treatment is completed.

  • Clinician Assessment-Based IV Hydration

    Other intervention

    IV fluids (normal saline (0.9% sodium chloride)) only as clinically indicated and ordered by their treating clinician, per standard of care.

Treatment groups

180 Participants
are divided into 2 treatment groups
Group A: Scheduled IV HydrationExperimental treatment 1 intervention
Group B: Clinician Assessment-Based IV HydrationOther 1 intervention

Trial outcomes

Primary outcomes

1

Incidence of at least one Grade ≥3 Treatment-Related Toxicities of Interest

Incidence of participants experiencing at least one Grade ≥3 according to National Cancer Institute Common Terminology Criteria for Adverse Events v6.0 (NCI CTCAE) treatment-related toxicity of interest, including mucositis, dysphagia, acute kidney injury, pain, constipation, dermatitis, xerostomia, or trismus, during concurrent chemoradiotherapy.

Time frame
From initiation of concurrent chemoradiotherapy through completion of treatment (approximately 6-7 weeks)

Secondary outcomes

1

Incidences of Individual Treatment-Related Toxicities of Interest

Incidence of treatment-related mucositis, dysphagia, acute kidney injury, pain, constipation, dermatitis, xerostomia, and trismus of any grade, as assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 6.0.

Time frame
From initiation of concurrent chemoradiotherapy through completion of treatment (approximately 6-7 weeks)
2

Incidence of Enteric Tube Placement

Incidence of participants requiring enteric feeding tube placement during treatment and follow-up.

Time frame
From initiation of treatment through 6 months after completion of chemoradiotherapy
3

Incidence of Hematologic Toxicities

Incidence of leukopenia, anemia, and thrombocytopenia assessed during weeks 3-6 of concurrent chemoradiotherapy treatment as assessed according to NCI CTCAE v6.0.

Time frame
Weeks 3-6 of concurrent chemoradiotherapy
4

Residual Grade of Toxicities of Interest at 3 Months

Residual severity (NCI CTCAE v6.0 Grades 0-5) of mucositis, dysphagia, acute kidney injury, pain, constipation, dermatitis, xerostomia, and trismus.

Time frame
3 months after completion of chemoradiotherapy

Other outcomes

Sponsors and contacts

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