Skip to main content
Top
Published in: Trials 1/2020

01-12-2020 | Care | Study protocol

Radiotherapy-related skin toxicity (RAREST-02): A randomized trial testing the effect of a mobile application reminding head-and-neck cancer patients to perform skin care (reminder app) on radiation dermatitis

Authors: Dirk Rades, Carlos Andres Narvaez, Claudia Doemer, Stefan Janssen, Denise Olbrich, Soeren Tvilsted, Antonio J. Conde-Moreno, Jon Cacicedo

Published in: Trials | Issue 1/2020

Login to get access

Abstract

Background

Radiotherapy of head-and-neck cancer can be associated with significant toxicities including dermatitis and oral mucositis. Severe toxicities may require interruptions of the radiation treatment associated with impairment of the patients’ prognoses. This study will investigate whether the addition of a reminder app to standard care can reduce dermatitis and oral mucositis rates during radiotherapy in these patients.

Methods

This randomized trial compares standard care supported by a reminder app (Arm A) to standard care alone (Arm B) with respect to grade ≥ 2 radiation dermatitis and oral mucositis at 60 Gy of radiotherapy, the minimum planned dose for patients receiving definitive or adjuvant radiotherapy for locally advanced head- and-neck cancer. Moreover, radiation-induced dermatitis and oral mucositis grade ≥ 3 at 60 Gy and both grade ≥ 2 and grade ≥ 3 at the end of radiation treatment (EOT) will be evaluated, as well as quality of life and pain. According to sample size calculations, 80 patients are required per arm within the full analysis set. Taking into account that 5% of patients will not qualify for full analysis set, 168 patients should be randomized. The impact of the reminder app will be considered clinically relevant, if the rates of grade ≥ 2 radiation dermatitis (primary endpoint) and oral mucositis (secondary endpoint) can be reduced by 20%.

Discussion

If the addition of a reminder app to standard care will lead to a significant reduction of radiation dermatitis and oral mucositis, it could become a helpful tool for patients with head-and-neck cancer during radiotherapy.

Trial registration

clinicaltrials.​gov (NCT04110977). Registered on September 27, 2019. First patient is planned to be included in December 2019.
Literature
1.
go back to reference Rades D, Kronemann S, Meyners T, Bohlen G, Tribius S, Kazic N, et al. Comparison of four cisplatin-based radiochemotherapy regimens for nonmetastatic stage III/IV squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2011;80:1037–44.CrossRef Rades D, Kronemann S, Meyners T, Bohlen G, Tribius S, Kazic N, et al. Comparison of four cisplatin-based radiochemotherapy regimens for nonmetastatic stage III/IV squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2011;80:1037–44.CrossRef
2.
go back to reference Rades D, Stoehr M, Kazic N, Hakim SG, Walz A, Schild SE, et al. Locally advanced stage IV squamous cell carcinoma of the head and neck: impact of pre-radiotherapy hemoglobin level and interruptions during radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:1108–14.CrossRef Rades D, Stoehr M, Kazic N, Hakim SG, Walz A, Schild SE, et al. Locally advanced stage IV squamous cell carcinoma of the head and neck: impact of pre-radiotherapy hemoglobin level and interruptions during radiotherapy. Int J Radiat Oncol Biol Phys. 2008;70:1108–14.CrossRef
3.
go back to reference Fesinmeyer MD, Mehta V, Blough D, Tock L, Ramsey SD. Effect of radiotherapy interruptions on survival in Medicare enrollees with local and regional head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2010;78:675–81.CrossRef Fesinmeyer MD, Mehta V, Blough D, Tock L, Ramsey SD. Effect of radiotherapy interruptions on survival in Medicare enrollees with local and regional head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2010;78:675–81.CrossRef
4.
go back to reference Rades D, Fehlauer F, Wroblesky J, Albers D, Schild SE, Schmidt R. Prognostic factors in head-and-neck cancer patients treated with surgery followed by intensity-modulated radiotherapy (IMRT), 3D-conformal radiotherapy, or conventional radiotherapy. Oral Oncol. 2007;43:535–43.CrossRef Rades D, Fehlauer F, Wroblesky J, Albers D, Schild SE, Schmidt R. Prognostic factors in head-and-neck cancer patients treated with surgery followed by intensity-modulated radiotherapy (IMRT), 3D-conformal radiotherapy, or conventional radiotherapy. Oral Oncol. 2007;43:535–43.CrossRef
5.
go back to reference Rades D, Stoehr M, Meyners T, Bohlen G, Nadrowitz R, Dunst J, et al. Evaluation of prognostic factors and two radiation techniques in patients treated with surgery followed by radio (chemo) therapy or definitive radio (chemo) therapy for locally advanced head-and-neck cancer. Strahlenther Onkol. 2008;184:198–205.CrossRef Rades D, Stoehr M, Meyners T, Bohlen G, Nadrowitz R, Dunst J, et al. Evaluation of prognostic factors and two radiation techniques in patients treated with surgery followed by radio (chemo) therapy or definitive radio (chemo) therapy for locally advanced head-and-neck cancer. Strahlenther Onkol. 2008;184:198–205.CrossRef
6.
go back to reference Tribius S, Kronemann S, Kilic Y, Schroeder U, Hakim S, Schild SE, et al. Radiochemotherapy including cisplatin alone versus cisplatin + 5-fluorouracil for locally advanced unresectable stage IV squamous cell carcinoma of the head and neck. Strahlenther Onkol. 2009;185:675–81.CrossRef Tribius S, Kronemann S, Kilic Y, Schroeder U, Hakim S, Schild SE, et al. Radiochemotherapy including cisplatin alone versus cisplatin + 5-fluorouracil for locally advanced unresectable stage IV squamous cell carcinoma of the head and neck. Strahlenther Onkol. 2009;185:675–81.CrossRef
7.
go back to reference Narvaez C, Doemer C, Idel C, Setter C, Olbrich D, Ujmajuridze Z, et al. Radiotherapy related skin toxicity (RAREST-01): Mepitel® film versus standard care in patients with locally advanced head-and-neck cancer. BMC Cancer. 2018;18:197.CrossRef Narvaez C, Doemer C, Idel C, Setter C, Olbrich D, Ujmajuridze Z, et al. Radiotherapy related skin toxicity (RAREST-01): Mepitel® film versus standard care in patients with locally advanced head-and-neck cancer. BMC Cancer. 2018;18:197.CrossRef
8.
go back to reference Rades D, Narvaez CA, Splettstößer L, Dömer C, Setter C, Idel C, et al. A randomized trial (RAREST-01) comparing Mepitel® film and standard care for prevention of radiation dermatitis in patients irradiated for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN). Radiother Oncol. 2019;139:79–82.CrossRef Rades D, Narvaez CA, Splettstößer L, Dömer C, Setter C, Idel C, et al. A randomized trial (RAREST-01) comparing Mepitel® film and standard care for prevention of radiation dermatitis in patients irradiated for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN). Radiother Oncol. 2019;139:79–82.CrossRef
9.
go back to reference National Institutes of Health/National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) version 5.0: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017. National Institutes of Health/National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) version 5.0: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017.
11.
go back to reference Cox JD, Stetz J, Pajak TF. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European Organization for Research and Treatment Of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–6.CrossRef Cox JD, Stetz J, Pajak TF. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European Organization for Research and Treatment Of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–6.CrossRef
12.
go back to reference Trotti A, Byhardt R, Stetz J, Gwede C, Corn B, Fu K, et al. Common toxicity criteria version 2.0. An improved reference for grading the acute effects of cancer treatment: impact on radiotherapy. Int J Radiat Oncol Biol Phys. 2000;47:13–47.CrossRef Trotti A, Byhardt R, Stetz J, Gwede C, Corn B, Fu K, et al. Common toxicity criteria version 2.0. An improved reference for grading the acute effects of cancer treatment: impact on radiotherapy. Int J Radiat Oncol Biol Phys. 2000;47:13–47.CrossRef
13.
go back to reference Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, et al. Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology: Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer. 2004;100(9 Suppl):1995–2025.CrossRef Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, et al. Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology: Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer. 2004;100(9 Suppl):1995–2025.CrossRef
Metadata
Title
Radiotherapy-related skin toxicity (RAREST-02): A randomized trial testing the effect of a mobile application reminding head-and-neck cancer patients to perform skin care (reminder app) on radiation dermatitis
Authors
Dirk Rades
Carlos Andres Narvaez
Claudia Doemer
Stefan Janssen
Denise Olbrich
Soeren Tvilsted
Antonio J. Conde-Moreno
Jon Cacicedo
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Care
Radiotherapy
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-020-04307-0

Other articles of this Issue 1/2020

Trials 1/2020 Go to the issue