"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”
A trial using a scan to improve treatment for oropharyngeal cancer during chemoradiotherapy (PEARL)
This trial is to re-plan radiotherapy treatment half way through so they can reduce the amount of radiotherapy to the nearby healthy tissue.
More about this trial
Researchers are looking for ways to improve treatment. One way might be to reduce the area of radiotherapy half way through the course of treatment.
You have planning for radiotherapy before you start. This is to work out where you have treatment and how much you have. During the
Researchers want to plan your radiotherapy again half way through treatment. So where you have treatment matches the smaller area of cancer. By doing this they hope this reduces the amount of radiotherapy to the healthy tissue. And this will decrease the side effects of radiotherapy.
The aims of this trial are to find:
- how well this works
- if it is possible to do
- how it affects the side effects
- how it affects
quality of life
Who can enter
The following bullet points list the entry conditions for this trial. Talk to your doctor or the trial team if you are unsure about any of these. They will be able to advise you.
Who can take part
You may be able to join this trial if all of the following apply. You:
- have oropharyngeal cancer that is a squamous cell carcinoma
- have cancer that has tested positive for human papilloma virus (
- are having
- have satisfactory blood test results
- are willing to use reliable contraception during the trial and for 6 months after if there is any chance you or your partner could become pregnant
- are at least 18 years old
Who can’t take part
You cannot join this trial if any of these apply. You:
- have cancer that has spread into the nearby areas such as the jaw and voice box (stage T4)
- have cancer that has spread to other parts of the body
- have cancer that has spread to 2 or more
- have a cancer that can’t be seen on a
PET CT scan
- have had previous radiotherapy to your head and neck
- have had another cancer in the past 5 years apart
non melanoma skincancer and carcinoma in situof the cervix
- have or had a medical condition that affects how you swallow
- are a smoker or you have stopped smoking within the past 2 years
This is a phase 1 trial. The team need 50 people to join.
Before starting your chemoradiotherapy you have a radiotherapy planning appointment. This is to work out where to give the radiotherapy and how much to give.
You have 33 treatments of radiotherapy over 6 weeks.
For the first 3 weeks you have it once a day Monday to Friday (15 treatments).
For the second 3 weeks you have an extra treatment of radiotherapy each week (18 treatments).
You have the extra treatment either by having your radiotherapy twice on 1 day during the week. Or by having treatment on the weekend.
You have your chemotherapy during radiotherapy either once a week or once every 3 weeks. Your doctor will talk to you about this.
PEARL-T sub study
You give blood samples and saliva (spit) samples:
- before starting treatment
- 2 weeks after starting treatment
- at the end of treatment then
- after treatment at 1 month
- 3 months
- 1 year
- 2 years
Researchers use these samples to look for substances (
You don’t have to give these samples if you don’t want to. You can still take part in the PEARL trial.
Quality of life
You fill in questionnaires:
• before starting treatment
• a month after you finish treatment
• then at 6 months
• 1 year
• 2 years
This is a quality of life study.
You see the doctor to have tests before taking part. These tests include:
- a physical examination
- blood tests
- test to see how well you swallow
- PET CT scan
You see the doctor each week during treatment to find out how you are.
After treatment you see the doctor at:
- 4 weeks
- 3 months
- 6 months
- 1 year
- 2 years
This to find out how you are and to test your swallowing.
You have a PET CT scan after 2 weeks of chemoradiotherapy and then at 3 months.
The trial team monitor you during treatment and afterwards. Contact your advice line or tell your doctor or nurse if any side effects are bad or not getting better.
The early side effects of radiotherapy happen during treatment and between 1 to 3 months after. These include:
- loss of taste
- dry mouth
- ulcers in the throat causing pain when swallowing
- a skin reaction like sunburn
Some side effects of radiotherapy can continue or happen after 3 months. These late side effects include:
- dry mouth
- swallowing problems
- teeth problems such as decay
We have information about the side effects of head and neck radiotherapy.
The chemotherapy used for oropharyngeal cancer is either:
Your doctor or a member of the trial team will talk to you about the possible side effects before you agree to join.
How to join a clinical trial
Dr Thomas Rackley
Dr Mererid Evans
Velindre NHS Trust
Cancer Research Wales
Velindre Radiotherapy Charitable Funds (Moondance)
Centre for trials Research