NCT02437825

Brief Summary

Salivary fistulae have been the bane of surgical salvage in the era of primary chemoradiation for head and neck (H\&N) cancers. The "blame"of prior chemoradiation tissue damage encouraged compensatory surgical techniques that focused on the insertion of non-irradiated tissue into the field. This study emphasizes a paradigm shift in the understanding and treatment of pharyngocutaneous fistulae. The detrimental effects of salivary enzymes on tissue healing and surgical anastomoses are addressed and novel treatment strategy is outlined.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Oct 2015

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 29, 2015

Completed
9 days until next milestone

First Posted

Study publicly available on registry

May 8, 2015

Completed
5 months until next milestone

Study Start

First participant enrolled

October 1, 2015

Completed
5.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2021

Completed
Last Updated

September 12, 2019

Status Verified

September 1, 2016

Enrollment Period

5.7 years

First QC Date

April 29, 2015

Last Update Submit

September 10, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • elimination of post-radiation salivary fistulae

    yes/no fistulae formation

    up to 7 days after the surgery

Secondary Outcomes (2)

  • saliva secretion rate

    up 14 days after the surgery

  • pain evaluation

    up to 14 days after the surgery

Study Arms (2)

octreotide treatment

EXPERIMENTAL

The studied drug Octreotide 100 mcg will be administered I.V in the evening prior to surgery and for two weeks on a thrice daily basis.

Drug: octreotide

placebo treatment

PLACEBO COMPARATOR

plasebo will be administrated I.V in the evening prior to surgery and two weeks on a thrice daily basis

Other: placebo

Interventions

Octreotide has been in clinical use for thirty years and approved for use in Israel in acromegaly and functional gastroenteropancreatic tumours. It is currently being used extensively in surgical patients to prevent pancreatic fistulae1, and in lymphorrhea (both lymphatic malformations and leaks from the thoracic duct)

Also known as: sundostatine
octreotide treatment
placeboOTHER

placebo ( saline) act as comperator in this study.

Also known as: saline
placebo treatment

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Chemoradiation
  • Total laryngectomy
  • Composite resections for oral/pharyngeal/laryngeal malignant tumors

You may not qualify if:

  • Pregnancy
  • Patients with malabsorption syndrome, short bowel or chologenic diarrhea not controlled by specific therapeutic means
  • Patients with uncontrolled diabetes mellitus or a fasting plasma glucose \> 250mg/d

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

HadassahMO

Jerusalem, Israel

RECRUITING

Related Publications (6)

  • Gilbert MR, Sturm JJ, Gooding WE, Johnson JT, Kim S. Pectoralis major myofascial onlay and myocutaneous flaps and pharyngocutaneous fistula in salvage laryngectomy. Laryngoscope. 2014 Dec;124(12):2680-6. doi: 10.1002/lary.24796. Epub 2014 Jul 30.

    PMID: 25132580BACKGROUND
  • Agra IM, Carvalho AL, Pontes E, Campos OD, Ulbrich FS, Magrin J, Kowalski LP. Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg. 2003 Dec;129(12):1317-21. doi: 10.1001/archotol.129.12.1317.

    PMID: 14676158BACKGROUND
  • Bomeli SR, Desai SC, Johnson JT, Walvekar RR. Management of salivary flow in head and neck cancer patients--a systematic review. Oral Oncol. 2008 Nov;44(11):1000-8. doi: 10.1016/j.oraloncology.2008.02.007. Epub 2008 May 16.

    PMID: 18486528BACKGROUND
  • Loguercio C, de Sio I, Romano M, del Vecchio Blanco C, Coltorti M. Effect of somatostatin on salivary secretion in man. Digestion. 1987;36(2):91-5. doi: 10.1159/000199405.

    PMID: 2436964BACKGROUND
  • Spinell C, Ricci E, Berti P, Miccoli P. Postoperative salivary fistula: therapeutic action of octreotide. Surgery. 1995 Jan;117(1):117-8. doi: 10.1016/s0039-6060(05)80242-9. No abstract available.

    PMID: 7809829BACKGROUND
  • Victora CG, Huttly SR, Fuchs SC, Olinto MT. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997 Feb;26(1):224-7. doi: 10.1093/ije/26.1.224.

    PMID: 9126524BACKGROUND

MeSH Terms

Conditions

Fistula

Interventions

OctreotideSodium Chloride

Condition Hierarchy (Ancestors)

Pathological Conditions, AnatomicalPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Peptides, CyclicMacrocyclic CompoundsPolycyclic CompoundsPeptidesAmino Acids, Peptides, and ProteinsChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium Compounds

Study Officials

  • jeffrey weinberger, MD

    hadassah MO

    PRINCIPAL INVESTIGATOR

Central Study Contacts

JEFFREY WEINBERGER, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 29, 2015

First Posted

May 8, 2015

Study Start

October 1, 2015

Primary Completion

June 1, 2021

Study Completion

June 1, 2021

Last Updated

September 12, 2019

Record last verified: 2016-09

Locations