Sparing reconstructive flaps during post‑operative radiotherapy for oral cavity cancer
Official title: Flap Sparing in Postoperative Radiotherapy of Oral Cavity Cancers: a De-escalation Randomized Phase III Trial
Run by Centre Francois Baclesse · NCT06798922 · Data updated 2026-11-12
This trial tests whether shielding reconstructive surgical flaps during post‑operative radiotherapy reduces treatment side effects for adults treated for oral cavity cancer.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 348 (estimated) |
| Sponsor | Centre Francois Baclesse Academic / other |
| Drugs / interventions | chemotherapy, immunotherapy, Radiation |
| Locations | 30 sites (Amiens and 29 other locations) |
| Status | Recruiting |
| Started | March 1, 2025 |
| Main results expected | March 1, 2031 |
| Study ends | March 1, 2034 |
| Registry record updated | October 27, 2026 |
| Trial ID | NCT06798922 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18 years) with oral cavity cancer who had reconstructive surgery with a soft tissue or soft tissue‑bone flap, have margins >1 mm, a performance status of 0–2, and are candidates for post‑operative IMRT or IMPT are ideal candidates.
✕Probably not a fit
Patients with very small local flaps that limit modulation, prior head and neck radiotherapy, metastatic disease, or recent other malignancies are unlikely to benefit from the flap‑sparing approach.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This phase 3 randomized trial compares post‑operative radiotherapy that intentionally spares reconstructive flaps with standard post‑operative radiotherapy that does not. Radiotherapy is delivered by IMRT with photons or by intensity‑modulated proton therapy (IMPT), and concomitant chemotherapy is permitted when clinically indicated. The trial aims to demonstrate the feasibility of flap‑sparing to reduce radiation‑related toxicity while maintaining local disease control. Eligible participants are adults who underwent resection and reconstruction with a soft tissue or soft tissue‑bone flap and have surgical margins greater than 1 mm.
Why it matters
Potential benefit: If successful, the approach could reduce radiation injury to the flap and surrounding tissues, lowering side effects while keeping cancer control intact.
How similar studies have gone: Organ‑ or structure‑sparing radiation techniques (for example salivary gland sparing) have reduced toxicity in head‑and‑neck cancer, but targeted flap‑sparing is relatively novel with limited prior data.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patient aged 18 years or older * Performance Status 0-2 * Patient with oral cavity cancer (soft tissue or soft tissue-bone flap), treated by reconstructive surgery with a flap. Oropharynx cancer whose flap extends significantly into the oral cavity may be included in the study * Quality of resection with margins \> 1 mm * Patient candidate to post-operative radiotherapy (Intensity-Modulated Radiation Therapy (IMRT) or proton therapy) * Concomitant chemotherapy is allowed (stratification parameter) * Perioperative immunotherapy is allowed (neoadjuvant and/or adjuvant setting) * Patient must have signed a written informed consent form prior to any trial specific procedures * Patient affiliated to the social security system Exclusion Criteria: * Local flap (small size limiting IMRT modulation potential) * History of radiotherapy of head and neck area * Metastatic disease * History of other malignancy within the previous 3 years (except for appropriately treated in-situ cervix carcinoma and non-melanoma skin carcinoma) * Simultaneous participation in another clinical study may compromise the conduct of this study. * Pregnant or lactating women * Patient assessed by the investigator to be unable or unwilling to comply with the requirements of the protocol * Patient deprived of freedom or under guardianship
Where it's running
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Centre François Baclesse
Caen, France Recruiting -
Chu Amiens
Amiens, France Not yet recruiting -
Institut de Cancérologie de l'Ouest
Angers, France Not yet recruiting -
Centre de la Baie
Avranches, France Not yet recruiting -
Chu Caen
Caen, France Not yet recruiting -
Centre Hospitalier
Cherbourg, France Not yet recruiting
Show 24 more locations
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Centre Jean Perrin
Clermont-Ferrand, France Not yet recruiting -
Chic
Créteil, France Not yet recruiting -
Centre Georges-François Leclerc
Dijon, France Not yet recruiting -
Centre Guillaume le Conquérant
Le Havre, France Not yet recruiting -
Centre Hospitalier
Libourne, France Not yet recruiting -
Centre Oscar Lambret
Lille, France Not yet recruiting -
Chu Limoges
Limoges, France Not yet recruiting -
Centre Léon Bérard
Lyon, France Not yet recruiting -
APHM Marseille
Marseille, France Not yet recruiting -
Institut Régional du Cancer Val D'aurelle
Montpellier, France Not yet recruiting -
Institut de Cancérologie de Lorraine
Nancy, France Not yet recruiting -
Centre Antoine Lacassagne
Nice, France Not yet recruiting -
APHP La Pitié
Paris, France Not yet recruiting -
Chu Poitiers
Poitiers, France Not yet recruiting -
Chu Reims
Reims, France Not yet recruiting -
Institut Jean Godinot
Reims, France Not yet recruiting -
Centre Eugène Marquis
Rennes, France Not yet recruiting -
Centre Frédéric Joliot
Rouen, France Not yet recruiting -
Centre Henri Becquerel
Rouen, France Not yet recruiting -
Chu Rouen
Rouen, France Not yet recruiting -
Institut de Cancérologie de l'Ouest
Saint-Herblain, France Not yet recruiting -
Iuct
Toulouse, France Not yet recruiting -
Chu Tours
Tours, France Not yet recruiting -
Institut Gustave Roussy
Villejuif, France Not yet recruiting
Study contacts
- Study coordinator: Juliette THARIAT, Professor
- Email: j.thariat@baclesse.unicancer.fr
- Phone: 33231455050
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.