ISRCTN ISRCTN17415294
DOI https://doi.org/10.1186/ISRCTN17415294
ClinicalTrials.gov (NCT) NCT02230800
Clinical Trials Information System (CTIS) 2012-004211-31
Protocol serial number 17979
Sponsor Royal Marsden NHS Foundation Trust
Funder Malaysian Palm Oil Board (Malaysia)
Submission date
08/01/2015
Registration date
12/01/2015
Last edited
12/08/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-looking-at-treatment-to-relieve-the-side-effects-of-radiotherapy-to-the-pelvis-ppalm

Contact information

Mrs Lone Gothard
Scientific

Royal Marsden Hospital
Academic Radiotherapy Department
Downs Road
Sutton
SM2 5PT
United Kingdom

Study information

Primary study designInterventional
Study designRandomised; Interventional
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleRandomised double-blind controlled phase II trial of Tocovid SupraBio in combination with pentoxifylline (PTX) in patients suffering long-term adverse effects of radiotherapy for pelvic cancer
Study acronymPPALM
Study objectivesAim: To test the benefits of oral Tocovid SupraBio (tocotrienols) with pentoxifylline (PTX) in patients suffering chronic gastrointestinal adverse effects following curative pelvic radiotherapy for cancer.
Ethics approval(s)NRES Committee London-Central, 20/08/2014, ref: 14/LO/1122
Health condition(s) or problem(s) studiedTopic: Cancer; Subtopic: Colorectal Cancer, Bladder Cancer, Gynaecological Cancer, Prostate Cancer; Disease: Bladder (advanced), Bladder (superficial), Cervix, Ovary/Fallopian tube, Prostate, Rectum, Testis, Uterus/Endometrium, Vagina
InterventionRandomisation: Treatment allocation will be in a 2:1 ratio of Tocovid SupraBio+PTX:Matched placebo and will be based on computer generated random permuted blocks.

Placebos, Matching placebos bd for 12 months; Tocovid SupraBio, 200mg po bd plus pentoxifylline (PTX) 400mg po bd for 12 months; Follow Up Length: 12 month(s)
Intervention typeDrug
PhasePhase II
Drug / device / biological / vaccine name(s)1. Tocovid SupraBio 2. Pentoxifylline
Primary outcome measure(s)

1. Change at 12 months in the bowel disease subset of the Modified IBDQ Quality of Life questionnaire

Key secondary outcome measure(s)

1. Change at 12 months in rectal IBDQ bleeding score between the two groups in those patients presenting with grade 2, 3 or 4 bleeding
2. Change at 12 months in IBDQ faecal incontinence score between the two groups in those patients presenting with grade 1 or greater incontinence
3. Proportion of items graded as marked or severe (grade 3 or 4)
4. Physician assessment of rectal dysfunction based on the modified CTCAE Version 4 grading
5. Patient self-assessments: QLQ-C30 and CR29 and the Gastrointestinal Symptom Rating Scale
6. Photographic assessment of rectal mucosa
7. Serum fibrosis marker levels

Completion date20/12/2019

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexAll
Target sample size at registration117
Total final enrolment62
Key inclusion criteria1. Age over 18 years.
2. Past history of a malignant pelvic neoplasm (T14 N02 M0) of the rectum, prostate, testis, bladder, uterine cervix, uterus, vagina, anal canal or ovary.
3. A minimum 12 months followup postradiotherapy (24 months for patients with past history of stage T4 and/or N2 disease)
4. A maximum 7 years postradiotherapy
5. No evidence of cancer recurrence
6. Gastrointestinal symptoms attributable to prior radiotherapy: grade 2 or higher in any CTCAE Version 4 category, or grade 1 with difficult intermittent symptoms
7. Symptoms are not relieved by appropriate lifestyle advice and medication over a 3 month period
8. Physical and psychological fitness for Tocovid SupraBio+PTX therapy
9. Written informed consent and availability for follow up
10. Willingness to keep to a specified level of dietary fat intake during the study
11. Symptoms are not relieved by appropriate life-style advice and medication over a 3-month period after optimal gastroenterological assessment
Key exclusion criteria1. Surgery for rectal cancer
2. Contraindication or other inability to undergo magnetic resonance imaging, if required to rule out malignancy
3. Dietary supplementation containing alphatocopherol above a daily dose of 30mg at any time during the last three months
4. Medication with pentoxifylline at any time since radiotherapy
5. Pregnancy or breast feeding
6. Ischaemic heart disease, uncontrolled hypertension, hypotension, acute myocardial infarction, cerebral haemorrhage, retinal haemorrhage, renal failure, liver failure and medication with insulin, ketorolac or vitamin K
7. Allergy to soya
8. Known hypersensitivity to the active constituent, pentoxifylline other methyl xanthines or any of the excipients’, as per SmPC for pentoxifylline
Date of first enrolment25/11/2014
Date of final enrolment05/01/2017

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centre

Royal Marsden Hospital
Academic Radiotherapy Department
Downs Road
Sutton
SM2 5PT
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
IPD sharing planThe datasets generated and/or analysed are available on request from the PPALM trial PI, Dr Alexandra Taylor (Alexandra.taylor@rmh.nhs.uk), via completion of a data access request form after such time that the primary analysis publication and any other key analyses have been completed.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 01/03/2022 11/02/2022 Yes No
Basic results 12/12/2020 10/01/2022 No No
HRA research summary 26/07/2023 No No
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes
Protocol file version 6.0 26/06/2017 12/08/2022 No No

Additional files

30159 PPALM Protocol_v6.0_26Jun2017.pdf
Protocol file

Editorial Notes

12/08/2022: Uploaded protocol (not peer-reviewed) as an additional file.
11/02/2022: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
14/01/2022: The IPD sharing statement has been added and the IPD sharing summary updated accordingly.
10/01/2022: The EudraCT basic results link has been added.
05/10/2020: The overall end date was changed from 30/09/2019 to 20/12/2019.
12/06/2020: The intention to publish date was changed from 31/12/2019 to 31/12/2020.
23/07/2019: The following changes were made to the trial record:
1. ClinicalTrials.gov number added.
2. The overall end date was changed from 05/01/2019 to 30/09/2019.
3. The intention to publish date was added.