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Trial registered on ANZCTR
Registration number
ACTRN12614000932662
Ethics application status
Approved
Date submitted
26/08/2014
Date registered
1/09/2014
Date last updated
3/05/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of Mepitel Film on skin reaction severity and moist desquamation rates in patients undergoing radiation therapy for head and neck cancer: a pilot study
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Scientific title
The effect of Mepitel Film compared with sorbolene cream on acute radiation-induced skin reaction severity and moist desquamation rates in patients undergoing radiation therapy for head and neck cancer: a randomized intra-patient controlled pilot study
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Secondary ID [1]
285232
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute radiation-induced skin reactions
292862
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Cancer of the Head and Neck region
292897
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Condition category
Condition code
Cancer
293160
293160
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0
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Head and neck
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Skin
293161
293161
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0
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
We changed the intervention from a management. to a prophylactic trial. The film is now applied from day one of radiation therapy until the end of the trial or until moist desquamation occurs. If moist desquamation occurs then these patches will be covered by the standard dressing that is used in each department.
The skin area of interest will be identified from the treatment plans and comprise of a skin area of at least 5 cm2 with a uniform high dose (>40Gy). Thi sarea will be divided into two similar halves, one half will be randomized to film and the other to cream.
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Intervention code [1]
290107
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Treatment: Devices
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Intervention code [2]
290135
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Prevention
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Comparator / control treatment
Sorbolene will be applied twice a day from day one of radiation therapyuntil the end of the trial or until moist desquamation occurs. If moist desquamation occurs then these patches will be covered by the standard dressing that is used in each department.
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Control group
Active
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Outcomes
Primary outcome [1]
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Skin reaction severity as determined by Radiation Induced Skin Reaction Assessment Scale (RISRAS) or Radiation Therapy Oncology Group (RTOG) score.
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Assessment method [1]
293017
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Timepoint [1]
293017
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RISRAS and RTOG scores will be determined 3x a week from the moment of faint erythema till the end of radiation treatment and once a week for 4 weeks after completion of radiation therapy.
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Secondary outcome [1]
310158
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Percentage of patients who develop moist desquamation either in the control area and/or in the treatment area and the time it takes for moist desquamation to develop.
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Assessment method [1]
310158
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Timepoint [1]
310158
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Time to development of moist desquamation.
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Secondary outcome [2]
310159
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Effect of psychosocial stress on skin reaction severity as determined by validated Distress Thermometer.
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Assessment method [2]
310159
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Timepoint [2]
310159
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This measures will be used at baseline and weekly after that.
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Secondary outcome [3]
310253
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Time to healing of moist desquamation
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Assessment method [3]
310253
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Timepoint [3]
310253
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Number of days it takes for the moist desquamation to heal
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Eligibility
Key inclusion criteria
patients receiving radiation and chemoradiation
squamous cell carcinoma of the oropharynx, nasopharynx and oral cavity
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Radiation or chemoradiation <30Gy
Distant metastatic disease
Previous radiation to the head and neck area
Skin consitions that may aggrevate radiation-induced skin reactions
Karnofski score<70%
Patients with facial hair on the treatment site
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Protocol has changed from a management to a preventative trial. Based on the RT plan, an area of high dose (>30Gy) of at least 5 by 10 cm will be selected and divided into 2 equal halves. One half will be randomized to Mepitel Film, the other to sorbolene cream.
Randomization of which half will be covered in film and which half in cream is done centrally based on computer-generated random numbers, provided by a biostatistician at the University of Otago, Wellington. The research radiation therapist sends a randomization request to the PI, Dr Herst who will allocate the superior/lateral or the inferior/medial to either film of cream based on the computer-generated numbers.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated random numbers produced by the University's biostatistician, Dr James Stanley
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
Participants will act as their own controls. The treatment plan will be used to identify a skin area of >5cm2 that has the highest skin dose. This area will be divided into two equal parts. One part will be randomly assigned to the Mepitel Film arm and the other half will be treated with sorbolene cream. Randomization will be based on computer generated random numbers. The trial cannot be blinded because of the obvious differences between film and cream.
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
This is a pilot study to determine the percentage of moist desquamation in the skin treated with sorbolene cream and that treated with Mepitel Film. Based on the results of this study we will be able to determine the number of participants needed to power a larger international study to 80% with an alpha of 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/11/2014
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Actual
15/05/2015
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Date of last participant enrolment
Anticipated
1/12/2016
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Actual
13/12/2016
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Date of last data collection
Anticipated
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Actual
11/03/2017
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Sample size
Target
30
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Accrual to date
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Final
36
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Recruitment outside Australia
Country [1]
6310
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New Zealand
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State/province [1]
6310
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Christchurch
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Country [2]
7374
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China
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State/province [2]
7374
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Funding & Sponsors
Funding source category [1]
289842
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University
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Name [1]
289842
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University of Otago
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Address [1]
289842
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23A Mein Street
PO BOX 7343
Wellington South
Wellington 6242
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Country [1]
289842
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New Zealand
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Funding source category [2]
289843
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Hospital
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Name [2]
289843
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Christchurch Hospital
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Address [2]
289843
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Private Bag 4710
Christchurch 8140
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Country [2]
289843
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New Zealand
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Funding source category [3]
289845
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Hospital
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Name [3]
289845
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Dunedin Hospital
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Address [3]
289845
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Private Bag 1921
Dunedin 9054
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Country [3]
289845
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New Zealand
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Funding source category [4]
289847
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Commercial sector/Industry
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Name [4]
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Molnlycke Healthcare
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Address [4]
289847
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Box 130 80
Gamlestadsvägen 3C
SE-402 52 Gothenburg
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Country [4]
289847
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Sweden
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Primary sponsor type
University
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Name
University of Otago
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Address
23A Mein Street
PO BOX 7343
Wellington South
Wellington 6242
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
288532
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Address [1]
288532
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Country [1]
288532
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Otago Human Ethics Committee
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Ethics committee address [1]
291574
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PO Box 56 Dunedin 9054
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Ethics committee country [1]
291574
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New Zealand
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Date submitted for ethics approval [1]
291574
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27/08/2014
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Approval date [1]
291574
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29/09/2014
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Ethics approval number [1]
291574
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H14/111
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Ethics committee name [2]
297576
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Drum Tower Hospital Ethics Committee
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Ethics committee address [2]
297576
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Drum tower hospital, No. 321 Zhongshan Avenue Nanjing China zip code: 210008.
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Ethics committee country [2]
297576
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China
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Date submitted for ethics approval [2]
297576
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Approval date [2]
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25/03/2016
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Ethics approval number [2]
297576
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protocol number 2016-019-12
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Summary
Brief summary
Background External beam irradiation is a common treatment option for most solid cancers. Although the skin of all patients receives a certain amount of radiation, the skin dose in patients with tumours close to the skin is high enough to cause severe reactions (moist desquamation). This is the case for 40-60% of breast and head and neck cancer patients. Severe skin reactions can be very painful and affect patient quality of life as well as increasing the chance of developing infections. Our previous three skin trials showed that soft silicone dressings decreased skin reaction severity in breast cancer patients in New Zealand (1–3). The dressings adhere closely to the folds and creases of the skin and prevent friction damage (due to items of clothing or other skin parts) to the radiation damaged skin (4). Damage protection by the dressings is best when they are used from the start of radiation treatment, resulting in a 90% reduction of skin reaction severity and a complete lack of moist desquamation (3). However, using dressings from the start of radiation treatment is not always practical. If started when the skin shows faint erythema (redness), the dressings decrease skin reaction severity up to 40% but do not affect moist desquamation rates (1,2). Mepitel Film has so far only been used in the preventative setting in breast cancer patients who received a skin dose of less than 40Gy. In addition to investigating the effect of Mepitel Film, we also want to measure the effect of patient stress levels on skin reaction severity. Our previous trial showed that breast cancer patients who are highly stressed during their course of radiation therapy have a much higher chance of developing moist desquamation. We wish to confirm these findings in a cohort of head and neck cancer patients. References 1. Diggelmann K, Zytkovicz A, Tuaine J, Bennett N, Kelly L, Herst P. Mepilex Lite dressings for the management of radiation-induced erythema: a systematic inpatient controlled clinical trial. Brit J Radiol [Internet]. 2010 Nov [cited 2012 May 9];83(995):971–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20647511 2. Paterson D, Poonam P, Bennett N, Peszynski R, Van Beekhuizen M, Jasperse M, et al. Randomized Intra-patient Controlled Trial of Mepilex Lite Dressings versus Aqueous Cream in Managing Radiation-Induced Skin Reactions Postmastectomy. J Cancer Sci Ther [Internet]. 2012 [cited 2013 Jul 3];04(11):347–56. Available from: http://www.omicsonline.org/1948-5956/JCST-04-347.digital/JCST-04-347.html 3. Herst P, Bennet N, Sutherland A, Peszynski R, Paterson D, Jasperse M. Prophylactic use of Mepitel Film completely prevents radiation-induced moist desquamation in an intra-patient controlled RCT of 78 breast cancer patients in New Zealand. Radiother Oncol. 2014;in press. 4. Herst P. Protecting the radiation-damaged skin from friction: a mini review. J Med Radiat Sci [Internet]. 2014 Jun 28 [cited 2014 Jul 4];61(2):119–25. Available from: http://doi.wiley.com/10.1002/jmrs.46
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Patries Herst
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Address
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Department of Radiation Therapy University of Otago, Wellington POBox 7343 Wellington South 6242
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Country
50966
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New Zealand
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Phone
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+64-4-3855475
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Fax
50966
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+64-4-3855375
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Email
50966
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[email protected]
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Contact person for public queries
Name
50967
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Patries Herst
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Address
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Department of Radiation Therapy University of Otago, Wellington POBox 7343 Wellington South 6242
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Country
50967
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New Zealand
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Phone
50967
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+64-4-3855475
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Fax
50967
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+64-4-3855375
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Email
50967
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[email protected]
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Contact person for scientific queries
Name
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Patries Herst
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Address
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Department of Radiation Therapy University of Otago, Wellington POBox 7343 Wellington South 6242
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Country
50968
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New Zealand
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Phone
50968
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+64-4-3855475
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Fax
50968
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+64-4-3855375
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Email
50968
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The effect of mepitel film on acute radiation-induced skin reactions in head and neck cancer patients: A feasibility study.
2018
https://dx.doi.org/10.1259/bjr.20170298
Embase
Mepitel Film is superior to Biafine cream in managing acute radiation-induced skin reactions in head and neck cancer patients: a randomised intra-patient controlled clinical trial.
2020
https://dx.doi.org/10.1002/jmrs.397
N.B. These documents automatically identified may not have been verified by the study sponsor.
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