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Trial registered on ANZCTR
Registration number
ACTRN12616000725460
Ethics application status
Approved
Date submitted
30/05/2016
Date registered
1/06/2016
Date last updated
23/07/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Does Mepitel Film decrease skin reactions caused by radiation therapy in head and neck cancer patients?
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Scientific title
Is Mepitel Film superior to a moisturing control cream in decreasing acute radiation-induced skin reactions in head and neck cancer patients?
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Secondary ID [1]
289328
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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
298929
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Head and Neck Cancer
298930
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Condition category
Condition code
Cancer
299006
299006
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0
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Head and neck
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Skin
299007
299007
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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
Mepitel Film is applied from day one of radiation therapy until the end of the trial (4 weeks after completion of radiation therapy) or until moist desquamation occurs. If moist desquamation occurs then these skin areas 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 by 10 cm with a uniformly high dose (>30Gy). This area will be divided into two similar halves, one half will be randomized to Mepitel Film and the other to a moisturising control cream.
Mepitel Film will be applied by the researcher (a radiation therapist or radiation oncologist) and replaced only when necessary (when the film curls up too much).
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Intervention code [1]
294883
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Prevention
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Intervention code [2]
294920
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Treatment: Devices
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Comparator / control treatment
The control cream is a common moisturising cream that does not contain sodium lauryl sulphate, for instance Sorbolene or Trolamine.
The control cream will be applied by the patients twice a day from the start of radiation treatment till the end of the trial (4 weeks after completion of radiation therapy) or until moist desquamation occurs. If moist desquamation occurs then these skin areas 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 by 10 cm with a uniformly high dose (>30Gy). This area will be divided into two similar halves, one half will be randomized to Mepitel Film and the other to a moisturising control cream.
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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]
298473
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Timepoint [1]
298473
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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]
324254
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Time to development of moist desquamation. Moist desquamation is assessed by the research radiation therapist/oncologist 3x a week using RISRAS and RTOG grades.
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Assessment method [1]
324254
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Timepoint [1]
324254
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The number of days after the start of radiation therapy until moist desquamation develops.
Moist desquamation is assessed by the research radiation therapist/oncologist 3x a week using RISRAS and RTOG grades.
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Secondary outcome [2]
324255
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Time to healing of moist desquamation. Moist desquamation is assessed by the research radiation therapist/oncologist 3x a week using RISRAS and RTOG grades.
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Assessment method [2]
324255
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Timepoint [2]
324255
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Number of days that moist desquamation is present. Moist desquamation is assessed by the research radiation therapist/oncologist 3x a week using RISRAS and RTOG grades.
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Eligibility
Key inclusion criteria
Patients receiving radiation and chemoradiation for 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)
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 control cream.
Randomization of which half will be covered in Mepitel Film and which half in control cream is done centrally based on computer-generated random numbers, provided by a biostatistician at the University of Otago, Wellington. The research radiation therapist/radiation oncologist 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 Dalice Sim
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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 at least 5 by 10 cm that has the highest uniform 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 control 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 / Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on preliminary analysis of our current pilot study, in order to see a difference of 30% in total RISRAS score (or 15% in researcher component of RISRAS) and power the trial to 90% and p value of 0.05 to see a difference of 30% in total RISRAS score (or 15% in researcher component of RISRAS), we need 72 patients, with attrition of 20% that would be 86 patients.
The statistical significance between differences in Mepitel Film and control cream RISRAS scores will be determined by non-parametric Wilcoxon signed ranks test, as previous trials have shown that the scores are not all normally distributed. Averages, standard deviations and unpaired two tailed student T tests will be used to determine dose measurements.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
After the feasibility study in NZ and China was completed (n=36), recruitment continued in Nanjing with another 32 patients enrolled (total 68) using the exact same protocol. Based on publication of the feasibility study. the hospital in Nanjing started providing the intervention, Mepitel Film, to patients at a reduced price in April 2018. No more patients were recruited after that time.
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Date of first participant enrolment
Anticipated
3/06/2016
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Actual
27/06/2016
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Date of last participant enrolment
Anticipated
1/12/2017
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Actual
14/03/2018
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Date of last data collection
Anticipated
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Actual
27/05/2018
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Sample size
Target
86
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Accrual to date
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Final
68
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Recruitment outside Australia
Country [1]
7923
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New Zealand
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State/province [1]
7923
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Christchurch
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Country [2]
7924
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China
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State/province [2]
7924
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Nanjing
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Funding & Sponsors
Funding source category [1]
293700
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University
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Name [1]
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University of Otago
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Address [1]
293700
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PO Box 56
Dunedin, 9054
New Zealand
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Country [1]
293700
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New Zealand
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Funding source category [2]
293701
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Hospital
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Name [2]
293701
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Christchurch Hospital
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Address [2]
293701
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2 Riccarton Avenue
Christchurch 8140
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Country [2]
293701
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New Zealand
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Funding source category [3]
293702
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Hospital
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Name [3]
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Drum Tower Hospital
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Address [3]
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321 Zhongshan Road
Gulou (Drum Tower) District
Nanjing, Jiangsu 210008
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Country [3]
293702
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China
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Funding source category [4]
293724
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Commercial sector/Industry
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Name [4]
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Molnlycke Healtcare LTD
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Address [4]
293724
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Box 130 80
Gamlestadsvägen 3C
SE-402 52 Gothenburg
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Country [4]
293724
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Sweden
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Primary sponsor type
University
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Name
Otago University
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Address
PO Box 56
Dunedin, 9054
New Zealand
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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]
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Address [1]
292556
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Country [1]
292556
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295139
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Drum Tower Hospital Ethics Committee
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Ethics committee address [1]
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321 Zhongshan Road Gulou (Drum Tower) District Nanjing, Jiangsu 210008
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Ethics committee country [1]
295139
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China
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Date submitted for ethics approval [1]
295139
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31/12/2015
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Approval date [1]
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25/03/2016
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Ethics approval number [1]
295139
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protocol number 2016-019-12
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Summary
Brief summary
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, such as 40-60% of breast and head and neck cancer patients is high enough to cause severe reactions. 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 in breast cancer patients in New Zealand showed that soft silicone dressings decreased skin reaction severity (1–4). The skin dose received by breast cancer patients was less than 40Gy. However, a small pilot study in NZ head and neck cancer patients receiving a higher skin dose (>45Gy) suggested that Mepitel Film was less effective. The aim of this trial is to determine in a larger cohort how effective Mepitel Film is in preventing and managing acute skin reactions caused by radiation therapy to cancer in the head and neck region. We used the preliminary results from the head and neck pilot study to recruit enough patients to be able to see a statistically significant decrease of 30% in skin reaction severity as measured by RISRAS trial. References 1. Diggelmann K, Zytkovicz A, Tuaine J, Bennett N, Kelly L, Herst P. Brit J Radiol [Internet]. 2010 Nov [cited 2012 May 9];83(995):971–8. 2. Paterson D, Poonam P, Bennett N, Peszynski R, Van Beekhuizen M, Jasperse M, et al. J Cancer Sci Ther [Internet]. 2012 [cited 2013 Jul 3];04(11):347–56. 3. Herst P, Bennet N, Sutherland A, Peszynski R, Paterson D, Jasperse M. Radiother Oncol., 2014 Jan;110(1):137-43. doi: 10.1016/j.radonc.2014.01.005. 4. Herst P. J Med Radiat Sci [Internet]. 2014 Jun 28 [cited 2014 Jul 4];61(2):119–25.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
2905
2905
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/AnzctrAttachments/370802-Wooding, BJR, 2017.pdf
(Publication)
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Contacts
Principal investigator
Name
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A/Prof 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
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New Zealand
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Phone
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+64-4-3855475
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Fax
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+64-4-3855375
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Email
66266
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[email protected]
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Contact person for public 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
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New Zealand
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Phone
66267
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+64-4-3855475
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Fax
66267
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+64-4-3855375
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Email
66267
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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
66268
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New Zealand
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Phone
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+64-4-3855475
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Fax
66268
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+64-4-3855375
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Email
66268
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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
No additional documents have been identified.
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