Trial Outcomes & Findings for Sulfasalazine in Preventing Acute Diarrhea in Patients With Cancer Who Are Undergoing Pelvic Radiation Therapy (NCT NCT01198145)

NCT ID: NCT01198145

Last Updated: 2020-05-12

Results Overview

The primary endpoint for this study is the maximal severity of diarrhea toxicity. Severity of diarrhea was graded using the terminology and grading categories defined in the NCI's Common Toxicity Criteria (CTCAE), Version 4.0. Grade 0 = None; 1=Mild; Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening as measured by the CTCAE version 4.0. Assessments were recorded during the course of RT and for 6 weeks following RT. The table below represents the worst graded diarrhea for each patient. A two-sided Wilcoxon rank-sum test will be used to test the equality of the distributions of maximum diarrhea severity grades between the two treatment arms.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

87 participants

Primary outcome timeframe

During radiation therapy and up to 6 weeks post radiation therapy

Results posted on

2020-05-12

Participant Flow

Participant milestones

Participant milestones
Measure
Arm I: Sulfasalazine
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Overall Study
STARTED
44
43
Overall Study
COMPLETED
43
42
Overall Study
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm I: Sulfasalazine
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Overall Study
Withdrawal by Subject
1
1

Baseline Characteristics

Sulfasalazine in Preventing Acute Diarrhea in Patients With Cancer Who Are Undergoing Pelvic Radiation Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.\> \> placebo: Given orally
Total
n=84 Participants
Total of all reporting groups
Age, Continuous
59 years
n=99 Participants
56.5 years
n=107 Participants
58 years
n=206 Participants
Sex: Female, Male
Female
15 Participants
n=99 Participants
18 Participants
n=107 Participants
33 Participants
n=206 Participants
Sex: Female, Male
Male
27 Participants
n=99 Participants
24 Participants
n=107 Participants
51 Participants
n=206 Participants
Region of Enrollment
United States
42 participants
n=99 Participants
42 participants
n=107 Participants
84 participants
n=206 Participants

PRIMARY outcome

Timeframe: During radiation therapy and up to 6 weeks post radiation therapy

Population: Two patients in Arm I and one patient from Arm II were not included in the baseline analysis nor the endpoint analyses due to cancellations and protocol violations.

The primary endpoint for this study is the maximal severity of diarrhea toxicity. Severity of diarrhea was graded using the terminology and grading categories defined in the NCI's Common Toxicity Criteria (CTCAE), Version 4.0. Grade 0 = None; 1=Mild; Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening as measured by the CTCAE version 4.0. Assessments were recorded during the course of RT and for 6 weeks following RT. The table below represents the worst graded diarrhea for each patient. A two-sided Wilcoxon rank-sum test will be used to test the equality of the distributions of maximum diarrhea severity grades between the two treatment arms.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Maximum Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After Radiotherapy (RT)
Grade 0
10 Participants
10 Participants
Maximum Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After Radiotherapy (RT)
Grade 1
13 Participants
15 Participants
Maximum Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After Radiotherapy (RT)
Grade 2
8 Participants
13 Participants
Maximum Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After Radiotherapy (RT)
Grade 3
10 Participants
4 Participants
Maximum Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After Radiotherapy (RT)
Grade 4
1 Participants
0 Participants

SECONDARY outcome

Timeframe: During radiation therapy and up to 6 weeks post radiation therapy

Population: Two patients in Arm I and one patient from Arm II were not included in the endpoint analyses due to cancellations and protocol violations. 42 patients from each arm started RT and were used for the analysis. 25 patients from Arm I and 29 patients from Arm II were evaluated after RT. Two patients from Arm 1 provided incomplete data.

The maximal severity of each of 5 different adverse even types (Tenesmus, Abdominal Pain, Constipation, Diarrhea, and Rectal Bleeding) were collected as a secondary endpoint. Severity of the events was graded using the terminology and grading categories defined in the NCI's Common Toxicity Criteria (CTCAE), Version 4.0. Grade 0 = None; 1=Mild; Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening. Adverse events were assessed during the course of RT and for 6 weeks following RT. The table below represents the worst grade for each patient for each type. Two-sided chi-square tests will be used to compare each percentage variable between treatment arms for each event type.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus during RT · Grade 0
27 Participants
30 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus during RT · Grade 1
6 Participants
9 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus during RT · Grade 2
7 Participants
3 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus during RT · Grade 3
2 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus during RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus after RT · Grade 0
18 Participants
21 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus after RT · Grade 1
5 Participants
7 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus after RT · Grade 2
0 Participants
1 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus after RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Tenesmus after RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain during RT · Grade 0
22 Participants
26 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain during RT · Grade 1
14 Participants
12 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain during RT · Grade 2
3 Participants
4 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain during RT · Grade 3
3 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain during RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain after RT · Grade 0
17 Participants
24 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain after RT · Grade 1
8 Participants
2 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain after RT · Grade 2
0 Participants
3 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain after RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Abdominal pain after RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation during RT · Grade 0
26 Participants
27 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation during RT · Grade 1
12 Participants
13 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation during RT · Grade 2
4 Participants
2 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation during RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation during RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation after RT · Grade 0
19 Participants
22 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation after RT · Grade 1
6 Participants
6 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation after RT · Grade 2
0 Participants
1 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation after RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Constipation after RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea during RT · Grade 0
10 Participants
11 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea during RT · Grade 1
13 Participants
14 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea during RT · Grade 2
9 Participants
13 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea during RT · Grade 3
9 Participants
4 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea during RT · Grade 4
1 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea after RT · Grade 0
11 Participants
14 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea after RT · Grade 1
12 Participants
10 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea after RT · Grade 2
2 Participants
3 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea after RT · Grade 3
0 Participants
2 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Diarrhea after RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding during RT · Grade 0
26 Participants
22 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding during RT · Grade 1
16 Participants
20 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding during RT · Grade 2
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding during RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding during RT · Grade 4
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding after RT · Grade 0
20 Participants
27 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding after RT · Grade 1
5 Participants
2 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding after RT · Grade 2
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding after RT · Grade 3
0 Participants
0 Participants
Maximum Severity of Each Outcome Variable (Rectal Bleeding, Abdominal Cramping, Tenesmus, Constipation, and Diarrhea) Measured During and After RT
Rectal bleeding after RT · Grade 4
0 Participants
0 Participants

SECONDARY outcome

Timeframe: During radiation therapy and up to 6 weeks post radiation therapy

Population: Two patients in Arm I and one patient from Arm II were not included in the endpoint analyses due to cancellations and protocol violations. 42 patients from each arm started RT and were used in that portion of the analysis. 25 patients from Arm I and 29 patients from Arm II were evaluated after RT. Two patients from Arm 1 provided incomplete data.

For each patient, an Area Under the Curve (AUC) summary statistic will be calculated taking into account the individual severity of diarrhea toxicity over time. Severity of diarrhea was graded using the terminology and grading categories defined in the NCI's Common Toxicity Criteria (CTCAE), Version 4.0. Grade 0 = None; 1=Mild; Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening. The curve was constructed using weekly assessments during and after RT. A separate analysis was done during the course of RT and every week for 6 weeks following RT.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Area Under the Curve That Combines the Individual Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After RT
During RT
4.0 grade*week
Standard Deviation 3.9
3.3 grade*week
Standard Deviation 3.0
Area Under the Curve That Combines the Individual Severity of Diarrhea Toxicity as Measured by the CTCAE v4.0 During and After RT
After RT
1.2 grade*week
Standard Deviation 1.7
1.3 grade*week
Standard Deviation 2.4

SECONDARY outcome

Timeframe: During radiation therapy and up to 6 weeks post radiation therapy

Population: Two patients in Arm I and one patient from Arm II were not included in the endpoint analyses due to cancellations and protocol violations. 42 patients from each arm started RT and were used in that portion of the analysis. 25 patients from Arm I and 29 patients from Arm II were evaluated after RT. Two patients from Arm 1 provided incomplete data.

Tenesmus, Abdominal pain, constipation, diarrhea and hemorrhaging were assessed during RT and up to 6 weeks after RT. Severity of these events were graded using the terminology and grading categories defined in the NCI's Common Toxicity Criteria (CTCAE), Version 4.0. Grade 0 = None; 1=Mild; Grade 2=Moderate, Grade 3=Severe, Grade 4=Life-threatening. For each patient, an average score for each outcome variable during and after RT calculated as follows: The sum of all severity scores for that variable divided by the number of severity scores for that variable recorded for the patient during the course of RT and for 6 weeks following RT.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Tenesmus during RT
0.2 Average Grade of Event
Standard Deviation 0.4
0.1 Average Grade of Event
Standard Deviation 0.2
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Tenesmus after RT
0.1 Average Grade of Event
Standard Deviation 0.2
0.1 Average Grade of Event
Standard Deviation 0.4
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Abdominal pain during RT
0.3 Average Grade of Event
Standard Deviation 0.4
0.2 Average Grade of Event
Standard Deviation 0.3
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Abdominal pain after RT
0.2 Average Grade of Event
Standard Deviation 0.3
0.2 Average Grade of Event
Standard Deviation 0.4
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Constipation during RT
0.2 Average Grade of Event
Standard Deviation 0.3
0.2 Average Grade of Event
Standard Deviation 0.3
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Constipation after RT
0.1 Average Grade of Event
Standard Deviation 0.3
0.1 Average Grade of Event
Standard Deviation 0.2
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Diarrhea during RT
0.8 Average Grade of Event
Standard Deviation 0.7
0.6 Average Grade of Event
Standard Deviation 0.6
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Diarrhea after RT
0.3 Average Grade of Event
Standard Deviation 0.4
0.3 Average Grade of Event
Standard Deviation 0.4
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Rectal bleeding during RT
0.2 Average Grade of Event
Standard Deviation 0.3
0.2 Average Grade of Event
Standard Deviation 0.3
Average Graded Severity for Tenesmus, Abdominal Pain, Constipation, Diarrhea and Hemorrhage During and After RT as Graded by CTCAE v4.0
Rectal bleeding after RT
0.1 Average Grade of Event
Standard Deviation 0.3
0.1 Average Grade of Event
Standard Deviation 0.2

SECONDARY outcome

Timeframe: During radiation therapy and up to 6 weeks post radiation therapy

Population: Two patients in Arm I and one patient from Arm II were not included in the endpoint analyses due to cancellations and protocol violations. 42 patients from each arm started RT and were used in that portion of the analysis. 25 patients from Arm I and 29 patients from Arm II were evaluated after RT. Two patients from Arm 1 provided incomplete data.

The number of patients that reported any grade 1 or higher adverse event was divided by the total number of patients evaluated. The analysis was done separately for each of the 5 outcomes and separately during RT and after RT.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Tenesmus during RT
35.7 percentage of participants
28.6 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Tenesmus after RT
11.9 percentage of participants
19.1 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Abdominal pain during RT
47.6 percentage of participants
38.1 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Abdominal pain after RT
19.1 percentage of participants
11.9 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Constipation during RT
38.1 percentage of participants
35.7 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Constipation after RT
14.3 percentage of participants
16.7 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Diarrhea during RT
76.2 percentage of participants
73.8 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Diarrhea after RT
33.3 percentage of participants
35.7 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Rectal bleeding during RT
38.1 percentage of participants
47.6 percentage of participants
Percentage of Patients in Each Arm That Experience Tenesmus, Abdominal Pain, Constipation, Diarrhea and Rectal Bleeding During and After RT
Rectal bleeding after RT
11.9 percentage of participants
4.8 percentage of participants

SECONDARY outcome

Timeframe: Up to 6 weeks post radiation therapy

Population: All patients that completed the questionnaire were included in the analysis. Questionnaires used were completed during the last week during RT and 6 weeks after RT.

Questions that were used in this analysis: 2\. Have you had a problem causing you to get up at night to have a bowel movement? 3. Have you had a problem causing you to lose control of your bowel movements? 4. Have you had a problem causing you to have a bowel movement within 30 minutes of a prior bowel movement? 5. Have you had to wear protective clothing or a pad in case you lost control of a bowel movement? 6. Have you had a problem causing you to be unable to tell the difference between stool and gas? 7. Have you had a problem causing you to have stools that are liquid? 1=yes 2=no q08 8. Have you found that once you feel the urge to have a bowel movement, you must do so within 15 minutes to avoid an accident? 9. Have you had cramping with a bowel movement? 10. Have you had blood in your bowel movement?

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=39 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=41 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q2
19 percentage of participants
10 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q3
11 percentage of participants
10 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q4
33 percentage of participants
33 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q5
7 percentage of participants
0 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q6
26 percentage of participants
23 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q7
11 percentage of participants
20 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q8
44 percentage of participants
43 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q9
4 percentage of participants
17 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
During RT : Q10
7 percentage of participants
7 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q2
39 percentage of participants
27 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q3
24 percentage of participants
22 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q4
55 percentage of participants
56 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q5
18 percentage of participants
12 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q6
37 percentage of participants
46 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q7
37 percentage of participants
37 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q8
70 percentage of participants
61 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q9
34 percentage of participants
34 percentage of participants
Percent of Patients in Each Arm That Recorded "Yes" to Each of Questions 2-10 on the Bowel Function Questionnaire
After RT : Q10
50 percentage of participants
29 percentage of participants

SECONDARY outcome

Timeframe: Up to 24 months post radiotherapy

Population: Two patients in Arm I and one patient from Arm II were not included in the endpoint analyses due to cancellations and protocol violations.

The number of patients reporting the use of anti-diarrheal medications divided by the number of patients evaluated for this endpoint.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=42 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Percentage of Patients in Each Arm That Require Any Type of Antidiarrheal Medications.
48.7 percentage of participants
28.6 percentage of participants

SECONDARY outcome

Timeframe: Up to 6 weeks post radiotherapy

Population: All completed QOL questionnaires were included in the analysis. Questionnaires used were completed during the first week during RT and 6 weeks after RT. From Arm I, 41 patients completed questionnaires, 39 during and 26 after RT. For Arm II, 42 patients completed the questions, 40 during and 29 after RT.

For each arm, the percentage of patients experience clinically significant deficits in overall QOL and fatigue as indicated by a score of 5 or lower on the 0-10 scale. The analysis was done using the questionnaire that was completed during the first week of radiotherapy (RT) and 6 weeks after RT.

Outcome measures

Outcome measures
Measure
Arm I: Sulfasalazine
n=41 Participants
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 Participants
Patients receive two oral placebo tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy. \> \> placebo: Given orally
Percentage of Patients in Each Arm That Experience Clinically Significant Deficits in Overall Quality of Life and Fatigue
During RT
17.9 percentage of participants
7.5 percentage of participants
Percentage of Patients in Each Arm That Experience Clinically Significant Deficits in Overall Quality of Life and Fatigue
After RT
26.9 percentage of participants
27.6 percentage of participants

Adverse Events

Arm I: Sulfasalazine

Serious events: 1 serious events
Other events: 42 other events
Deaths: 0 deaths

Arm II: Placebo

Serious events: 2 serious events
Other events: 40 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Arm I: Sulfasalazine
n=43 participants at risk
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 participants at risk
placebo: Given orally
Blood and lymphatic system disorders
Anemia
0.00%
0/43
2.4%
1/42 • Number of events 1
Gastrointestinal disorders
Abdominal pain
2.3%
1/43 • Number of events 1
0.00%
0/42
Gastrointestinal disorders
Constipation
0.00%
0/43
2.4%
1/42 • Number of events 1
Gastrointestinal disorders
Gastrointestinal disorders - Other, specify
0.00%
0/43
2.4%
1/42 • Number of events 1
Gastrointestinal disorders
Tenesmus
0.00%
0/43
2.4%
1/42 • Number of events 1

Other adverse events

Other adverse events
Measure
Arm I: Sulfasalazine
n=43 participants at risk
Patients receive two 500 mg oral sulfasalazine tablets twice daily during radiotherapy and for 4 weeks after completion of radiotherapy.
Arm II: Placebo
n=42 participants at risk
placebo: Given orally
Blood and lymphatic system disorders
Anemia
34.9%
15/43 • Number of events 53
40.5%
17/42 • Number of events 82
Cardiac disorders
Sick sinus syndrome
2.3%
1/43 • Number of events 2
0.00%
0/42
Gastrointestinal disorders
Abdominal pain
34.9%
15/43 • Number of events 56
52.4%
22/42 • Number of events 68
Gastrointestinal disorders
Anal pain
2.3%
1/43 • Number of events 1
0.00%
0/42
Gastrointestinal disorders
Constipation
34.9%
15/43 • Number of events 40
35.7%
15/42 • Number of events 57
Gastrointestinal disorders
Diarrhea
76.7%
33/43 • Number of events 150
76.2%
32/42 • Number of events 154
Gastrointestinal disorders
Dyspepsia
2.3%
1/43 • Number of events 2
2.4%
1/42 • Number of events 1
Gastrointestinal disorders
Gastrointestinal disorders - Other, specify
0.00%
0/43
2.4%
1/42 • Number of events 1
Gastrointestinal disorders
Lower gastrointestinal hemorrhage
39.5%
17/43 • Number of events 44
35.7%
15/42 • Number of events 40
Gastrointestinal disorders
Mucositis oral
2.3%
1/43 • Number of events 1
0.00%
0/42
Gastrointestinal disorders
Nausea
4.7%
2/43 • Number of events 5
4.8%
2/42 • Number of events 2
Gastrointestinal disorders
Rectal pain
4.7%
2/43 • Number of events 6
0.00%
0/42
Gastrointestinal disorders
Tenesmus
39.5%
17/43 • Number of events 43
38.1%
16/42 • Number of events 49
General disorders
Fatigue
7.0%
3/43 • Number of events 9
4.8%
2/42 • Number of events 6
Immune system disorders
Allergic reaction
0.00%
0/43
2.4%
1/42 • Number of events 1
Infections and infestations
Abdominal infection
2.3%
1/43 • Number of events 1
0.00%
0/42
Infections and infestations
Rash pustular
2.3%
1/43 • Number of events 2
0.00%
0/42
Infections and infestations
Vaginal infection
2.3%
1/43 • Number of events 1
2.4%
1/42 • Number of events 2
Injury, poisoning and procedural complications
Dermatitis radiation
2.3%
1/43 • Number of events 1
2.4%
1/42 • Number of events 3
Investigations
Lymphocyte count decreased
4.7%
2/43 • Number of events 2
16.7%
7/42 • Number of events 33
Investigations
Neutrophil count decreased
9.3%
4/43 • Number of events 5
14.3%
6/42 • Number of events 14
Investigations
Platelet count decreased
9.3%
4/43 • Number of events 11
19.0%
8/42 • Number of events 15
Investigations
White blood cell decreased
18.6%
8/43 • Number of events 22
42.9%
18/42 • Number of events 57
Metabolism and nutrition disorders
Hypocalcemia
0.00%
0/43
2.4%
1/42 • Number of events 1
Metabolism and nutrition disorders
Hypokalemia
0.00%
0/43
2.4%
1/42 • Number of events 2
Metabolism and nutrition disorders
Hyponatremia
0.00%
0/43
2.4%
1/42 • Number of events 1
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/43
2.4%
1/42 • Number of events 5
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other, specify
0.00%
0/43
2.4%
1/42 • Number of events 1
Nervous system disorders
Dizziness
0.00%
0/43
2.4%
1/42 • Number of events 1
Nervous system disorders
Headache
2.3%
1/43 • Number of events 1
0.00%
0/42
Nervous system disorders
Peripheral sensory neuropathy
0.00%
0/43
2.4%
1/42 • Number of events 5
Nervous system disorders
Syncope
2.3%
1/43 • Number of events 1
0.00%
0/42
Renal and urinary disorders
Cystitis noninfective
2.3%
1/43 • Number of events 1
0.00%
0/42
Renal and urinary disorders
Hematuria
2.3%
1/43 • Number of events 2
0.00%
0/42
Renal and urinary disorders
Urinary frequency
2.3%
1/43 • Number of events 1
0.00%
0/42
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysesthesia syndrome
0.00%
0/43
2.4%
1/42 • Number of events 1
Skin and subcutaneous tissue disorders
Rash acneiform
0.00%
0/43
2.4%
1/42 • Number of events 1
Skin and subcutaneous tissue disorders
Rash maculo-papular
0.00%
0/43
4.8%
2/42 • Number of events 2
Skin and subcutaneous tissue disorders
Urticaria
0.00%
0/43
2.4%
1/42 • Number of events 1

Additional Information

Robert C. Miller, M.D., M.S.

Mayo Clinic

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60