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Cutaneous Squamous Cell Carcinoma (CSCC)Phase 3SPINO-RTNCT06692556

Study of a Strategy Integrating Adjuvant Radiation Therapy Versus Strategy Based on Monitoring in the Treatment of Carcinomas Spinocellular With High Risk of Recurrence

A Phase 3 study testing Adjuvant radiotherapy in people with Cutaneous Squamous Cell Carcinoma (CSCC), run by Centre Leon Berard at 28 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The goal of this clinical trial is to evaluate a strategy integrating adjuvant radiation therapy versus strategy based on monitoring in the treatment of carcinomas spinocellular with high risk of recurrence (SCC). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cutaneous Squamous Cell Carcinoma (CSCC)
What is being tested?
Adjuvant radiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
266 participants
Where
28 sitesFrance
Study dates
21 Feb 2025to Jun 2031
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • I1. Patients aged ≥ 18 years at the time of signing the informed consent form; I2. Patients with histologically confirmed localized cutaneous squamous cell carcinoma;
  • Note: Patients with carcinoma of the external auditory canal may be included in the study;
  • I3. Patients treated with complete surgical excision (R0), regardless of the margin (submillimeter or supramillimeter);
  • I4. Disease with a high risk of recurrence defined by one of the following scenarios:
  • presence of microscopic EPN without any other risk factors;
  • presence of microscopic EPN with a single other risk factor;
Show all 10Show fewer
  • presence of 2 risk factors other than microscopic EPN;
  • presence of 3 risk factors other than microscopic EPN;
  • Note: The risk factors considered are immunosuppression (limited to untreated hematologic disease), a tumor diameter >20 mm (longest axis, measured preferably clinically, or, failing that, histologically), a specific location (lip/ear/temple), deep invasion (tumor thickness >6 mm (Breslow) or invasion beyond the subcutaneous fat), poor differentiation, or desmoplasia;
  • I5. Patient informed and having signed a consent form to participate in the study; I6. Patient enrolled in a health insurance plan (or beneficiary of such a plan).

Who cannot join

  • NI1. Patients with in situ or mixed CEC; NI2. History of CEC with a high risk of recurrence in the same lymphatic drainage area (head and neck, trunk, or limb) within 2 years prior to the randomization date; NI3. History of CEC treated with systemic therapy; NI4. Patients with SCC localized to the endonasal, intraoral, anogenital, or vulvar mucosa;
  • NI5. Patients with recurrent SCC or SCC at very high risk of recurrence defined by one of the following criteria:
  • EPN with ≥ 2 other risk factors,
  • > 3 risk factors,
  • bone invasion,
  • immunosuppression due to immunosuppressive treatments (regardless of the reason). NI6. Patients with CEC presenting a single risk factor other than EPN; NI7. Patient with CEC and lymph node or distant metastasis; NI8. Patient with a history of cancer undergoing systemic and/or locoregional anticancer treatment;
  • Note: Local treatment of cutaneous keratoses with fluoropyrimidines is permitted outside the theoretical radiation field);
  • NI9. Patient with a contraindication to radiation therapy; NI10. Patient with a history of radiation therapy to the site of the lesion; NI11. Participation in another clinical trial that may interfere with the assessment of the primary endpoint; NI12. Patient under legal guardianship or conservatorship, or deprived of liberty; NI13. Pregnant or breastfeeding woman.

Trial locations and contacts

28 sites in 1 country. Contact the study team or a site near you to ask about taking part.

28 sites in 1 country

France28 sites, 20 recruiting
  • Centre Hospitalier Universitaire Amiens-Picardie

    Amiens, Somme, 80054

    Active, not recruiting
  • Centre Hospitalier Simone Veil de Blois

    Blois, Loir-et-Cher, 41016

    Guido BENS, Dr, bensgui@ch-blois.fr

    Guido BENS, Dr

    Recruiting
  • CHU de Bordeaux - Hôpital Saint André

    Bordeaux, New Aquitaine, 33076

    Emilie GERARD, Dr, 05 56 79 47 05 ext. 05 56 79 49 75, emilie.gerard@chu-bordeaux.fr

    Marie BEYLOT-BARRY, Dr, 05 57 82 25 00, marie.beylot-barry@chu-bordeaux.fr

    Not yet recruiting
  • Centre Hospitalier Régional Universitaire de Brest - Hôpital Morvan

    Brest, Finistère, 29200

    Withdrawn
  • Hôpital de la Cavale Blanche

    Brest, Finistère, 29200

    Gurvan DISSAUX, Dr, 02 98 22 33 98, gurvan.dissaux@chu-brest.fr

    Not yet recruiting
  • Centre Hospitalier Universitaire Estaing

    Clermont-Ferrand, Puy-de-Dôme, 63033

    Sandrine MANSARD, Dr, +33 4 73 75 05 50, smansard@chu-clermontferrand.fr

    Sandrine MANSARD, Dr

    Recruiting
  • Centre Georges François Leclerc

    Dijon, Bourgogne-Franche-Comté, 21079

    Active, not recruiting
  • Centre Hospitalier Universitaire de Grenoble-Alpes

    La Tronche, Isère, 38700

    Sabiha TRABELSI-MESSAI, Dr, +33 4 76 76 66 16, strabelsimessai@chu-grenoble.fr

    Sabiha TRABELSI-MESSAI, Dr

    Not yet recruiting
  • Centre De Radiothérapie Guillaume Le Conquérant

    Le Havre, Normandy, 76600

    Paul LESUEUR, Dr, 02 35 13 66 13, p.lesueur@cglc.fr

    Romain MALLET, Dr, 02 35 13 66 13, r.mallet@cglc.fr

    Not yet recruiting
  • Centre Hospitalier Emile Roux

    Le Puy-en-Velay, Auvergne-Rhône-Alpes, 43000

    Withdrawn
  • Groupe Hospitalier Bretagne Sud

    Lorient, Morbihan, 56322

    Caroline JACOBZONE-LEVEQUE, Dr, +33 6 16 98 31 79, c.jacobzoneleveque@ghbs.bzh

    Caroline JACOBZONE-LEVEQUE, Dr

    Recruiting
  • Centre Léon Bérard

    Lyon, 69373

    Mona AMINI-ADLE, Dr, +33 4 78 78 59 96, mona.amini-adle@lyon.unicancer.fr

    Mona AMINI-ADLE, Dr

    Recruiting
  • Centre Hospitalier Annecy Genevois

    Metz-Tessy, Haute-Savoie, 74374

    Julie DE QUATREBARBES, Dr, +33 4 50 63 68 63, jdequatrebarbes@ch-annecygenevois.fr

    Julie DE QUATREBARBES, Dr

    Recruiting
  • Centre Hospitalier Universitaire de Nantes - Hôtel-Dieu

    Nantes, Loire-Atlantique, 44093

    Gaëlle QUEREUX, Dr, +33 2 40 08 31 44, gaelle.quereux@chu-nantes.fr

    Gaëlle QUEREUX, Dr

    Recruiting
  • Centre Antoine Lacassagne

    Nice, Provence-Alpes-Côte d'Azur Region, 06189

    Damien GIACCHERO, Dr, 04 93 86 73 68, Damien.giacchero@gmail.com

    Dorian CULIE, Dr, 04 92 03 17 89, Dorian.culie@nice.unicancer.fr

    Not yet recruiting
  • Hôpital Bichat Claude-Bernard

    Paris, Île-de-France Region, 75877

    Active, not recruiting
  • Centre Hospitalier Universitaire de Bordeaux

    Pessac, Gironde, 33604

    Active, not recruiting
  • Hospices Civils de Lyon - Centre Hospitalier Lyon Sud

    Pierre-Bénite, Auvergne-Rhône-Alpes, 69495

    Emmanuel MESNY, Dr, emmanuel.mesny@chu-lyon.fr

    Nicolas POULALHON, Dr, 04 78 86 45 69 ext. 04 78 86 13 29, nicolas.poulalhon@chu-lyon.fr

    Not yet recruiting
  • Institut Godinot

    Reims, Marne, 51726

    Active, not recruiting
  • Centre Hospitalier Universitaire de Rennes

    Rennes, Ille-et-Vilaine, 35033

    Monica DINULESCU, Dr, monica.dinulescu@chu-rennes.fr

    Monica DINULESCU, Dr

    Not yet recruiting
  • Centre hospitalier de Roanne

    Roanne, Pays de la Loire Region, 42300

    Amel BLANCHARD, Dr, +33 4 77 44 32 77, amel.blanchard@ch-roanne.fr

    Amel BLANCHARD, Dr

    Recruiting
  • Centre Hospitalier Romans - Hopitaux Drôme Nord

    Romans-sur-Isère, Drôme, 26102

    François SKOWRON, Dr, +33 4 75 05 75 80, f.skowron@hopitaux-drome-nord.fr

    François SKOWRON, Dr

    Recruiting
  • Centre Hospitalier Universitaire Rouen - Hôpital Charles Nicolle

    Rouen, Seine-Maritime, 76031

    Anne-Bénédicte DUVAL-MODESTE, Dr, +33 2 32 88 81 41, anne-benedicte.duval-modeste@chu-rouen.fr

    Anne-Bénédicte DUVAL-MODESTE, Dr

    Not yet recruiting
  • Centre Hospitalier Universitaire de Saint-Etienne - Hôpital Nord

    Saint Priest En Jarez, Pays de la Loire Region, 42271

    Elodie GUILLAUME, Dr, +33 4 77 91 71 02, elodie.guillaume@chu-st-etienne.fr

    Elodie GUILLAUME, Dr

    Recruiting
  • Hôpital d'instruction des armées Sainte-Anne

    Toulon, Var, 83800

    Withdrawn
  • Centre de Radiothérapie Marie Curie

    Valence, Drôme, 26000

    Jean-Baptiste GUY, Dr, dr.guy@cmc-valence.org

    Jean-Baptiste GUY, Dr

    Not yet recruiting
  • Centre Hospitalier de Valence

    Valence, Drôme, 26000

    Florent GRANGE, Dr, +33 4 75 75 75 49, fgrange@valence.fr

    Florent GRANGE, Dr

    Recruiting
  • Institut de Cancérologie de Lorraine

    Vandœuvre-lès-Nancy, MMeurthe-et-Moselle, 54519

    Sophie RENARD, Dr, +33 3 83 59 86 10, s.renard@nancy.unicancer.fr

    Sophie RENARD, Dr

    Recruiting

Other trials in France

About this study

Official title: Randomized Comparative Multicenter Phase III Study of a Strategy Integrating Adjuvant Radiation Therapy Versus Strategy Based on Monitoring in the Treatment of Carcinomas Spinocellular With High Risk of Recurrence

The goal of this clinical trial is to evaluate a strategy integrating adjuvant radiation therapy versus strategy based on monitoring in the treatment of carcinomas spinocellular with high risk of recurrence (SCC).

The investigators will compare the disease-free survival (DFS) of patients treated with adjuvant radiation therapy versus surveillance in high risk of recurrence SCC.

Read more

The main question it aims to answer is:

Is DFS different between the "adjuvant radiotherapy" group and the "surveillance" group?

Participants will:

  • be distributed in one of the two arms
  • will be followed up every 4 months for 2 years, then every 6 months (clinical examination, identification of concomitant treatments, imaging, quality-of-life questionnaire)
  • followed up until their death or their progression whether local, regional or metastatic
Read the detailed description

The use of adjuvant radiotherapy appears to provide clinical benefit, both theoretically and based on available retrospective data. This is why some patients already benefit from this complementary treatment. However, given the lack of prospective data, the use of adjuvant radiotherapy is based on heterogeneous criteria, depending on the choice of the clinician in charge of the patient or the habits of his institution.

The sponsor team therefore propose to conduct a national prospective study to compare the efficacy and safety of a strategy integrating adjuvant radiotherapy versus a strategy based on surveillance in patients with SCC at high risk of recurrence.

Considering that there is no validated standard after surgery for patients with a high risk of recurrence, it is not possible to determine a standard arm and an experimental arm. This study therefore falls within the framework of a Research Involving the Human Person of Category 2.

This protocol constitutes the first prospective evaluation of adjuvant radiotherapy, within the framework of a comparative study. This study will thus make it possible to avoid the use of this therapeutic alternative, without rigorous evaluation in a prospective framework. Its robust methodology will make it possible to determine whether adjuvant radiotherapy provides a clinical benefit to patients at high risk of recurrence. It will modify the standards of care for this patient population.

Being tested
Adjuvant radiotherapy
Keywords
Squamous cell carcinomas at high risk of recurrence, Adjuvant radiotherapy, Surveillance, Peri Nervous System Sheathing

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Adjuvant radiotherapyRadiation

    Patients will receive an adjuvant radiotherapy corresponding to an equivalent dose of 45 to 50 Gy (Equivalent Dose in 2 Gy Fractions [EQD2] with a tumor alpha/beta ratio of 10 Gy) delivered on the operating bed.

    Patients will be treated by :

    • either external radiation therapy using high-energy electrons or photons:
    • 45 Gy in 15 fractions of 3 Gy
    • 50 Gy in 25 fractions of 2 Gy
    • or interstitial brachytherapy or brachytherapy via skin applicators:
    • 36 Gy in 8 fractions of 4.5 Gy
    • 36 Gy in 9 fractions of 4 Gy
    • 40 Gy in 8 fractions of 5 Gy

    Radiation therapy should be started within 8 weeks after surgery (or 10 if delayed healing).

    Patients will be monitored regularly until the date of the first relapse (local, regional or metastatic), or until the date of death (if no relapse).

    Regardless of the type of relapse, remedial treatments will be left to the the investigator's discretion up to the first metastatic relapse.

Study groups in NCT06692556
Study groupRoleWhat they receive
Adjuvant radiotherapyActive comparatorRadiation therapy should be started within 8 to 12 weeks after surgery. An equivalent dose of 45 to 50 Gy will be delivered on the operating bed. The irradiation techniques used may be either external radiation therapy with high-energy photons or electrons or brachytherapy. Patients will be monitored regularly until the date of the first local, regional or metastatic relapse, or until the date of death if they do not relapse. Regardless of the type of relapse, remedial treatments will be left to the The investigator's discretion; they will be collected in the data collection book as well as data on subsequent relapses, up to the first metastatic relapse.
Receives: Radiation: Adjuvant radiotherapy
SurveillanceNo interventionPatients will not receive any treatment after surgery and will be monitored regularly until the date of their first local, regional or metastatic relapse, or until the date of death if they do not relapse. Regardless of the type of relapse, the treatment to be used is left to the discretion of the investigator; it will be collected in the data collection book as well as data on subsequent relapses up to the first metastatic relapse.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Disease-Free Survival (DFS)

    DFS is defined as the time from the date of randomization to the date of recurrence (local, lymph node or metastatic) or death from any cause. A new skin lesion will not be considered a statistical event. Patients without an event at the date of analysis will be censored at the last date of new disease-free status.

    DFS will be estimated by the Kaplan Meier method and described in terms of median in each arm. DFS distributions will be compared between arms using a Log-Rank test. The hazard ratio from a Cox model will be calculated and presented with its 95% confidence interval. The rate of patients without recurrence at 1 and 2 years post-randomization will also be presented with their associated confidence interval.

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

Secondary outcomes (8)
  1. Local recurrence-free survival (lrFS)

    lrFS is defined as the time from randomization (or surgery) to the first occurrence of regional recurrence or death from any cause.

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  2. Regional Recurrence-Free Survival (RrFS)

    RrFS is The time from randomization (or surgery) to the first occurrence of regional recurrence or death from any cause, whichever came first

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  3. Metastatic recurrence-free survival (MrFS)

    MrFS is defined as the time elapsed between the date of randomization and the date of metastatic recurrence or death from any cause. Patients without an event at the analysis date will be censored at the last date of news without metastatic disease.

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  4. Overall Survival (OS)

    OS is defined as the time from the date of randomization to the date of death from any cause. Patients without an event at the analysis date will be censored at the last date of death-free news.

    Measured: every 4 months for 2 years, then every 6 months until the condition progresses or the patient dies. If progression, updates annually. Assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes fir

  5. Tolerance/toxicity

    The safety will be described according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTC AE) Version 5 grid by reporting the number and percentage of patients with toxicity by grade. Adverse events will be coded according to the MedDRA® dictionary and will be described by System Organ Class and Preferred Term. The number of patients with at least one AE by grade, at least one AE related to treatment, at least one serious AE (according to pharmacovigilance), at least one serious AE related to treatment will be described by treatment arm. A listing of serious AEs will be published

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  6. Quality of Life (QoL)

    QoL, will be assessed using the EORTC QLQ-C30 and the EORTC QLQ-ELD14 for the patients ≥ 75 years of age. The difference between the scores at inclusion and during follow-up will be calculated per patient. A difference of 10 points on each score will be considered clinically relevant. A graphic representation in the form of a spider plot will allow to globally visualize the evolution on all the items between the different measurement times.

    Measured: Inclusion, every 4 months for 1 year, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  7. Interest of radiotherapy in the subgroup of patients over 75 years old

    Due to the stratification, the aged population will be well distributed in a balanced way between the treatment arms. The main efficacy criterion and quality of life of this subpopulation will be studied in more detail.

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

  8. Interest of radiotherapy in the subgroup of patients with Perineural Neoplastic Invasion (PNI)

    Due to the stratification, the population with PNI will be well balanced among the treatment arms. The main efficacy criterion and quality of life of this subpopulation will be studied in more detail.

    Measured: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Nov 2024
  2. Study start21 Feb 2025
  3. Primary completionJun 2031 (estimated)
  4. Study completionJun 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Eligible patients will be randomized (ratio 1:1) using an online platform into one of the two study arms: * "Adjuvant radiotherapy" arm (=133), * "Surveillance" arm (n=133)
Masking
None (open label)
Enrolment
266 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06692556
Sponsor's protocol ID
SPINO-RT (ET24-046)
Acronym
SPINO-RT
Status last verified
Apr 2026
First submitted
14 Nov 2024
Last updated
24 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Adjuvant radiotherapy in people with Cutaneous Squamous Cell Carcinoma (CSCC), run by Centre Leon Berard at 28 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 24 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Julien GAUTIER (+33 4.26.55.68.29, julien.gautier@lyon.unicancer.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Disease-Free Survival (DFS) (time frame: Inclusion, every 4 months for 2 years and then every 6 months until death or progression, assessed up to 36 months of follow-up from the last patient enrolled or until the 120th event occurs (wichever comes first)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2026.

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