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Neck Dissection vs Radiotherapy for Cervical Metastases in Advanced Hypopharyngeal Cancer

Not Applicable
Not yet recruiting
Conditions
Hypopharyngeal Carcinoma
Interventions
Radiation: Definitive radiotherapy
Procedure: Neck dissection followed by radiotherapy(50Gy) according to risk factors
Registration Number
NCT03367884
Lead Sponsor
Tianjin Medical University Cancer Institute and Hospital
Brief Summary

At the time of diagnosis, approximately 60%-80% of patients with hypopharyngeal cancer are found with cervical lymph node metastasis. Cervical nodal metastasis is an important prognostic factor in hypopharyngeal cancer. Induction chemotherapy is frequently used in advanced hypopharynx cancer. However, sometimes CR was obtained at the tumor's primary site but not in the palpable lymph nodes in the neck, the large cervical lymph node metastasis poorly responded to induction chemotherapy in a considerable percentage of patients. At present, patients with primary tumor achieved CR preferred to receive definitive radiotherapy no matter cervical lymph node metastasis SD or progression. But, radiotherapy was poor effective to the big cervical lymph node metastasis, because the inner of big cervical lymph node metastasis was hypoxic and necrosis. The investigators conducted a prospective, randomised trial to compare neck dissection with definitive radiotherapy for advanced hypopharyngeal cancer cervical lymph node metastasis with poor response to induction chemotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  1. Ability to understand and the willingness to sign a written informed consent document
  2. Age≥ 18 and≤ 75 years
  3. Histological/ cytological/ Imaging examination proven hypopharyngeal squamous-cell carcinoma in preoperative assessment
  4. Advanced hypopharyngeal cancer with metastatic cervical lymph node more than 2cm in diameter
  5. EPOG≤1,KPS≥ 70
  6. No contraindication of surgery and radiotherapy
  7. No serious disease history of the heart, liver, kidney, lung and other important organs
  8. Expected survival period≥ 12 months
  9. Good compliance
Exclusion Criteria
  1. Inability to provide an informed consent
  2. Other malignancy tumor history,(except for cured skin basal cell carcinoma and papillary thyroid carcinoma)
  3. Serious cardiovascular, liver, respiratory, kidney and neurologic and psychiatric disease with clinical symptoms
  4. The patient has received prior surgery or radiotherapy (except for biopsy)
  5. The patient has received chemotherapy or immunotherapy
  6. Pregnant or lactating women
  7. Other disease requiring simultaneous surgery or radiotherapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Radiotherapy groupDefinitive radiotherapyDefinitive radiotherapy (70Gy)
Neck dissection groupNeck dissection followed by radiotherapy(50Gy) according to risk factorsNeck dissection followed by radiotherapy(50Gy) according to risk factors
Primary Outcome Measures
NameTimeMethod
Neck control rates2 years

The percentage of patients without cervical lymph node metastasis

Secondary Outcome Measures
NameTimeMethod
Disease-free survival5 years

The proportion of patients did not find clear evidence of recurrence or metastasis

Overall survival5 years

The proportion of patients who survived

Quality of life(QOL) QLQ-HN351 year

Evaluated by the European Organization for Research and Treatment of Cancer(EORTC) QLQ-HN35

Quality of life(QOL) QLQ-C301 year

Evaluated by the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30

Trial Locations

Locations (1)

Tianjin Medical University Cancer Institute and Hospital

🇨🇳

Tianjin, Tianjin, China

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