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SWOG-9451, Combination Chemo & RT For Patients With Stage III/Stage IV Cancer of the Hypopharynx or Tongue

Phase 2
Terminated
Conditions
Head and Neck Cancer
Interventions
Drug: Induction chemotherapy
Radiation: low-LET cobalt-60 gamma ray therapy
Registration Number
NCT00002735
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining more than one chemotherapy drug with radiation therapy may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy and radiation therapy in treating patients with stage III or stage IV cancer of the hypopharynx or tongue.

Detailed Description

OBJECTIVES: I. Determine the complete histologic response rate (which represents the rate of organ preservation) to induction with cisplatin/fluorouracil followed by radiotherapy plus cisplatin in patients with selected stage III/IV cancer of the hypopharynx or base of the tongue. II. Evaluate the feasibility of accruing and treating patients with this regimen in a multi-institutional setting. III. Determine the overall complete response rate in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to center and tumor site (hypopharynx vs base of tongue). Base of tongue stratum closed as of November 15, 1998. Regimen A: Patients receive cisplatin IV over 90 minutes on days 1 and 22 and fluorouracil IV over 120 minutes on days 1-5 and 22-26. Patients with measurable neck nodes discontinue therapy if disease has progressed by day 22. All patients who achieve complete or partial response at day 43 proceed to regimen B. All others proceed to resection followed by radiotherapy (off study). Regimen B (begins within 3-4 weeks of start of second induction course): Patients receive cisplatin IV over 90 minutes every 3 weeks for 3 courses. Concurrently, patients receive radiotherapy 5 days a week for 5.6 weeks. Patients are reassessed at 8-12 weeks after radiotherapy. Patients who are disease free are observed. Other patients undergo surgical resection of nodes and/or primary tumor. Patients are followed every 4-6 weeks for 1 year, every 2 months for 1 year, every 4 months for 2 years, every 6 months for 1 year, then annually thereafter.

PROJECTED ACCRUAL: Up to 70 patients (35/tumor site) will be accrued for this study over 3.5 years.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
68
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment armfluorouracilinduction chemotherapy followed by chemoradiation
Treatment armInduction chemotherapyinduction chemotherapy followed by chemoradiation
Treatment armlow-LET cobalt-60 gamma ray therapyinduction chemotherapy followed by chemoradiation
Treatment armcisplatininduction chemotherapy followed by chemoradiation
Primary Outcome Measures
NameTimeMethod
Complete response23 to 27 weeks after beginning treatment

Complete disappearance of all measurable and evaluable disease. No new lesions, No disease related symptoms. No evidence of non-evaluable disease, including normalization of markers and other abnormal lab values. Specifically, the rate of organ preservation (no surgery required at the primary tumor site).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (18)

Veterans Affairs Medical Center - Brooklyn

🇺🇸

Brooklyn, New York, United States

USC/Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Veterans Affairs Medical Center - Kansas City

🇺🇸

Kansas City, Missouri, United States

Cleveland Clinic Cancer Center

🇺🇸

Cleveland, Ohio, United States

Oklahoma Medical Research Foundation

🇺🇸

Oklahoma City, Oklahoma, United States

Veterans Affairs Medical Center - Oklahoma City

🇺🇸

Oklahoma City, Oklahoma, United States

Veterans Affairs Medical Center - Temple

🇺🇸

Temple, Texas, United States

CCOP - Scott and White Hospital

🇺🇸

Temple, Texas, United States

University of Texas Medical Branch

🇺🇸

Galveston, Texas, United States

University of Colorado Cancer Center

🇺🇸

Denver, Colorado, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

MBCCOP - LSU Medical Center

🇺🇸

New Orleans, Louisiana, United States

Veterans Affairs Medical Center - Ann Arbor

🇺🇸

Ann Arbor, Michigan, United States

Veterans Affairs Medical Center - Detroit

🇺🇸

Detroit, Michigan, United States

University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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