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Radiation Therapy With or Without Chemotherapy in Treating Patients With Advanced Cancer of the Larynx

Phase 3
Completed
Conditions
Head and Neck Cancer
Registration Number
NCT00002496
Lead Sponsor
Radiation Therapy Oncology Group
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. It is not yet known if chemotherapy plus radiation therapy is more effective than radiation therapy alone in treating patients with advanced cancer of the larynx.

PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy with or without chemotherapy in treating patients with advanced cancer of the larynx.

Detailed Description

OBJECTIVES: I. Compare, in a phase III setting, overall and disease-free survival with preservation of laryngeal function in patients with stage III/IV squamous cell carcinoma of the glottic and supraglottic larynx treated with cisplatin/fluorouracil (CDDP/5-FU) followed by radiotherapy vs. concomitant radiotherapy plus CDDP vs. radiotherapy alone. II. Compare the tumor response after completion of chemotherapy but prior to initiation of radiotherapy with that following completion of radiotherapy and concurrent chemotherapy. III. Compare the patterns of relapse (local and regional recurrence and distant metastasis) with these treatments. IV. Compare the incidence of second primary tumors in patients treated on these three regimens. V. Compare the acute and chronic adverse effects of these three regimens. VI. Compare the morbidity experienced with neck dissection and/or laryngeal salvage surgery following treatment with these regimens. VII. Compare quality of life of patients with laryngeal preservation vs. patients requiring salvage laryngectomies. VIII. Compare the quality of life of patients receiving radiotherapy alone vs. those receiving chemotherapy as well.

OUTLINE: Randomized study. Patients on any arm, clinically staged N+ undergo neck dissection following completion of radiotherapy. Arm I: 2-Drug Combination Chemotherapy followed by Radiotherapy. Cisplatin, CDDP, NSC-119875; Fluorouracil, 5-FU, NSC-19893; followed by regional irradiation using linear accelerators with photon energies of 1.25-6 MV, electron energies of 8-17 MeV, or Co60. Arm II: Radiotherapy plus Single-Agent Chemotherapy/Radiosensitization. Regional irradiation using equipment as in Arm I; plus CDDP. Arm III: Radiotherapy. Regional irradiation using equipment as in Arm I.

PROJECTED ACCRUAL: 546 patients (182/arm) will be entered over approximately 3 years. If any arm is clearly inferior in laryngectomy-free survival after 137 patients have completed 2 years of follow-up study, that arm will be closed to further accrual. A second interim analysis will be conducted after 410 patients have completed 2 years of follow-up.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
Not specified
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (18)

CCOP - Carle Cancer Center

πŸ‡ΊπŸ‡Έ

Urbana, Illinois, United States

CCOP - Kalamazoo

πŸ‡ΊπŸ‡Έ

Kalamazoo, Michigan, United States

Beth Israel Deaconess Medical Center

πŸ‡ΊπŸ‡Έ

Boston, Massachusetts, United States

Pretoria Academic Hospital

πŸ‡ΏπŸ‡¦

Pretoria, South Africa

University of Pittsburgh Cancer Institute

πŸ‡ΊπŸ‡Έ

Pittsburgh, Pennsylvania, United States

CCOP - Illinois Oncology Research Association

πŸ‡ΊπŸ‡Έ

Peoria, Illinois, United States

New England Medical Center Hospital

πŸ‡ΊπŸ‡Έ

Boston, Massachusetts, United States

CCOP - Iowa Oncology Research Association

πŸ‡ΊπŸ‡Έ

Des Moines, Iowa, United States

Hahnemann University Hospital

πŸ‡ΊπŸ‡Έ

Philadelphia, Pennsylvania, United States

Ireland Cancer Center

πŸ‡ΊπŸ‡Έ

Cleveland, Ohio, United States

CCOP - Colorado Cancer Research Program, Inc.

πŸ‡ΊπŸ‡Έ

Denver, Colorado, United States

Indiana University Cancer Center

πŸ‡ΊπŸ‡Έ

Indianapolis, Indiana, United States

Veterans Affairs Medical Center - Indianapolis (Roudebush)

πŸ‡ΊπŸ‡Έ

Indianapolis, Indiana, United States

Veterans Affairs Medical Center - Atlanta (Decatur)

πŸ‡ΊπŸ‡Έ

Decatur, Georgia, United States

CCOP - Northern New Jersey

πŸ‡ΊπŸ‡Έ

Hackensack, New Jersey, United States

Veterans Affairs Medical Center - East Orange

πŸ‡ΊπŸ‡Έ

East Orange, New Jersey, United States

CCOP - Metro-Minnesota

πŸ‡ΊπŸ‡Έ

Saint Louis Park, Minnesota, United States

H. Lee Moffitt Cancer Center and Research Institute

πŸ‡ΊπŸ‡Έ

Tampa, Florida, United States

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