Head and Neck Tumors Clinical Trial
Official title:
Randomized, Open-label Economic and Medical Study on the Lymph Node Management of Squamous Cell Carcinoma of the Oral Cavity and Oropharynx T1-T2N0 Operable : Comparison of the Reference Strategy Based on a the Systematic Lymph Node Dissection Versus the Strategy Based on the Technique of Sentinel Lymph Node.
Currently, patients with cancer of oral cavity or oropharynx T1-T2N0 classified, are treated
surgically with systematic lymph node dissection while in 70%, there is no lymph node
metastasis. The technique of identifying the sentinel node (GS) is validated for these
tumors because the status of the sentinel node is predictive of the other nodes status in
the neck. This helps to diagnose the presence of metastases without lymph node dissection
and thus select patients requiring a treatment node. However, the oncological and functional
results of a therapeutic strategy based on identifying the GS is unknown.
This open-label randomized multicenter clinical trial aims to compare the oncologic and
functional outcome of two strategies : the current management versus the management based on
the sentinel lymph node.
The hypothesis is based on a nodal control difference at 2 years in both arms not exceeding
10%. The medico-economic analysis will be conducted in two stages : a classic stage on 2
years with estimated incremental cost-effectiveness and incremental cost-utility, then a
step with log term modeling.
A reduction in morbidity and treatment costs in the sentinel node arm are expected in this
study.
This study schedules the screening visit (V0) and then 9 follow-up visits during 24 months.
At the screening, after verification of the eligibility criteria and signature of the
informed consent form, the subject will be randomized in one of 2 arms. At the inclusion the
following exams have to be done : clinical exam, panendoscopy, cytologic and histologic
analysis and CT-Scan (or MRI). For each visit, the investigator will perform a clinical exam
and the subjects should complete some questionnaires themselves from V0 to V3, V6 (12
months) and V9. At the last visit (24 months) the patients will have a CTC-Scan ou MRI.
At the end of the follow-up period (24 months), the data of subjects survival will be
recorded during three years.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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