Head and Neck Cancer Clinical Trial
Official title:
Multicentre Randomised Trial of Inductive and Adjuvant Perilymphatically Injected Proleukin (rlL-2) in The Treatment of Operable Primary Squamous Cell Carcinoma of The Oral Cavity and Oropharynx
RATIONALE: Interleukin-2 may stimulate a person's white blood cells to kill cancer cells of
the mouth or oropharynx. Radiation therapy uses high-energy x-rays to damage tumor cells. It
is not known whether giving interleukin-2 with surgery and radiation therapy is more
effective than surgery and radiation therapy alone.
PURPOSE: This randomized phase III trial is studying surgery and radiation therapy alone to
see how well they work compared to surgery, radiation therapy, and interleukin-2 in treating
patients with cancer of the mouth or oropharynx.
OBJECTIVES:
- Compare the disease-free and overall survival in patients with previously untreated
squamous cell carcinoma of the oral cavity or oropharynx treated with resection with or
without and neoadjuvant and adjuvant perilymphatic interleukin-2 (IL-2) and
radiotherapy.
- Compare the response rate in patients treated with these regimens.
- Determine the local and systemic effects of locoregional IL-2 on host-tumor interaction
and immune properties in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
center and tumor stage (T2, N0-2 vs T2, N3 or T3-4, N0-3). Patients are randomized to 1 of 2
treatment arms.
- Arm I: Patients undergo induction comprising interleukin-2 (IL-2) via perilymphatic
injections to the ipsilateral myelohyoid muscle and insertion of the
sternocleidomastoid muscle on days 1-5 and 8-12. Within 10 days after the last IL-2
injection, patients undergo en bloc resection of the primary tumor and corresponding
lymphatic drainage area and pre-study margins. Beginning within 4 weeks after surgery,
patients with T2, N0-3 disease but with pathohistological evidence of node invasion or
capsular rupture of node metastasis or T3-4, N0-3 disease undergo adjuvant radiotherapy
5 days a week for 4.5-6.5 weeks. Beginning within 4 weeks after surgery or radiotherapy
(if applicable), patients receive adjuvant IL-2 via perilymphatic injections to the
contralateral myelohyoid muscle and insertion of the sternocleidomastoid muscle on days
1-5. Adjuvant IL-2 continues monthly for at least 1 year in the absence of disease
progression.
- Arm II: Patients undergo resection and radiotherapy (if eligible) as in arm I. Patients
are followed monthly for 1 year and then every 2 months for 2 years.
PROJECTED ACCRUAL: A total of 260 patients (130 per treatment arm) will be accrued for this
study.
;
Allocation: Randomized, Primary Purpose: Treatment
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