Head and Neck Cancer Clinical Trial
Official title:
A Phase III Randomized Trial Comparing Single Agent Cisplatin With the Combination of 5-Fluorouracil and Cisplatin, Concurrent With Radiation Therapy in Stage III and IV Squamous Cell Head and Neck Cancer
RATIONALE: Radiation therapy uses high energy x-rays to kill tumor cells. Drugs used in
chemotherapy, such as cisplatin and fluorouracil, work in different ways to stop the growth
of tumor cells, either by killing the cells or by stopping them from dividing. Giving
radiation therapy together with cisplatin and fluorouracil may kill more tumor cells. It is
not yet known whether radiation therapy and cisplatin are more effective with or without
fluorouracil in treating patients with head and neck cancer.
PURPOSE: This randomized phase III trial is studying radiation therapy and cisplatin to
compare how well they work with or without fluorouracil in treating patients with stage III
or stage IV head and neck cancer.
OBJECTIVES:
- To compare the relapse-free survival of patients treated with radiotherapy and cisplatin
with vs without fluorouracil.
- To compare the overall survival, local control without surgery, and patterns of failure
in patients treated with these regimens.
- To compare the acute and long-term toxicity of these regimens in these patients.
- To compare the quality of life of patients treated with these regimens.
- To prospectively collect biopsy material, mucosal scrapings, and serum in an effort to
generate hypotheses for future correlative studies.
OUTLINE: This is a multicenter study. Patients are stratified according to radiotherapy
schedule (once daily vs twice daily) and radiotherapy planning (2D vs 3D vs
intensity-modulated radiotherapy). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo full-dose radiotherapy once or twice daily 5 days a week for up
to 7 weeks and receive cisplatin IV over 1 hour on days 1, 22, and 43 of radiotherapy.
- Arm II: Patients undergo radiotherapy as in arm I and receive fluorouracil IV and
cisplatin IV continuously on days 1-4 and 22-25 of radiotherapy.
Patients with biopsy-verified residual disease at the primary site or local recurrence after
achieving a complete response to chemoradiotherapy may undergo salvage surgery 12 weeks after
the completion of chemoradiotherapy.
Patients complete questionnaires periodically to assess late toxicity and quality of life.
After completion of study treatment, patients are followed periodically.
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