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CompletedNCT00002839Updated Jul 9, 2018

Combination Chemotherapy Plus Radiation Therapy To Preserve the Larynx in Patients With Cancer of the Hypopharynx or Larynx

A Phase 3 interventional study of cisplatin and fluorouracil in Head and Neck Cancer, sponsored by European Organisation for Research and Treatment of Cancer - EORTC. Completed at 20 sites in 6 countries. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2018-07-09.

Sponsored by European Organisation for Research and Treatment of Cancer - EORTC · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
564
Allocation
Randomized
Ages
18 Years to 120 Years
Sex
All
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Study 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 chemotherapy with radiation therapy may kill more tumor cells and allow doctors to preserve the part of the body where the cancer started. It is not yet known which regimen of cisplatin and fluorouracil combined with radiation therapy is more effective in treating resectable cancer of the hypopharynx or larynx.

PURPOSE: Randomized phase III trial to compare the effectiveness of two regimens of cisplatin and fluorouracil combined with radiation therapy in preserving the larynx in patients who have resectable cancer of the hypopharynx or larynx.

Read the detailed description

OBJECTIVES:

  • Compare relapse-free survival and larynx preservation in patients with resectable hypopharyngeal or laryngeal cancer treated with sequential vs alternating cisplatin and fluorouracil and radiotherapy.
  • Compare the health-related quality of life in patients treated with these regimens.
  • Compare the cost-effectiveness of these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified by performance status, disease site, tumor stage, node stage, and center.

Patients are randomized to one of two treatment arms. Both groups may receive either conventional radiotherapy in single daily fractions, 5 days per week, for 7 weeks (option 1) or hyperfractionated radiotherapy in 2 daily fractions, 5 days per week, for 4-5 weeks (option 2), according to institutional policy.

  • Arm I: Patients receive cisplatin and fluorouracil every 3 weeks. Patients with a complete or partial response on day 42 receive 2 additional courses of chemotherapy followed by 7 weeks of radiotherapy beginning on day 80. After radiotherapy, patients with a complete remission enter follow-up; those with a partial remission proceed to surgery. Patients with stable or progressive disease proceed immediately to surgery with or without postoperative radiotherapy.
  • Arm II: Patients receive cisplatin and fluorouracil every 3 weeks for 4 courses. Patients treated on radiotherapy option 1 are evaluated 2 months after completion of radiotherapy; those with a complete remission enter follow-up while all others proceed to surgery. Patients treated on option 2 are evaluated on day 42; those with a partial or complete response complete chemoradiotherapy and are then evaluated and treated like option 1 patients. Patients with stable or progressive disease on day 42 proceed to surgery with or without a third course of chemotherapy on week 7.

Patients are followed every 3 months for 3 years and at least every 6 months thereafter.

PROJECTED ACCRUAL: A total of 564 patients will be accrued for this study within 4 years.

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Conditions studied

  • Head and Neck Cancer

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Keywords

  • stage II squamous cell carcinoma of the hypopharynx
  • stage III squamous cell carcinoma of the hypopharynx
  • stage IV squamous cell carcinoma of the hypopharynx
  • stage III squamous cell carcinoma of the larynx
  • stage IV squamous cell carcinoma of the larynx
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In context

Laryngeal Diseases

136 studies on the registry are indexed under Laryngeal Diseases; 23 are open to participants now.

This study's planned enrollment of 564 is above the median of 41 across 111 interventional studies indexed under Laryngeal Diseases.

Browse Laryngeal Diseases studies →

Lead sponsor

European Organisation for Research and Treatment of Cancer - EORTC is the lead sponsor of 342 studies on the registry; 23 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically proven squamous cell carcinoma of the head and neck, including:

    • Stage III/IV cancer of the glottic or supraglottic larynx

      • Eligible T4 tumor defined as:

        • Bulging the valleculae
        • Bulging the hyothyroid membrane
        • Minimal thyroid cartilage invasion or suspicion of invasion on imaging
    • Stage II/III/IV cancer of the pyriform sinus or of the hypopharyngeal aspect of the aryepiglottic fold (with or without extension to postcricoid area)

      • No massive destruction of the thyroid cartilage
      • No continuity between primary tumor and a lymph node
  • Operable on first attempt (as assessed by head and neck surgeon) by classical total laryngectomy with or without partial pharyngectomy

    • No requirement for extended surgery (circumferential pharyngolaryngectomy)
    • No tumor suitable for partial (functional) surgery or requiring extended surgery that necessitates any kind of flap for closure
    • No N2c tumor unless no requirement for bilateral resection of internal jugular veins
  • Measurable or evaluable disease by panendoscopy and CT scan or MRI

    • Esophagoscopy required
    • Bronchofiberscopy recommended
  • No requirement for tracheotomy

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0-2 OR
  • WHO 0-2

Hematopoietic:

  • WBC at least 4,000/mm\^3

Hepatic:

  • Bilirubin no greater than 2.0 times normal

Renal:

  • Creatinine no greater than 1.5 mg/dL OR
  • Creatinine clearance at least 60 mL/min

Other:

  • No medical, psychological, or geographical condition that precludes study compliance
  • No serious nonmalignant systemic disease
  • No second malignancy except:

    • Carcinoma in situ of the cervix
    • Adequately treated nonmelanomatous skin cancer
  • No poor nutritional status unlikely to be restored to fair status within 3 weeks
  • No contraindication to CT scan or general anesthesia

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior anticancer biologic therapy

Chemotherapy

  • No prior anticancer chemotherapy

Endocrine therapy

  • No prior anticancer endocrine therapy

Radiotherapy

  • No prior anticancer radiotherapy

Surgery

  • See Disease Characteristics

Other

  • No other prior anticancer therapy
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Enrollment
564 participants (estimated)

Interventions

  • Drugcisplatin
  • Drugfluorouracil
  • Procedureconventional surgery
  • Procedureneoadjuvant therapy
  • Radiationradiation therapy
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Study locations

20 sites
  • Algemeen Ziekenhuis Middelheim
    Antwerp, 2020, Belgium
  • Universitair Ziekenhuis Antwerpen
    Edegem, B-2650, Belgium
  • CHR de Besancon - Hopital Jean Minjoz
    Besancon, 25030, France
  • Centre Regional Francois Baclesse
    Caen, 14076, France
  • Centre Hospitalier Universitaire de Dijon
    Dijon, 21033, France
  • Centre de Lutte Contre le Cancer, Georges-Francois Leclerc
    Dijon, 21079, France
  • Centre Oscar Lambret
    Lille, 59020, France
  • Centre Hospitalier Regional et Universitaire de Lille
    Lille, 59037, France
  • CRLCC Nantes - Atlantique
    Nantes-Saint Herblain, 44805, France
  • Centre Antoine Lacassagne
    Nice, 06189, France
  • Hopital Charles Nicolle
    Rouen, 76031, France
  • Centre Alexis Vautrin
    Vandoeuvre-les-Nancy, 54511, France
  • Rambam Medical Center
    Haifa, 31096, Israel
  • Istituto Nazionale per lo Studio e la Cura dei Tumori
    Milano (Milan), 20133, Italy
  • Ospedale Civile Monselice
    Monselice, Padova, 35043, Italy
  • Azienda Ospedaliera "Santa Maria Degli Angeli"
    Pordenone, 33170, Italy
  • Vrije Universiteit Medisch Centrum
    Amsterdam, 1007 MB, Netherlands
  • Leiden University Medical Center
    Leiden, 2300 CA, Netherlands
  • Academisch Ziekenhuis Maastricht
    Maastricht, 6202 AZ, Netherlands
  • Centre Hospitalier Universitaire Vaudois
    Lausanne, CH-1011, Switzerland
07

References and documents

Publications

  • Lefebvre JL, Rolland F, Tesselaar M, Bardet E, Leemans CR, Geoffrois L, Hupperets P, Barzan L, de Raucourt D, Chevalier D, Licitra L, Lunghi F, Stupp R, Lacombe D, Bogaerts J, Horiot JC, Bernier J, Vermorken JB; EORTC Head and Neck Cancer Cooperative Group; EORTC Radiation Oncology Group. Phase 3 randomized trial on larynx preservation comparing sequential vs alternating chemotherapy and radiotherapy. J Natl Cancer Inst. 2009 Feb 4;101(3):142-52. doi: 10.1093/jnci/djn460. Epub 2009 Jan 27. PubMed 19176454 ↗
  • Lefebvre J, Horiot J, Rolland F, et al.: Phase III study on larynx preservation comparing induction chemotherapy and radiotherapy versus alternating chemoradiotherapy in resectable hypopharynx and larynx cancers. EORTC protocol 24954-22950. [Abstract] J Clin Oncol 25 (Suppl 18): A-LBA6016, 303s, 2007.
  • Bottomley A, Tridello G, Coens C, Rolland F, Tesselaar ME, Leemans CR, Hupperets P, Licitra L, Vermorken JB, Van Den Weyngaert D, Truc G, Barillot I, Lefebvre JL. An international phase 3 trial in head and neck cancer: quality of life and symptom results: EORTC 24954 on behalf of the EORTC Head and Neck and the EORTC Radiation Oncology Group. Cancer. 2014 Feb 1;120(3):390-8. doi: 10.1002/cncr.28392. Epub 2013 Oct 25. PubMed 24452673 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 9, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00002839
Lead sponsor
European Organisation for Research and Treatment of Cancer - EORTC
Responsible party
Sponsor
First posted
Jan 27, 2003
Start date
Jul 1996
Primary completion
May 2004
Last update
Jul 9, 2018

Study contacts

Jean-Louis Lefebvre, MD
study chair · Centre Oscar Lambret
Jean-Claude Horiot, MD, PhD
study chair · Centre Georges Francois Leclerc
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2018. You cannot join it, but the record below documents what was studied.

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