radiation therapy in treating patients with head and neck cancer

Conditions: Head and Neck Cancer; Non-melanomatous Skin Cancer

Summary: rationale: radiation therapy uses high-energy x-rays to damage tumor cells. it is not yet known which regimen of radiation therapy is more effective for head and neck cancer. purpose: randomized phase iii trial to compare the effectiveness of different regimens of radiation therapy in treating patients who have head and neck cancer.

objectives: * compare adjuvant continuous hyperfractionated accelerated radiotherapy vs conventional radiotherapy, in terms of preventing disease recurrence, in patients with head and neck cancer. * compare the early and late toxic effects of these treatments in this patient population. * compare disease-free and overall survival of patients receiving these treatments. * assess quality of life in patients receiving these treatments. outline: this is a randomized, multicenter study. patients are randomized to one of two treatment arms. * arm i: patients undergo radiotherapy 3 times daily, with an interval of at least 6 hours between any 2 treatments, 5 days a week, for just over 2 weeks, for a total of 13-14 treatment days. * arm ii: patients undergo radiotherapy daily, 5 days a week, for 6-6.5 weeks. quality of life is assessed at baseline and then annually for 5 years. patients are followed every 3 months for 3 years, every 6 months for 2 years, and then annually thereafter. projected accrual: a total of 460 patients (230 per arm) will be accrued for this study within 2-3 years.

Eligibility criteria:
disease characteristics: * histologically confirmed squamous cell carcinoma of the head and neck including, but not limited to, the following: * oral cavity * oropharynx * hypopharynx * larynx * nasal sinuses * skin * undergone curative surgery within the past 70 days * all macroscopic disease removed * at high or intermediate risk of recurrence * no low risk of recurrence * no evidence of distant metastases * considered treatable by radiotherapy patient characteristics: age: * not specified performance status: * not specified life expectancy: * not specified hematopoietic: * not specified hepatic: * not specified renal: * not specified other: * no other prior or concurrent malignancy that would preclude study participation * no other uncontrolled medical illness that would preclude study participation prior concurrent therapy: biologic therapy * not specified chemotherapy * not specified endocrine therapy * not specified radiotherapy * see disease characteristics surgery * see disease characteristics

Keywords: squamous cell carcinoma of the skin stage i squamous cell carcinoma of the lip and oral cavity stage ii squamous cell carcinoma of the lip and oral cavity stage iii squamous cell carcinoma of the lip and oral cavity stage iv squamous cell carcinoma of the lip and oral cavity stage i squamous cell carcinoma of the oropharynx stage ii squamous cell carcinoma of the oropharynx stage iii squamous cell carcinoma of the oropharynx stage iv squamous cell carcinoma of the oropharynx stage i squamous cell carcinoma of the hypopharynx 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 i squamous cell carcinoma of the larynx stage ii squamous cell carcinoma of the larynx stage iii squamous cell carcinoma of the larynx stage iv squamous cell carcinoma of the larynx stage i squamous cell carcinoma of the paranasal sinus and nasal cavity stage ii squamous cell carcinoma of the paranasal sinus and nasal cavity stage iii squamous cell carcinoma of the paranasal sinus and nasal cavity stage iv squamous cell carcinoma of the paranasal sinus and nasal cavity salivary gland squamous cell carcinoma stage i salivary gland cancer stage ii salivary gland cancer stage iii salivary gland cancer stage iv salivary gland cancer