RATIONALE: Endoscopic surgery is a less invasive type of surgery for laryngeal cancer and may have fewer side effects and improve recovery. Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known whether endoscopic surgery is more effective than radiation therapy in treating laryngeal cancer of the glottis. PURPOSE: This randomized phase II trial is studying endoscopic surgery to see how well it works compared with radiation therapy in treating patients with stage 0, stage I, or stage II laryngeal cancer of the glottis.
OBJECTIVES: * Determine the feasibility of conducting a large phase III randomized study in the future, comparing radiotherapy vs endoscopic excision in patients with stage 0-II laryngeal cancer of the glottis. * Determine patient acceptability of the proposed trial design. * Compare the effect of using dedicated head and neck research nurses vs general nurses on patient recruitment. * Refine outcome measures, including voice analysis and quality of life. OUTLINE: This is a randomized, controlled, multicenter, pilot study. Patients are stratified according to participating center and T stage (Tis or T1 vs T2a). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients undergo endoscopic excision via CO\_2 laser or cold steel. * Arm II: Patients undergo radiotherapy once daily, 5 days a week, for 3-4 weeks. Patients undergo vocal analysis at baseline and at 6 months and 1 and 2 years after randomization. Quality of life is assessed at baseline, at 1 year, and then annually for 5 years. After completion of study treatment, patients are followed periodically for up to 5 years. Peer Reviewed and Funded or Endorsed by Cancer Research UK PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Enrollment
50
Southmead Hospital
Bristol, England, United Kingdom
Aintree University Hospital
Liverpool, England, United Kingdom
Clatterbridge Centre for Oncology
Merseyside, England, United Kingdom
James Cook University Hospital
Middlesbrough, England, United Kingdom
Norfolk and Norwich University Hospital
Norwich, England, United Kingdom
Royal Infirmary - Castle
Glasgow, Scotland, United Kingdom
Feasibility
Patient acceptability
Voice analysis
Quality of life
Economic assessment
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