A Phase II Randomized Trial for Early-stage Squamous Cell Carcinoma of the Oropharynx: Radiotherapy vs Trans-oral Robotic Surgery (ORATOR) (ORATOR)
This study is currently recruiting participants.
(see Contacts and Locations)
Verified July 2016 by Lawson Health Research Institute
Sponsor:
Lawson Health Research Institute
Information provided by (Responsible Party):
David Palma, Lawson Health Research Institute
ClinicalTrials.gov Identifier:
NCT01590355
First received: May 1, 2012
Last updated: July 11, 2016
Last verified: July 2016
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Purpose
The historical standard treatment for early-stage squamous cell carcinoma of the oropharynx is radiation therapy. Some patients require chemotherapy with the radiation, and some patients require surgery if the tumour or lymph nodes have not responded after radiation.
This study will compare radiation therapy with a new surgical treatment called transoral robotic surgery (TORS). TORS is a new surgical approach using a robot to assist the surgeon in removing the tumour, potentially with fewer side effects than older surgical techniques.
| Condition | Intervention | Phase |
|---|---|---|
|
Early-Stage Squamous Cell Carcinoma of the Oropharynx |
Radiation: Radiotherapy Procedure: Transoral Robotic Surgery + Neck Dissection |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Randomized Trial for Early-stage Squamous Cell Carcinoma of the Oropharynx: Radiotherapy vs Trans-oral Robotic Surgery (ORATOR) |
Further study details as provided by Lawson Health Research Institute:
Primary Outcome Measures:
- Quality of Life [ Time Frame: 1-year post treatment ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Overall Survival [ Time Frame: At the end of 3 years and at the end of 5 years ] [ Designated as safety issue: No ]
- Progression-free survival [ Time Frame: At the end of 3 years and at the end of 5 years ] [ Designated as safety issue: No ]
- Quality of life at other time points [ Time Frame: Every 6 months for 5 years from 1st date of treament ] [ Designated as safety issue: No ]
- Toxicity [ Time Frame: 5 years from date of first treatment ] [ Designated as safety issue: No ]
- Swallowing Function [ Time Frame: 5 years from date of first treatment ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 68 |
| Study Start Date: | June 2012 |
| Estimated Study Completion Date: | June 2021 |
| Estimated Primary Completion Date: | June 2021 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Radiotherapy plus or minus Chemotherapy
Radiotherapy plus or minus chemotherapy with surgical treatment for salvage of persistent disease
|
Radiation: Radiotherapy
Gross Tumour and Nodes: 70 Gy in 35 fractions over 7 weeks. High-risk nodal areas: 63 Gy in 35 fractions over 7 weeks. Low-risk nodal areas: 56 Gy in 35 fractions over 7 weeks
|
|
Experimental: Transoral Robotic Surgery + Neck Dissection
Transoral robotic excision will be carried out using the da Vinci surgical robot. The spatula cautery will be used to remove the tumours with 1 cm margins. At the time of surgery circumferential margins will be taken and sent for frozen section analysis. The resection will proceed until negative margins are obtained if feasible.
|
Procedure: Transoral Robotic Surgery + Neck Dissection
Transoral robotic excision will be carried out using the da Vinci surgical robot.
|
Eligibility| Ages Eligible for Study: | 18 Years and older (Adult, Senior) |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- age 18 or older
- willing to provide informed consent
- ECOG performance status 0-2
- Histologically confirmed squamous cell carcinoma primary rumour site in the oropharynx (includes tonsil, soft palate, base of tongue, walls of oropharynx)
- Tumour stage:T1 or T2, with likely negative resections at surgery
- Nodal stage: N0, N1, or N2 (less than or equal to 4 cm in maximum dimension in any plane, on either side of the neck), without extranodal extension on pre-randomization imaging.
- Patient assessed at head and neck multidisciplinary clinic (with assessment by radiation oncologist and surgeon) and presented at multidisciplinary tumour board prior to randomization.
Exclusion Criteria:
- Serious medical comorbidities or other contraindications to radiotherapy, chemotherapy or surgery
- Prior history of head and neck cancer within 5 years
- Prior head and neck radiation at any time
- Metastatic disease
- Inability to attend full course of radiotherapy or follow-up visits
- Neck disease with unknown primary site
- Prior invasive malignant disease unless disease-free for at least 5 years or more, with the exception of non-melanoma skin cancer
- unable or unwilling to complete QoL questionnaires
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01590355
Please refer to this study by its ClinicalTrials.gov identifier: NCT01590355
Contacts
| Contact: David Palma | 519-685-8500 | david.palma@lhsc.on.ca |
Locations
| Australia | |
| Royal Adelaide Hospital | Recruiting |
| Adelaide, Australia, 5000 | |
| Contact: Suren Krishnan, OMA,FRACS 61882225682 krishnan.suren@gmail.com | |
| Contact: Martin Borg, FRANZCR 0882286700 mborg@health.sa.gov.au | |
| Canada, British Columbia | |
| British Columbia Cancer Agency | Not yet recruiting |
| Vancouver, British Columbia, Canada, V5Z4E6 | |
| Contact: Eitan Prisman, FRCSC 604-877-6000 ext 2680 eitan.prisman@ubc.ca | |
| Contact: Eric Berthelet, FRCPC 604-877-6000 ext 2680 eberthelet@bccancer.bc.ca | |
| Canada, Ontario | |
| London Regional Cancer Program of the Lawson Health Research Institute | Recruiting |
| London, Ontario, Canada, N6A 4L6 | |
| Contact: David Palma, MD, PhD 519-685-8650 david.palma@lhsc.on.ca | |
| Principal Investigator: David Palma, MD, PhD | |
| Principal Investigator: Anthony Nichols, MD | |
| The Ottawa Hospital Cancer Centre | Recruiting |
| Ottawa, Ontario, Canada, K1H 8L6 | |
| Contact: Stephanie Johnson-Obaseki, MD,FRCSC 613-737-7700 ext 78596 stjohnson@toh.on.ca | |
| Contact: Michael Odell, MD,FRCSC 613-737-7700 modell@toh.on.ca | |
| University Health Network | Recruiting |
| Toronto, Ontario, Canada, M5G2M9 | |
| Contact: John R deAlmeida, FRSCS 416-946-2182 john.dealmeida@uhn.ca | |
| Contact: Andrew Bayley, FRCPC 416-946-4501 ext 2121 andrew.bayley@rmp.uhn.on.ca | |
| Canada, Quebec | |
| Jewish General Hospital | Recruiting |
| Montréal, Quebec, Canada, H3T 1E2 | |
| Contact: Michael P Hier, MDCM,FRCSC 514-340-8222 ext 5387 mhier@jgh.mcgill | |
Sponsors and Collaborators
Lawson Health Research Institute
Investigators
| Principal Investigator: | David Palma, MD, PhD | London Regional Cancer Program of the Lawson Health Research Institute |
| Principal Investigator: | Anthony Nichols, MD | London Regional Cancer Program of the Lawson Health Research Institute |
More Information
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | David Palma, Principal Investigator, Lawson Health Research Institute |
| ClinicalTrials.gov Identifier: | NCT01590355 History of Changes |
| Other Study ID Numbers: | ORATOR |
| Study First Received: | May 1, 2012 |
| Last Updated: | July 11, 2016 |
| Health Authority: | Canada: Ethics Review Committee |
Additional relevant MeSH terms:
|
Carcinoma, Squamous Cell Carcinoma Oropharyngeal Neoplasms Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Squamous Cell |
Pharyngeal Neoplasms Otorhinolaryngologic Neoplasms Head and Neck Neoplasms Neoplasms by Site Pharyngeal Diseases Stomatognathic Diseases Otorhinolaryngologic Diseases |
ClinicalTrials.gov processed this record on September 23, 2016