Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma
| Status: | Terminated |
|---|---|
| Conditions: | Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/17/2017 |
| Start Date: | September 23, 2014 |
| End Date: | December 8, 2017 |
A Phase II Study of Transoral Robotic Surgery With Adjuvant Therapy for Surgically Resectable HPV-positive Oropharyngeal Cancer
Standard-of-care treatment options for oropharyngeal cancer often result in long-term side
effects that interfere with normal quality of life. A minimally-invasive transoral robotic
surgery (TORS) approach has been developed to operate on the disease site while affecting the
surrounding tissue as little as possible. Researchers think that this approach may help to
control the disease and avoid such long-term side effects.
The goal of this clinical research study is to learn if minimally-invasive transoral robotic
surgery (TORS) can help to control HPV-positive oropharyngeal cancer. Transoral means through
the mouth. The TORS approach is called the Intuitive Surgical da Vinci Surgical System.
Researchers also want to learn if this surgery affects participants' ability to speak and
swallow.
effects that interfere with normal quality of life. A minimally-invasive transoral robotic
surgery (TORS) approach has been developed to operate on the disease site while affecting the
surrounding tissue as little as possible. Researchers think that this approach may help to
control the disease and avoid such long-term side effects.
The goal of this clinical research study is to learn if minimally-invasive transoral robotic
surgery (TORS) can help to control HPV-positive oropharyngeal cancer. Transoral means through
the mouth. The TORS approach is called the Intuitive Surgical da Vinci Surgical System.
Researchers also want to learn if this surgery affects participants' ability to speak and
swallow.
Study Surgery:
If you are found to be eligible to take part in this study, you will be scheduled for
surgery. You will receive general anesthesia to make you sleep during the procedure. You will
be asked to sign a separate consent form that describes the anesthesia and its risks. If the
doctor thinks it is needed, the abnormal area will be looked at with a tube that has a
lighted camera on one end (called a laryngoscopy) to check the size of the tumor and to look
for any additional cancerous areas.
The tumor will be exposed with standard equipment after the teeth are protected with a dental
guard. Using the robotic surgical system, the tumor will be removed.
Your affected lymph nodes will be surgically removed through your neck. The robotic system
will not be used for that part of the surgery. The nerve that controls the shoulder, the
blood vessel that brings blood back to the heart from the brain and neck, and the major
muscle of the front of the neck will all be saved, unless the tumor in the lymph nodes has
grown directly into those areas. A drain will be placed before the surgical wound is closed.
The drain will usually be removed within a week after surgery.
Based on the results of surgery, you will receive adjuvant therapy (therapy after the
surgery). For example, if your surgery does not remove enough of the cancer, you will be
referred to receive radiation therapy. There will likely need to be a 1-2 week delay before
you can receive radiation therapy. Your doctor will discuss this therapy with you in more
detail, including the risks.
Length of Study:
The surgery will be stopped if the doctor thinks the tumor is too large to be removed with
the robotic system. You will be taken off study if you are unable to follow study directions.
Your participation on the study will be over after the follow-up visits and data collection.
Follow-Up Visits:
Within 1-4 weeks after surgery (+/- 3 days):
- You will have a physical exam, including a cranial nerve exam of your tongue, palate,
and facial nerves.
- You will have an MBS.
- You will meet with a speech pathologist.
- You will complete the questionnaires about your speech and swallowing function.
At 6 months (+/- 2 months), 12 months (+/- 2 months), and 24 months (+/- 6 months) after
surgery:
- You will have an MBS.
- You will have a cranial nerve exam of your tongue, palate, and facial nerves.
- You will meet with a speech pathologist.
- You will complete the questionnaires about your speech and swallowing function.
As often as the doctor thinks it is needed for up to 5 years after surgery, the study staff
will check your medical record to find out how you are doing and about any treatments and
follow-up you have had.
This is an investigational study. The robotic surgical procedure (the daVinci Surgical
System) is FDA approved and commercially available. The study doctor can explain how the
surgery is designed to work.
Up to 150 participants will be enrolled in this study. All will be enrolled at MD Anderson.
If you are found to be eligible to take part in this study, you will be scheduled for
surgery. You will receive general anesthesia to make you sleep during the procedure. You will
be asked to sign a separate consent form that describes the anesthesia and its risks. If the
doctor thinks it is needed, the abnormal area will be looked at with a tube that has a
lighted camera on one end (called a laryngoscopy) to check the size of the tumor and to look
for any additional cancerous areas.
The tumor will be exposed with standard equipment after the teeth are protected with a dental
guard. Using the robotic surgical system, the tumor will be removed.
Your affected lymph nodes will be surgically removed through your neck. The robotic system
will not be used for that part of the surgery. The nerve that controls the shoulder, the
blood vessel that brings blood back to the heart from the brain and neck, and the major
muscle of the front of the neck will all be saved, unless the tumor in the lymph nodes has
grown directly into those areas. A drain will be placed before the surgical wound is closed.
The drain will usually be removed within a week after surgery.
Based on the results of surgery, you will receive adjuvant therapy (therapy after the
surgery). For example, if your surgery does not remove enough of the cancer, you will be
referred to receive radiation therapy. There will likely need to be a 1-2 week delay before
you can receive radiation therapy. Your doctor will discuss this therapy with you in more
detail, including the risks.
Length of Study:
The surgery will be stopped if the doctor thinks the tumor is too large to be removed with
the robotic system. You will be taken off study if you are unable to follow study directions.
Your participation on the study will be over after the follow-up visits and data collection.
Follow-Up Visits:
Within 1-4 weeks after surgery (+/- 3 days):
- You will have a physical exam, including a cranial nerve exam of your tongue, palate,
and facial nerves.
- You will have an MBS.
- You will meet with a speech pathologist.
- You will complete the questionnaires about your speech and swallowing function.
At 6 months (+/- 2 months), 12 months (+/- 2 months), and 24 months (+/- 6 months) after
surgery:
- You will have an MBS.
- You will have a cranial nerve exam of your tongue, palate, and facial nerves.
- You will meet with a speech pathologist.
- You will complete the questionnaires about your speech and swallowing function.
As often as the doctor thinks it is needed for up to 5 years after surgery, the study staff
will check your medical record to find out how you are doing and about any treatments and
follow-up you have had.
This is an investigational study. The robotic surgical procedure (the daVinci Surgical
System) is FDA approved and commercially available. The study doctor can explain how the
surgery is designed to work.
Up to 150 participants will be enrolled in this study. All will be enrolled at MD Anderson.
Inclusion Criteria:
1. Patients with a previously untreated, T1 or T2, N0-N2b transorally resectable (as
determined by the treating surgeon), histologically proven HPV positive, squamous cell
carcinoma (SCC) of the oropharynx.
2. Eastern Cooperative Oncology Group (ECOG) PS 0-2.
3. Age >/= 18 years.
4. Negative serum pregnancy test in females of childbearing potential.
5. Patients must sign a study-specific informed consent form prior to treatment.
Exclusion Criteria:
1. Evidence of distant metastases (below the clavicle) by clinical or radiographic
examination.
2. Evidence of any other primary cancers or metastases. Evidence of deep soft-tissue or
bony invasion, which would preclude TMIS by clinical and/or radiographic exam.
3. Contraindications to general anesthesia.
4. Patients who have had chemotherapy or radiotherapy to the oropharynx prior to entering
the study.
5. Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements
6. Patients with tumors whose resection would necessitate a free-tissue transfer for
reconstruction of the surgical defect.
We found this trial at
1
site
1515 Holcombe Blvd
Houston, Texas 77030
Houston, Texas 77030
713-792-2121
University of Texas M.D. Anderson Cancer Center The mission of The University of Texas MD...
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