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采用先进技术治疗声门上型鳞状细胞癌:肿瘤学结局、功能结局、生活质量和成本效益的观察性前瞻性评估(SUPRA-QoL)。

Treatment of supraglottic squamous cell carcinoma with advanced technologies: observational prospective evaluation of oncological outcomes, functional outcomes, quality of life and cost-effectiveness (SUPRA-QoL).

机构信息

Department of Otorhinolaryngology, UCLouvain, CHU UCL Namur (Site Godinne), Head & Neck Surgery, Yvoir, Belgium.

Department of Nuclear Medicine, UCLouvain, CHU UCL Namur (Site Godinne), Yvoir, Belgium.

出版信息

BMC Cancer. 2023 Jun 1;23(1):493. doi: 10.1186/s12885-023-10953-9.

Abstract

BACKGROUND

Over the past decade, therapeutic options in head and neck supraglottic squamous cell carcinoma have constantly evolved. The classical total laryngectomy has been partially replaced by alternative organ- and function-sparing techniques with the same prognosis but less morbidity, such as Radiotherapy, Transoral Laser Microsurgery (TLM) and Trans-Oral Robotic Surgery (TORS). Up to now, a prospective comparison of these innovant techniques has not been conducted.

METHODS/DESIGN: We will conduct an original international multicentric prospective nonrandomized clinical trial to compare the efficacy between these treatments (Arm 1: Radiotherapy ± chemotherapy; Arm 2: TLM and Arm 3: TORS) with 4 classes of outcomes: quality of life (QoL), oncological outcomes, functional outcomes and economic resources. The population will include cT1-T2 /cN0-N1/M0 supraglottic squamous cell carcinoma. The primary outcome is a Clinical Dysphagia QoL evaluation assessed by the MD Anderson Dysphagia questionnaire. Secondary outcomes include others QoL evaluation, oncological and functional measures and cost parameters. The sample size needs to reach 36 patients per arm (total 108).

DISCUSSION

In the current literature, no prospective head-to-head trials are available to compare objectively these different treatments. With the increase of highly efficient treatments and the increase of oncological survival, it is imperative also to develop management strategies that optimize QoL and functional results. We will conduct this innovate prospective trial in order to obtain objective data in these two main issues.

TRIAL REGISTRATION

NCT05611515 posted on 10/11/2022 (clinicaltrial.fgov).

摘要

背景

在过去的十年中,头颈部声门上型鳞状细胞癌的治疗选择不断发展。经典的全喉切除术已部分被具有相同预后但发病率更低的替代器官和功能保留技术所取代,例如放疗、经口激光显微手术(TLM)和经口机器人手术(TORS)。到目前为止,这些创新技术还没有进行前瞻性比较。

方法/设计:我们将开展一项原创的国际多中心前瞻性非随机临床试验,比较这些治疗方法(臂 1:放疗±化疗;臂 2:TLM 和臂 3:TORS)的疗效,疗效评估指标包括 4 类:生活质量(QoL)、肿瘤学结果、功能结果和经济资源。纳入人群为 cT1-T2/cN0-N1/M0 声门上型鳞状细胞癌。主要结局是通过 MD Anderson 吞咽困难问卷评估临床吞咽困难 QoL。次要结局包括其他 QoL 评估、肿瘤学和功能指标以及成本参数。每个治疗臂需要达到 36 例患者(共 108 例)。

讨论

在目前的文献中,没有前瞻性头对头试验可以客观比较这些不同的治疗方法。随着高效治疗方法的增加和肿瘤生存率的提高,也必须制定管理策略,以优化 QoL 和功能结果。我们将开展这项创新性的前瞻性试验,以在这两个主要问题上获得客观数据。

试验注册

NCT05611515 于 2022 年 10 月 11 日在 clinicaltrial.fgov 上注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/547b/10234038/6c35ceecb3b6/12885_2023_10953_Fig1_HTML.jpg

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