Hypofractionated Definitive Chemoradiotherapy for Oesophageal Cancer (HYROC)

June 2, 2026 updated by: Peter S.N. van Rossum, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

HYpofractionated Definitive chemoRadiotherapy for Oesophageal Cancer (HYROC): a Multicenter Phase II Feasibility Study

The goal of this clinical trial is to learn if hypofractionation of definitive chemoradiotherapy can treat patients with locally advanced esophageal cancer. The main question it aims to answer is if this treatment is feasible and safe. We also want to investigate the toxicity, in particular the radiation-induced lymphopenia.

Normally, definitive chemoradiotherapy for patients with locally advanced esophageal cancer consist of 28 fractions of 1.8 Gy with concurrent 6 cycles of carboplatin and paclitaxel in 5.5 weeks. In this study, participants will receive 20 fractions of 2.4 Gy with concurrent 6 cycles of carboplatin and paclitaxel in 4 weeks. The follow-up will be conform standard-of-care.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Netherlands
      • Amsterdam, Netherlands
      • Apeldoorn, Netherlands
        • Not yet recruiting
        • Gelre Ziekenhuizen
        • Contact:
        • Principal Investigator:
          • Karel Eechoute
      • Apeldoorn, Netherlands
        • Not yet recruiting
        • Radiotherapiegroep
        • Contact:
        • Principal Investigator:
          • Paul M. Jeene
      • Groningen, Netherlands
        • Recruiting
        • UMCG
        • Contact:
        • Principal Investigator:
          • Christina T. Muijs
      • Heerlen, Netherlands
        • Not yet recruiting
        • Zuyderland Medisch Centrum
        • Contact:
        • Principal Investigator:
          • Fabienne Warmerdam
      • Maastricht, Netherlands
        • Not yet recruiting
        • Maastro
        • Contact:
        • Principal Investigator:
          • Maaike Berbée
      • Nijmegen, Netherlands
        • Not yet recruiting
        • Radboud UMC
        • Contact:
        • Principal Investigator:
          • Heidi Rütten

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥18 years.
  • Histologically confirmed oesophageal or GOJ carcinoma (adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, large cell carcinoma or undifferentiated carcinoma).
  • An oesophageal tumour location can involve the proximal, middle and/or distal third of the oesophagus.
  • If the tumour extends below the GOJ into the cardia, the bulk of the tumour must involve the oesophagus or GOJ (i.e. Siewert type I or II). The tumour should not extend more than 5 cm into the stomach.
  • Clinical stage cT1N1-3M0 or cT2-4aN0-3M0, using the Tumour-Node-Metastasis classification system (TNM, 8th edition), deemed suitable for definitive CRT with curative intent.
  • No evidence of distant metastases (M0), as confirmed by standard staging procedures including Fluorine-18 Fluorodeoxyglucose (18F-FDG) PET/CT.
  • World Health Organization (WHO) performance status 0-2.

  • Adequate hematologic, renal, and hepatic function:

    • Platelet count ≥100 × 10⁹/L
    • Absolute neutrophil count ≥1.5 × 10⁹/L
    • Glomerular filtration rate ≥50 mL/min
    • Total bilirubin ≤1.5 × upper normal limit
  • Written informed consent obtained before any study-specific procedures.
  • Able to comply with study procedures and scheduled follow-up.

Exclusion Criteria:

  • High grade dysplasia without histological evidence of invasive carcinoma.
  • Presence of distant metastases (M1).
  • Patients with pathological lymph nodes at both supraclavicular and celiac trunk level.
  • Prior thoracic or upper abdominal radiotherapy that would preclude safe delivery of the planned radiotherapy dose.
  • Prior chemotherapy for oesophageal or gastric cancer.
  • Presence of an oesophageal stent.
  • Active uncontrolled infection.
  • Clinically significant comorbidities that would preclude safe administration of CRT (e.g. severe pulmonary, cardiac, or hepatic impairment).
  • Pregnancy or breastfeeding.
  • Known hypersensitivity to paclitaxel, carboplatin, or any of their excipients.
  • History of malignancies, with the exception of basal cell carcinoma of the skin, ductal carcinoma in situ of breast, cervical intraepithelial neoplasia of uterine cervix, or other malignancies that do not interfere with the prognosis of oesophageal cancer.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Hypofractionated definitive chemoradiotherapy
Participants receive 20 fractions of 2.4 Gy with concurrent 6 cycles of carboplatin and paclitaxel in 4 weeks.
Radiation: Hypofractionation
20 fractions of 2.4 Gy
Drug: carboplatin + paclitaxel (CP)
6 cycles of carboplatin (AUC 2) and paclitaxel (50 mg/m2) given every 4-5 days, 6 cycles in total in 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of patients who complete all 20 fractions of radiotherapy and receive all 6 cycles of concurrent chemotherapy.
Time Frame: Immediately after the treatment.
Feasibility, defined as ≥50% of patients completing all 20 radiotherapy fractions and all 6 planned chemotherapy cycles.
Immediately after the treatment.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence and severity of grade ≥4 RIL, and absolute lymphocyte count nadirs.
Time Frame: Baseline, after first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after the treatment.
The RIL will be scored according to CTCAE v5.0.
Baseline, after first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after the treatment.
Incidence of grade ≥3 acute toxicity.
Time Frame: Baseline, after first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after the treatment.
The acute toxicity will be scored according to CTCAE v5.0.
Baseline, after first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after the treatment.
Proportion of patients who complete at least 19 of 20 radiotherapy fractions and at least 5 out of 6 planned chemotherapy cycles.
Time Frame: Immediately after the treatment.
Immediately after the treatment.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence and severity of treatment-related adverse events.
Time Frame: After first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
The adverse events will be scored according to CTCAE v5.0.
After first week of treatment, after second week of treatment, after third week of treatment, after fourth week of treatment, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
Progression Free Survival (PFS) and Overall Survival (OS).
Time Frame: 1 year, 2 years, 3 years, 4 years, 5 years
1 year, 2 years, 3 years, 4 years, 5 years
Patient-reported quality of life during and after the treatment.
Time Frame: Baseline, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
Assessed using validated questionnaires collected through the POCOP national prospective cohort.
Baseline, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
Costs associated with the treatment.
Time Frame: 3 months after treatment.
3 months after treatment.
Feasibility and clinical outcomes of the treatment compared to a propensity score-matched standard-of-care cohort.
Time Frame: 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
A propensity score-matched cohort will be assembled using data from the University Medical Center Groningen (UMCG) prospective registry for toxicity comparison, and the Netherlands Cancer Registry (NCR) for OS comparison.
3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
1. Association of dosimetric parameters of the lungs and heart with radiation-induced lymphopenia. 2. Association of target volume size with radiation-induced lymphopenia.
Time Frame: 1 month after treatment
  1. Associations between predefined lung and heart dose-volume parameters and radiation-induced lymphopenia will be assessed. Dose-volume parameters will include V5Gy, V10Gy, V15Gy, V20Gy, V25Gy, V30Gy, V35Gy, V40Gy, V45Gy, and mean dose. Radiation-induced lymphopenia will be assessed as grade ≥3 at any time during treatment, grade ≥4 at any time during treatment, and grade ≥3 in week 3 of treatment. Associations will be reported separately for each parameter and definition as odds ratios with 95% confidence intervals.
  2. Associations between the predefined target volume parameter 'planning target volume' (PTV) measured in cubic centimeters, and radiation-induced lymphopenia will be assessed using the same definitions as described above. Associations will be reported separately for PTV and radiation-induced lymphopenia definition as odds ratio (per 100 cm3) with 95% confidence interval.
1 month after treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Collaborators

University Medical Center Groningen

Investigators

  • Principal Investigator: Peter S.N. van Rossum, Amsterdam University Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 28, 2026

Primary Completion (Estimated)

April 1, 2028

Study Completion (Estimated)

July 1, 2028

Study Registration Dates

First Submitted

April 13, 2026

First Submitted That Met QC Criteria

June 2, 2026

First Posted (Actual)

June 8, 2026

Study Record Updates

Last Update Posted (Actual)

June 8, 2026

Last Update Submitted That Met QC Criteria

June 2, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NL-010499

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Due to the sensitivity of the collected data, the data itself cannot be published or shared without restrictions. We will consult the Data Protection Officer and Research Data Management regarding potential for sharing the data, and Legal Research Support regarding setting up conditions for reuse.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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