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Hypofractionated Definitive Chemoradiotherapy for Oesophageal Cancer (HYROC)

2 de junio de 2026 actualizado por: 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.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Estimado)

60

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

Ubicaciones de estudio

  • Países Bajos
      • Amsterdam, Países Bajos
        • Reclutamiento
        • Amsterdam UMC
        • Contacto:
        • Contacto:
        • Investigador principal:
          • Peter S.N. van Rossum
      • Apeldoorn, Países Bajos
        • Aún no reclutando
        • Gelre Ziekenhuizen
        • Contacto:
          • Dr. K. Eechoute
          • Número de teléfono: +31 88 105 3300
          • Correo electrónico: k.eechoute@gelre.nl
        • Investigador principal:
          • Karel Eechoute
      • Apeldoorn, Países Bajos
        • Aún no reclutando
        • Radiotherapiegroep
        • Contacto:
        • Investigador principal:
          • Paul M. Jeene
      • Groningen, Países Bajos
        • Reclutamiento
        • UMCG
        • Contacto:
          • Dr. C.T. Muijs
          • Número de teléfono: +31 50 361 6161
          • Correo electrónico: c.t.muijs@umcg.nl
        • Investigador principal:
          • Christina T. Muijs
      • Heerlen, Países Bajos
        • Aún no reclutando
        • Zuyderland Medisch Centrum
        • Contacto:
        • Investigador principal:
          • Fabienne Warmerdam
      • Maastricht, Países Bajos
        • Aún no reclutando
        • Maastro
        • Contacto:
        • Investigador principal:
          • Maaike Berbée
      • Nijmegen, Países Bajos
        • Aún no reclutando
        • Radboud UMC
        • Contacto:
        • Investigador principal:
          • Heidi Rütten

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Descripción

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.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Hypofractionated definitive chemoradiotherapy
Participants receive 20 fractions of 2.4 Gy with concurrent 6 cycles of carboplatin and paclitaxel in 4 weeks.
Radiación: Hypofractionation
20 fractions of 2.4 Gy
Droga: 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.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Proportion of patients who complete all 20 fractions of radiotherapy and receive all 6 cycles of concurrent chemotherapy.
Periodo de tiempo: 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.

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Incidence and severity of grade ≥4 RIL, and absolute lymphocyte count nadirs.
Periodo de tiempo: 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.
Periodo de tiempo: 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.
Periodo de tiempo: Immediately after the treatment.
Immediately after the treatment.

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Incidence and severity of treatment-related adverse events.
Periodo de tiempo: 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).
Periodo de tiempo: 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.
Periodo de tiempo: 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.
Periodo de tiempo: 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.
Periodo de tiempo: 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.
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

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

Colaboradores

University Medical Center Groningen

Investigadores

  • Investigador principal: Peter S.N. van Rossum, Amsterdam University Medical Center

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

28 de abril de 2026

Finalización primaria (Estimado)

1 de abril de 2028

Finalización del estudio (Estimado)

1 de julio de 2028

Fechas de registro del estudio

Enviado por primera vez

13 de abril de 2026

Primero enviado que cumplió con los criterios de control de calidad

2 de junio de 2026

Publicado por primera vez (Actual)

8 de junio de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

8 de junio de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

2 de junio de 2026

Última verificación

1 de junio de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • NL-010499

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Descripción del plan IPD

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.

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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