Concurrent Chemoradiation With Concomitant Boost In Locally Advanced Rectal Cancer
29 mars 2016 mis à jour par: Lorenzo Fuccio, IRCCS Azienda Ospedaliero-Universitaria di Bologna
Concurrent Chemoradiation With Concomitant Boost In Locally Advanced Rectal Cancer: A Phase II Study.
Neoadjuvant chemoradiation (CRT), is considered the standard treatment of locally advanced rectal cancer with a positive impact on locoregional control and survival.However, patients with T4 rectal cancer show high risk of local recurrence after conventional treatment.
Therefore investigators designed a prospective Phase II study on patients with locally advanced rectal cancer or locally recurrences, to evaluate the efficacy in terms of pathological response and resectability of concomitant boost RT (55 Gy/5 weeks) with concurrent Raltitrexed and Oxaliplatin (Tom-Ox) chemotherapy.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
Neoadjuvant chemoradiation (CRT), is considered the standard treatment of locally advanced rectal cancer with a positive impact on locoregional control and survival.
However, patients with T4 rectal cancer show high risk of local recurrence (LR) after conventional treatment.
This was a prospective Phase II study on patients with locally advanced rectal cancer or locally recurrences, to evaluate the efficacy in terms of pathological response and resectability of concomitant boost RT (55 Gy/5 weeks) with concurrent Raltitrexed and Oxaliplatin (Tom-Ox) chemotherapy.
The primary aim was to assess the pathological complete response rate.
Key secondary aim was the resectability.
Secondary aims were evaluation of treatment-related acute and late toxicity, local control, disease-free survival and overall survival (OS).
The follow-up period of each subjects started after the radiochemotherapy treatment and ended after a maximum of 36 months of observation or until death.
Type d'étude
Interventionnel
Inscription (Réel)
18
Phase
- Phase 2
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Histologically proven locally advanced (T4N0-2) or locally recurrent rectal adenocarcinoma;
- Age ≥ 18 years;
- Eastern Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
Exclusion Criteria:
- Metastatic patients
- unfit surgery patients,
- pregnant or breast feeding females
- patients with clinically detectable ascites
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Radiotherapy plus Tom-Ox
Patients received concomitant boost RT (55 Gy/5 weeks) with concurrent Tom-Ox chemotherapy.
The concurrent chemotherapy consisted of 15 min intravenous infusion Raltitrexed (Tomudex ®) 3 mg/m2 and a two-hours intravenous infusion of Oxaliplatin (Eloxatin ®) at 130 mg/m 2, 20 min after raltitrexed, on days 1, 17, 35.
|
Radiotherapy was applied as conformal 3-D technique and was delivered with photon energies of 10 - 15 MV.
The beams were delivered by an Elekta Precise Linac equipped with standard multi leaf collimators (MLC).
A daily online check of isocenter position was performed using portal imaging, with set-up correction in case of displacement > 0.5 cm in any direction.
Radiation dose delivered to PTV2 was 45 Gy (1.8 Gy/fraction) with a concomitant boost dose to the PTV1 of 10 Gy with accelerated fractionation at 2.2 Gy/fraction, five consecutive days for week.
The concurrent chemotherapy consisted of 15 min intravenous infusion Raltitrexed (Tomudex ®) 3 mg/m2 and a two-hours intravenous infusion of Oxaliplatin (Eloxatin ®) at 130 mg/m 2, 20 min after raltitrexed, on days 1, 17, 35.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Number of patients defined as good responders (G1 or G2) according to the Mandard regression grading system.
Délai: 8 weeks after chemo-radiotherapy
|
Pathologic responses of the primary tumours were defined according to the Mandard regression grading system: grade 1 was recorded when no tumour cells remained in the primary tumour and lymph nodes (pCR); grade 2 was characterized by the presence of rare residual cancer cells scattered through the fibrosis; grade 3 was characterized by an increase in the number of residual cancer cells, but fibrosis still predominated; grade 4 showed residual cancer outgrowing fibrosis; and grade 5 was characterized by an absence of regressive changes.
Good responders were defined those patients with a pathologic response with Mandard G1 or G2 and poor responder patients with Mandard G3, G4 or G5.
|
8 weeks after chemo-radiotherapy
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Number of patients in which a surgical resection was feasible
Délai: 8 weeks after chemo-radiotherapy
|
8 weeks after chemo-radiotherapy
|
|
|
Number of participants with treatment-related adverse events as assessed by CTCAE v3.0
Délai: Up to 36 months. In details, follow-up examinations were performed 4 weeks after surgery and every 6 months until the established length of follow-up or death.
|
CTCAE v 3.0 was used to score acute and late radiation toxicity.
|
Up to 36 months. In details, follow-up examinations were performed 4 weeks after surgery and every 6 months until the established length of follow-up or death.
|
|
The number of patients without disease (i.e. rectal cancer) during the follow-up.
Délai: Up to 36 months.
|
The disease-free survival (DFS) was defined as the time from the diagnosis to the documented local or distant recurrence or last follow-up.
|
Up to 36 months.
|
|
The number of patients still alive at the end of follow-up
Délai: Up to 36 months
|
The overall-survival (OS) was defined as the time from the diagnosis until death for any cause or the last follow-up.
|
Up to 36 months
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Les enquêteurs
- Directeur d'études: Alessio G Morganti, Prof, Division of Radiation Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 janvier 2005
Achèvement primaire (Réel)
1 janvier 2008
Achèvement de l'étude (Réel)
1 février 2012
Dates d'inscription aux études
Première soumission
19 mars 2016
Première soumission répondant aux critères de contrôle qualité
29 mars 2016
Première publication (Estimation)
30 mars 2016
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
30 mars 2016
Dernière mise à jour soumise répondant aux critères de contrôle qualité
29 mars 2016
Dernière vérification
1 mars 2016
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies du système digestif
- Tumeurs
- Tumeurs par site
- Tumeurs gastro-intestinales
- Tumeurs du système digestif
- Maladies gastro-intestinales
- Maladies intestinales
- Tumeurs intestinales
- Maladies rectales
- Tumeurs colorectales
- Tumeurs rectales
- Mécanismes moléculaires de l'action pharmacologique
- Inhibiteurs d'enzymes
- Antimétabolites, Antinéoplasique
- Antimétabolites
- Agents antinéoplasiques
- Antagonistes de l'acide folique
- Raltitrexed
Autres numéros d'identification d'étude
- TOMOX Rectal Study
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
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