Chemotherapy With or Without Surgery in Treating Patients With Metastatic Colorectal Cancer That Cannot Be Removed by Surgery
A Randomized Trial of Initial Surgery in Advanced Asymptomatic Colorectal Cancer Patients Receiving Chemotherapy for Metastatic Disease
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving chemotherapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether chemotherapy is more effective when given alone or together with surgery in treating patients with colorectal cancer.
PURPOSE: This randomized phase II/III trial is studying how well chemotherapy works and compares it with surgery followed by chemotherapy in treating patients with metastatic colorectal cancer that can not be removed by surgery.
調査の概要
詳細な説明
OBJECTIVES:
- To determine whether overall survival is improved in patients with asymptomatic, unresectable metastatic colorectal cancer treated with chemotherapy alone versus surgery followed by chemotherapy.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I (control arm): Patients receive systemic chemotherapy according to standard local practice. Patients who develop symptoms from their primary tumor receive treatment as required including surgery, if indicated.
- Arm II (experimental arm): Patients undergo surgery at the discretion of the surgeon. Beginning 8 weeks after completion of surgery, patients receive chemotherapy according to standard local practice.
Patients complete quality-of-life questionnaires (EQ-5D) at baseline and then periodically during and after completion of study treatment.
After completion of study treatment, patients are followed every 3 months.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
研究の種類
入学 (予想される)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
-
-
England
-
London、England、イギリス、NW1 2BU
- University College Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed colorectal cancer
- Metastases which are unresectable at presentation
- No known unresectable primary tumor on CT/MRI scan
Primary tumor does not require immediate or emergency intervention including surgery, radiotherapy, laser, or stenting
- Patients who are treated with colonic stents are eligible
- No unequivocal extensive peritoneal metastases
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Must be fit for systemic chemotherapy and surgery
- Hemoglobin > 10.0 g/dL
- WBC > 3.0 x 10^9/L
- Platelet count > 100 x 10^9/L
- Bilirubin < 25 μmol/L
- GFR > 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 3 months (female) or up to 2 months (male) after completion of study therapy
- No history of malignant disease within the past 5 years except for nonmelanomatous skin cancer or carcinoma in situ of the cervix
- No serious medical co-morbidity (e.g., uncontrolled inflammatory bowel disease, uncontrolled angina, recent [within the past 6 months] myocardial infarction, or another serious medical condition) judged to compromise ability to tolerate chemotherapy and/or surgery
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Concurrent participation in a trial of chemotherapy, if eligible, allowed
- Concurrent short-course radiotherapy for operable rectal cancer allowed
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
---|
Accrual rate in months 10 to 12 (phase II)
|
Overall survival for ≥ 2 years (phase III)
|
二次結果の測定
結果測定 |
---|
生活の質(フェーズ III)
|
Morbidity of surgery (phase II)
|
Percentage of patients who receive chemotherapy following surgery (must be over 80%) (phase II)
|
Morbidity of chemotherapy and surgery (phase III)
|
Economic evaluation (phase III)
|
協力者と研究者
捜査官
- 主任研究者:Austin Obichere, MD、University College London Hospitals
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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