Pretherapeutic Paraaortic Lymphadenectomy in Women With Locally Advanced Cervical Cancer Versus Definitive Chemoradiotherapy (LiLACs)
A Phase III Randomized Study of Pretherapeutic Paraaortic Lymphadenectomy in Women With Locally Advanced Cervical Cancer Dispositioned to Definitive Chemoradiotherapy
연구 개요
상태
상세 설명
All eligible patients will be equally randomized between the 2 following treatment groups:
- Standard of care arm: standard chemoradiation (whole pelvis chemoradiation therapy).
- Experimental arm: pretherapeutic paraaortic lymphadenectomy followed by tailored chemoradiation. Pretherapeutic lymphadenectomy will be performed via the laparoscopic extraperitoneal or transperitoneal approach using either traditional laparoscopy or robotically-assisted laparoscopy.
The surgery (extraperitoneal or transperitoneal laparoscopic lymphadenectomy) is considered investigational.
Chemoradiation treatment (with either pelvis or tailored radiation) is considered as standard treatment approved in France for the treatment of cervical cancer.
연구 유형
단계
- 3단계
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Women with clinical stage from 1B2 to 4A cervical squamous cell carcinoma, adenosquamous, or adenocarcinoma.
- Women with FDG-PET positive or indeterminate pelvic lymph nodes or indeterminate low common iliac nodes (see addendum below) and negative paraaortic nodes.
- Women with planned treatment of primary definitive chemoradiation therapy.
- Patient information and written informed consent form signed.
- Age ≥ 18 years old.
- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤ 2.
- Life expectancy ≥ 3 months.
Exclusion Criteria:
- Women with stage 1A or 1B1 cancer.
- Women with prior radiotherapy to the pelvis or retroperitoneal surgery.
- Women with neuroendocrine histologies, or histologies other than squamous, adenosquamous or adenocarcinoma.
- Women with FDG PET positive high common / paraaortic lymph node metastasis confirmed by biopsy (see addendum below).
- Women who have undergone simple or radical hysterectomy prior to radiotherapy.
- Women with planned treatment of radiotherapy only (without chemotherapy).
- Women with planned treatment of palliative radiotherapy.
- Women with metastatic disease outside of pelvis.
- Women who have completed treatment for other malignancies (except non-melanomatous skin cancer) < 5 years from their new diagnosis of cervical cancer.
- Women who are pregnant, women who are likely to be pregnant or are breastfeeding.
- Women with any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with patient's safety, provision of informed consent or compliance to study procedures.
- Women not affiliated with Social Security System in France.
- Women deprived of liberty or under guardianship.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
활성 비교기: Standard of care arm
Standard chemoradiation based on FluoroDeoxyGlucose-Positon Emission Tomography (FDG-PET) imaging status of the pelvic nodes
|
patients with negative paraaortic lymph nodes on PET imaging will be managed with external beam radiotherapy to the pelvis at a usual dose of 45 Gy. Limited boosts will be indicated individually on clinically involved parametria or pelvic nodes. The external beam radiation therapy will be followed by intracavitary brachytherapy with intent to cure (HDR, LDR or PDR). Patients who complete both external beam radiation and intracavitary radiotherapy will receive a total dose of 80-90 Gy low-dose equivalent to Point A. Concurrent platinum-based chemotherapy will be given with definitive radiation therapy. |
|
실험적: Experimental arm
Pretherapeutic paraaortic lymphadenectomy followed by tailored chemoradiation.
Pretherapeutic lymphadenectomy will be performed via the laparoscopic extraperitoneal or transperitoneal approach
|
Patients with negative paraaortic lymph nodes will be managed with external beam radiotherapy to the pelvis (as defined by the surgical clips applied at the lower limit of the paraaortic node dissection) at a usual dose of 45 Gy. Limited boosts will be indicated individually on clinically involved parametria or pelvic nodes. The external beam radiation therapy will be followed by intracavitary brachytherapy (High Dose Rate (DR), Low DR or Pulse DR) with intent to cure. Patients with metastatic disease to paraaortic lymph nodes will receive extended-field external beam radiotherapy followed by intracavitary brachytherapy with intent to cure. Patients who complete both external beam radiation and intracavitary radiotherapy will receive a total dose of 80-90 Gy low-dose equivalent to Point A. Concurrent platinum-based chemotherapy (in the 2 sub groups above) will be given with definitive radiation therapy. |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Overall survival
기간: up to 10 years
|
A Positon Emission Tomography (PET) scan will be obtained at 3 months after completion of chemoradiation therapy.
CT scans will be obtained every 6 months for the next three years thereafter.
Follow-up surveillance of patients will consist of serial clinical examinations by an oncologist every 3 months for the first 2 years, every 6 months for the next 3 years; then, patients will be followed annually only for collection of their survival data.
Patients will come off study at 5 years after completion of initial chemoradiation therapy or at time of death.
|
up to 10 years
|
공동 작업자 및 조사자
스폰서
수사관
- 수석 연구원: Alejandra Martinez, Dr, Institut Claudius Regaud
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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