Hypofractionated Definitive Chemoradiotherapy for Oesophageal Cancer (HYROC)
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.
研究概览
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名:Iris Agterberg
- 电话号码:+31 204441571
- 邮箱:i.agterberg@amsterdamumc.nl
研究联系人备份
- 姓名:Dr. P.S.N. van Rossum
- 邮箱:p.s.n.vanrossum@amsterdamumc.nl
学习地点
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Amsterdam、荷兰
- 招聘中
- Amsterdam UMC
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接触:
- Iris Agterberg
- 电话号码:+31 204441571
- 邮箱:i.agterberg@amsterdamumc.nl
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接触:
- Dr. P.S.N. van Rossum
- 电话号码:+31 204441571
- 邮箱:p.s.n.vanrossum@amsterdamumc.nl
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首席研究员:
- Peter S.N. van Rossum
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Apeldoorn、荷兰
- 尚未招聘
- Gelre Ziekenhuizen
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接触:
- Dr. K. Eechoute
- 电话号码:+31 88 105 3300
- 邮箱:k.eechoute@gelre.nl
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首席研究员:
- Karel Eechoute
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Apeldoorn、荷兰
- 尚未招聘
- Radiotherapiegroep
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接触:
- Dr. P.M. Jeene
- 电话号码:+31 88 779 0000
- 邮箱:p.jeene@radiotherapiegroep.nl
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首席研究员:
- Paul M. Jeene
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Groningen、荷兰
- 招聘中
- UMCG
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接触:
- Dr. C.T. Muijs
- 电话号码:+31 50 361 6161
- 邮箱:c.t.muijs@umcg.nl
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首席研究员:
- Christina T. Muijs
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Heerlen、荷兰
- 尚未招聘
- Zuyderland Medisch Centrum
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接触:
- Dr. F. Warmerdam
- 电话号码:+31 88 459 7777
- 邮箱:f.warmerdam@zuyderland.nl
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首席研究员:
- Fabienne Warmerdam
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Maastricht、荷兰
- 尚未招聘
- Maastro
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接触:
- Dr. M. Berbée
- 电话号码:+31 88 445 5600
- 邮箱:maaike.berbee@maastro.nl
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首席研究员:
- Maaike Berbée
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Nijmegen、荷兰
- 尚未招聘
- Radboud UMC
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接触:
- Dr. H. Rütten
- 电话号码:+31 24-361 11 1
- 邮箱:Heidi.Rutten@radboudumc.nl
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首席研究员:
- Heidi Rütten
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:Hypofractionated definitive chemoradiotherapy
Participants receive 20 fractions of 2.4 Gy with concurrent 6 cycles of carboplatin and paclitaxel in 4 weeks.
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20 fractions of 2.4 Gy
6 cycles of carboplatin (AUC 2) and paclitaxel (50 mg/m2) given every 4-5 days, 6 cycles in total in 4 weeks.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Proportion of patients who complete all 20 fractions of radiotherapy and receive all 6 cycles of concurrent chemotherapy.
大体时间:Immediately after the treatment.
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Feasibility, defined as ≥50% of patients completing all 20 radiotherapy fractions and all 6 planned chemotherapy cycles.
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Immediately after the treatment.
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Incidence and severity of grade ≥4 RIL, and absolute lymphocyte count nadirs.
大体时间: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.
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The RIL will be scored according to CTCAE v5.0.
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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.
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Incidence of grade ≥3 acute toxicity.
大体时间: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.
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The acute toxicity will be scored according to CTCAE v5.0.
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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.
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Proportion of patients who complete at least 19 of 20 radiotherapy fractions and at least 5 out of 6 planned chemotherapy cycles.
大体时间:Immediately after the treatment.
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Immediately after the treatment.
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Incidence and severity of treatment-related adverse events.
大体时间: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
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The adverse events will be scored according to CTCAE v5.0.
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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
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Progression Free Survival (PFS) and Overall Survival (OS).
大体时间:1 year, 2 years, 3 years, 4 years, 5 years
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1 year, 2 years, 3 years, 4 years, 5 years
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|
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Patient-reported quality of life during and after the treatment.
大体时间:Baseline, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
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Assessed using validated questionnaires collected through the POCOP national prospective cohort.
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Baseline, 3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
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Costs associated with the treatment.
大体时间:3 months after treatment.
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3 months after treatment.
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Feasibility and clinical outcomes of the treatment compared to a propensity score-matched standard-of-care cohort.
大体时间:3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
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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.
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3 months after treatment, 1 year, 2 years, 3 years, 4 years, 5 years
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1. Association of dosimetric parameters of the lungs and heart with radiation-induced lymphopenia. 2. Association of target volume size with radiation-induced lymphopenia.
大体时间:1 month after treatment
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1 month after treatment
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合作者和调查者
调查人员
- 首席研究员:Peter S.N. van Rossum、Amsterdam University Medical Center
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- NL-010499
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
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