Advanced Oesophageal Cancer Study to Compare Quality of Life and Palliation of Dysphagia.

NCT ID: NCT00193882

Last Updated: 2017-07-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-07-07

Study Completion Date

2013-06-18

Brief Summary

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To compare the treatment of gullet cancer with radiotherapy alone and assess the advantage and toxicity of adding chemotherapy. The hypothesis to be tested is as follows: That the addition of chemotherapy to a short course of radiation treatment improves the proportion of patients who achieve relief of dysphagia and improves quality of life compared to radiation alone in patients with advanced oesophageal cancer.

Detailed Description

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Prospective radical treatment trials in oesophageal cancer have shown responses in both radiotherapy alone and radiotherapy when combined with chemotherapy. Retrospective studies show a response in the palliative setting to relieve dysphagia. The response, durability and quality of life end points have not been previously fully documented. This will be addressed by this trial.

Dysphagia is the commonest presenting symptom due to local disease obstructing the oesophagus. Difficulty eating not only affects the patient's ability to maintain nutrition, but also impacts on all areas of quality of life. Relief of dysphagia becomes the highest priority for treatment.

At the time of developing this protocol there were no randomised trials comparing chemo-radiotherapy and radiotherapy in the palliative setting.

Few studies have prospectively assessed quality of life data for patients with oesophageal cancer, and although toxicity and survival data is available, there is no long-term data on quality of life. This trial will assess quality of life in a consecutive manner using a standardised self-reporting measure of quality of life, and compare quality of life across two groups having different treatments.

Eligible patients are those with proven carcinoma of the oesophagus who are deemed not suitable for definitive radical treatment due to the advanced nature of disease, presence of metastases or intercurrent illness, who have symptomatic dysphagia requiring loco-regional palliation.

Patients will be randomised to the following treatment options:

1. Radiotherapy Alone

* 35 Gy in 15 fractions (Australia and New Zealand) or
* 30 Gy in 10 fractions(Canada ONLY)
2. Chemo-Radiotherapy

* 35 Gy in 15 fractions (Australia and New Zealand) or
* 30 Gy in 10 fractions (Canada ONLY)
* Cisplatin 80mg/m2 IV day 1 (or 20mg/m2/day IV days 1 - 4)
* 5-Fluorouracil 800mg/m2/day IV days 1 - 4

Patients will have an initial baseline assessment then be followed up weekly during treatment, monthly for 1 year post treatment and then 3 monthly.

Conditions

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Esophagus Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A: Radiotherapy

Radiotherapy alone

Group Type ACTIVE_COMPARATOR

Radiotherapy

Intervention Type RADIATION

35 Gy in 15 fractions

B: Chemo-radiotherapy

Chemotherapy (Cisplatin + 5-Fluorouracil ) and Radiotherapy

Group Type EXPERIMENTAL

Cisplatin

Intervention Type DRUG

80mg/m2 IV day 1

Radiotherapy

Intervention Type RADIATION

35 Gy in 15 fractions

5-Fluorouracil

Intervention Type DRUG

800mg/m2/day IV days 1 - 4

Interventions

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Cisplatin

80mg/m2 IV day 1

Intervention Type DRUG

Radiotherapy

35 Gy in 15 fractions

Intervention Type RADIATION

5-Fluorouracil

800mg/m2/day IV days 1 - 4

Intervention Type DRUG

Other Intervention Names

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Cisplatin Injection Radiation Radiation Therapy DBL Flurouracil Injection BP, Efudix

Eligibility Criteria

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Inclusion Criteria

* Biopsy proven Carcinoma of the oesophagus.
* Not a candidate for radical/curative treatment due to the advanced nature of the disease, presence of metastases, or intercurrent illness. (It should be noted that, patients with mediastinal nodes and no more distant disease maybe suitable for radical treatment).
* Symptomatic patients with dysphagia scores of ≥ 1 i.e. able to eat only some solids (see Mellow Scale appendix 1)
* Performance status ECOG ≤ 2
* Patients must begin treatment within 2 weeks of randomization.
* Patient is at least 18 years old.
* Adequate haematological function to undergo chemotherapy. Peripheral blood - Neutrophils \> 1.5 x 10\^9/L - Platelets \> 100 x 10\^9/L
* Adequate renal function, Creatinine - Calculated clearance ≥ 50 ml/min
* Patients capable of childbearing are using adequate contraception.
* Written informed consent of patient.

Exclusion Criteria

* Previous mega-voltage external beam Radiotherapy or brachy-therapy delivered to the region of the chest.
* Synchronous active malignancies.
* Pregnant or lactating patients.
* Patients unfit for any treatment component.
* Tracheo-oesophageal fistula.
* Stents in situ.
* Previous chemotherapy for Oesophageal Cancer
* CT scan of thorax and abdomen more than 8 weeks prior to randomization
* Full Blood Count, Biochemistry (including creatinine) and creatinine clearance more than 2 weeks prior to randomization
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Health and Medical Research Council, Australia

OTHER

Sponsor Role collaborator

Canadian Cancer Trials Group

NETWORK

Sponsor Role collaborator

Trans Tasman Radiation Oncology Group

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Penniment, FRANZCR

Role: STUDY_CHAIR

Royal Adelaide Hopsital

Locations

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Liverpool Hospital

Liverpool, New South Wales, Australia

Site Status

Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Royal North Shore Hospital

Sydney, New South Wales, Australia

Site Status

Premion - Wesley

Auchenflower, Queensland, Australia

Site Status

Royal Brisbane Hospital

Herston, Queensland, Australia

Site Status

Radiation Oncology - Mater Centre

South Brisbane, Queensland, Australia

Site Status

North Queensland Oncology Service

Townsville, Queensland, Australia

Site Status

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status

Launceston General Hospital

Launceston, Tasmania, Australia

Site Status

Peter MacCallum - Box Hill Hospital

Box Hill, Victoria, Australia

Site Status

Peter MacCallum - Moorrabbin

East Bentleigh, Victoria, Australia

Site Status

Andrew Love Cancer Care Centre, Geelong Hospital

Geelong, Victoria, Australia

Site Status

Peter MacCallum Cancer Centre

Melbourne, Victoria, Australia

Site Status

Royal Perth Hospital

Perth, Western Australia, Australia

Site Status

Cross Cancer Centre

Edmonton, Alberta, Canada

Site Status

Cancer Care Manitoba Winnipeg

Winnipeg, Manitoba, Canada

Site Status

Saint John Regional Hospital - Atlantic Health Sci

Saint John, New Brunswick, Canada

Site Status

Nova Scotia Cancer Centre

Halifax, Nova Scotia, Canada

Site Status

Cancer Centre of Southeastern Ontario Kingston

Kingston, Ontario, Canada

Site Status

Grand River Cancer Centre

Kitchener, Ontario, Canada

Site Status

Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

Hotel-Dieu de Quebec

Québec, , Canada

Site Status

Christchurch Hospital

Christchurch, , New Zealand

Site Status

Princess Royal Hospital

Hull, , United Kingdom

Site Status

Countries

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Australia Canada New Zealand United Kingdom

References

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Penniment MG, De Ieso PB, Harvey JA, Stephens S, Au HJ, O'Callaghan CJ, Kneebone A, Ngan SY, Ward IG, Roy R, Smith JG, Nijjar T, Biagi JJ, Mulroy LA, Wong R; TROG 03.01/CCTG ES.2 group. Palliative chemoradiotherapy versus radiotherapy alone for dysphagia in advanced oesophageal cancer: a multicentre randomised controlled trial (TROG 03.01). Lancet Gastroenterol Hepatol. 2018 Feb;3(2):114-124. doi: 10.1016/S2468-1253(17)30363-1. Epub 2017 Dec 14.

Reference Type DERIVED
PMID: 29248399 (View on PubMed)

Related Links

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http://www.trog.com.au

Click here for more information about this study on the TROG official website

Other Identifiers

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NCIC CTG ES.2

Identifier Type: OTHER

Identifier Source: secondary_id

TGA 2004/83

Identifier Type: OTHER

Identifier Source: secondary_id

NHMRC 291103

Identifier Type: OTHER

Identifier Source: secondary_id

TROG 03.01

Identifier Type: -

Identifier Source: org_study_id

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