Study on Early Stage Bulky Cervical Cancers

NCT ID: NCT01917695

Last Updated: 2015-08-13

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-08-31

Study Completion Date

2018-08-31

Brief Summary

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The aim of this study is to establish the role of neoadjuvant chemotherapy and chemo irradiation in carcinoma cervix and to compare its results with the concurrent chemo irradiation in terms of overall survival, disease free survival and quality of life.

Detailed Description

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Early stage bulky cancers of the cervix, (defined as FIGO Stages IB2, IIA2 and IIB) form a distinctive subset of "curable" cervical cancers with good 5 year survival rates with adequate treatment. Concurrent chemo radiation with or without salvage surgery is at present the standard of care for this group of cervical cancers. However, when pelvic recurrences occur, the morbidity of salvage surgery after radiotherapy, especially brachytherapy is often higher than the morbidity of salvage radiotherapy following radical surgery. The advantages of downsizing the disease without the use of brachytherapy are tempting and open a completely new philosophy in radical treatment for "curable" early stage bulky cancers of the cervix. This approach is appealing especially in developing countries where the load of cervical cancers is high and radiotherapy (brachytherapy) resources are scarce.

The results of two Phase II trials conducted at Govt. Royapettah Hospital, Chennai (Neoadjuvant Chemotherapy followed by Radical Hysterectomy: Cisplatin + 5FU vs. Cisplatin +Paclitaxel) and at Govt. General Hospital,Chennai (Neoadjuvant Chemoradiation with weekly cisplatin and 50 EBRT followed by radical Hysterectomy) and one retrospective study ( Preoperative 50 GY EBRT followed by Radical Hysterectomy) have shown similar response rates and acceptable toxicity profiles when compared to concurrent chemoradiation (EBRT + Brachytherapy+ Chemotherapy). Similar studies have been published elsewhere with similar results.

With this in mind we are planning to conduct a Phase III Randomised control trial comparing Neoadjuvant Chemotherapy + Radical Hysterectomy and Neoadjuvant Chemoradiation + Radical Hysterectomy with concurrent chemoradiation in this subset of cervical cancers

Conditions

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Carcinoma Cervix

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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Concurrent Radical Chemoradiation

Paclitaxel(175 mg/sq.m) + Cisplatin (75 mg/sq.m) chemotherapy - 2 cycles of 3 weekly cycle Concurrent Radiotherapy - 50 Gy EBRT + Brachytherapy (7Gy HDR x 3 doses) All to be completed within 8-10 weeks

Group Type ACTIVE_COMPARATOR

Chemotherapy

Intervention Type DRUG

cisplatin 75 mg/m2 Paclitaxel 175 mg/m2

External Beam Radiotherapy

Intervention Type RADIATION

50 Gy/2 Gy/25 # external beam RT to cervix. four field technique. given concurrently with chemotherapy weeks 1 - 5

Brachytherapy

Intervention Type RADIATION

Ir - 192 HDR Brachytherapy - intracavitary. 7Gy x 3#. given after completion of chemoRT.

Neoadjuvant Chemoradiation + Radical Hysterectomy

Paclitaxel(175 mg/m2) + Cisplatin(75 mg/m2) chemotherapy - 2 cycles of 3 weekly cycle Concurrent Radiotherapy - 50 Gy EBRT - completed within 5 weeks Radical Hysterectomy - 3 weeks after completion of RT All to be completed within 8-10 weeks

Group Type EXPERIMENTAL

Chemotherapy

Intervention Type DRUG

cisplatin 75 mg/m2 Paclitaxel 175 mg/m2

External Beam Radiotherapy

Intervention Type RADIATION

50 Gy/2 Gy/25 # external beam RT to cervix. four field technique. given concurrently with chemotherapy weeks 1 - 5

Radical Hysterectomy

Intervention Type PROCEDURE

Type III Radical Hysterectomy + Bilateral Pelvic Node Dissection

Neoadjuvant Chemotherapy + Radical Hysterectomy

Paclitaxel(175 mg/m2) + Cisplatin (75 mg/m2) chemotherapy - 3 cycles of 3 weekly cycle Radical Hysterectomy - 3 weeks after completion of chemotherapy All to be completed within 8-10 weeks

Group Type EXPERIMENTAL

Chemotherapy

Intervention Type DRUG

cisplatin 75 mg/m2 Paclitaxel 175 mg/m2

Radical Hysterectomy

Intervention Type PROCEDURE

Type III Radical Hysterectomy + Bilateral Pelvic Node Dissection

Interventions

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Chemotherapy

cisplatin 75 mg/m2 Paclitaxel 175 mg/m2

Intervention Type DRUG

External Beam Radiotherapy

50 Gy/2 Gy/25 # external beam RT to cervix. four field technique. given concurrently with chemotherapy weeks 1 - 5

Intervention Type RADIATION

Brachytherapy

Ir - 192 HDR Brachytherapy - intracavitary. 7Gy x 3#. given after completion of chemoRT.

Intervention Type RADIATION

Radical Hysterectomy

Type III Radical Hysterectomy + Bilateral Pelvic Node Dissection

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients with histologically confirmed bulky cervical Squamous cell carcinoma (FIGO stage IB2, II A2, IIB).
2. Age 18-60 years
3. Karnofsky performance status of ≥70%; ECOG PS ≤ 2

Exclusion Criteria

1. Nonsquamous Histologies
2. Other systemic diseases, comorbidities precluding full participation in the study
3. Concomitant treatment with any experimental drug
4. Pregnant or nursing women
5. Previous or concomitant malignant diseases other than non-melanoma skin cancer
6. Previous radiation to the pelvis
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Rajkumar Kottayasamy Seenivasagam

OTHER

Sponsor Role lead

Responsible Party

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Rajkumar Kottayasamy Seenivasagam

MCh Surgical Oncology trainee

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Rajaraman Ramamurthy, MS MCh

Role: STUDY_CHAIR

centre for oncology, Government Royapettah Hospital

Locations

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Government Royapettah Hospital

Chennai, Tamil Nadu, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Rajaraman Ramamurthy, MS MCh

Role: CONTACT

+919444046168

Subbiah Shanmugam, Ms MCh

Role: CONTACT

+919360206030

Facility Contacts

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Rajaraman Ramamurthy, MS MCh

Role: primary

+919444046168

Subbiah Shanmugam, MS MCh

Role: backup

+919360206030

Other Identifiers

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GRHCO-01

Identifier Type: -

Identifier Source: org_study_id

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