Dose-escalation Trial of Preoperative Radiotherapy and Concurrent Chemotherapy in Locally Advanced Rectal Cancer

NCT ID: NCT02964468

Last Updated: 2019-06-26

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

NA

Total Enrollment

525 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2020-05-31

Brief Summary

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The aim of this study is to evaluate the increase of radiation dose administered in patients diagnosed with locally advanced rectal cancer in terms of ypRC with tolerable toxicity, using IMRT (concomitant boost technique).

Detailed Description

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The hypothesis that arises is an improvement in the proportion of pathological complete responses, resulting therapeutic gain, as a result of a higher dose of radiation delivered to the tumor volume without incurring a higher gastrointestinal toxicity to the patient or surgical complications later, thanks to the use of intensity modulated radiotherapy (concomitant boost technique) that allows us to significantly reduce the administered dose organs at risk.

Conditions

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Locally Advanced Rectal 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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Treatment with IMRT Dose Escalation

Dose Escalation Intensity Modulated Radiotherapy treatment

Group Type EXPERIMENTAL

Dose Escalation Intensity Modulated Radiotherapy treatment

Intervention Type RADIATION

Radiotherapy:

IMRT treatment (concomitant boost technique) 25 fractions fraction 2,15Gy by administering a total dose of tumor and lymph nodes 53,75Gy on more margin. Simultaneously we will proceed to the irradiation of pelvic lymph node chains according to protocol, a division of 1,8Gy per session until a total dose of 45 Gy.

Chemotherapy:

According to routine clinical practice of the participating centers.

Treatment with 3DCRT

3DCRT treatment (sequential boost)

Group Type ACTIVE_COMPARATOR

3DCRT treatment (sequential boost)

Intervention Type RADIATION

Radiotherapy:

3DCRT treatment (sequential boost) 25 fractions fraction 1,8Gy by administering a total dose of 45 Gy on tumor and lymph nodes and lymph node chains more pelvic margin determined according to protocol.

3 fractions fraction 1,8Gy by sequentially administering an additional dose of tumor and lymph nodes 5,4Gy on more margin.

Chemotherapy:

According to routine clinical practice of the participating centers.

Interventions

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3DCRT treatment (sequential boost)

Radiotherapy:

3DCRT treatment (sequential boost) 25 fractions fraction 1,8Gy by administering a total dose of 45 Gy on tumor and lymph nodes and lymph node chains more pelvic margin determined according to protocol.

3 fractions fraction 1,8Gy by sequentially administering an additional dose of tumor and lymph nodes 5,4Gy on more margin.

Chemotherapy:

According to routine clinical practice of the participating centers.

Intervention Type RADIATION

Dose Escalation Intensity Modulated Radiotherapy treatment

Radiotherapy:

IMRT treatment (concomitant boost technique) 25 fractions fraction 2,15Gy by administering a total dose of tumor and lymph nodes 53,75Gy on more margin. Simultaneously we will proceed to the irradiation of pelvic lymph node chains according to protocol, a division of 1,8Gy per session until a total dose of 45 Gy.

Chemotherapy:

According to routine clinical practice of the participating centers.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Pathologically proven diagnosis of adenocarcinoma of the rectum
* Clinically determined to be stage T3 or T4,N0-N2, and M0 -staged by MRI or transrectal ultrasound of the rectum
* Patients who are medically operable and who have resectable adenocarcinoma of the rectum at least \<11cm from the anal verge
* Adequate liver/renal and haematological function.
* Eastern Cooperative Oncology Group (ECOG) performance 0-2
* Age ≥ 18 years
* Full blood count obtained within 2 weeks prior to registration on study, with adequate bone marrow function defined as follows:

* Absolute neutrophil count (ANC) ≥ 1,800 cells/mm3
* Platelets ≥ 100,000 cells/mm3
* Haemoglobin ≥ 8.0 g/dl
* Serum creatinine within normal institutional limits
* Bilirubin within normal institutional limits
* AST and ALT \< 2.5 x the IULN
* Patient must sign study specific informed consent prior to study entry

Exclusion Criteria

* Prior systemic chemotherapy for colorectal cancer; note that prior chemotherapy for a different cancer is allowable.
* Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
* Any evidence of distant metastases (M1)
* A synchronous primary colon carcinoma
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Grupo de Investigación Clínica en Oncología Radioterapia

OTHER

Sponsor Role lead

Responsible Party

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Fernando Campos

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fernando López Campos, Investigator

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitario Ramón y Cajal

Locations

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Hospital General de Elche

Elche, Alicante, Spain

Site Status RECRUITING

Consorcio Hospitalario Provincial de Castellón

Castellon, Castellón, Spain

Site Status RECRUITING

Hospital Universitario Santiago de Compostela

Santiago de Compostela, La Coruña, Spain

Site Status RECRUITING

Hospital Universitario Rey Juan Carlos

Móstoles, Madrid, Spain

Site Status RECRUITING

Hospital General Universitario de Ciudad Real

Ciudad Real, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario de Fuenlabrada

Fuenlabrada, , Spain

Site Status RECRUITING

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario La Paz

Madrid, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Valencia

Valencia, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Fernando López Campos, Investigator

Role: CONTACT

Facility Contacts

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Sandra Miranda

Role: primary

Virginia Morillo

Role: primary

Paula Peleteiro

Role: primary

María Dolores De Las Peñas Cabrera

Role: primary

MªVictoria De Torres Olambrada

Role: primary

Fernando López Campos

Role: primary

Isabel Rodríguez

Role: primary

Ester Jordá Sorolla

Role: primary

Other Identifiers

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RTRC--001

Identifier Type: -

Identifier Source: org_study_id

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