A Randomized Controlled Trial Evaluating of Prophylactic Irradiation in CRT for cT1bN0M0 ESCC

NCT ID: NCT04328948

Last Updated: 2025-05-22

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE3
• Total Enrollment: 280 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-07-01
• Study Completion Date: 2030-03-31

Brief Summary

This study is conducted to investigate whether modified chemoradiotherapy with elective nodal irradiation reduces the locoregional recurrence that cannot be completely resected by salvage endoscopic resection and preserve esophagus without compromising overall survival.

Conditions

Esophageal Squamous Cell Carcinoma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Chemoradiation therapy with elective nodal irradiation

Chemoradiotherapy consists of 5-FU (1,000 mg / m2, day1-4, day29-32), CDDP (75 mg /m2, day1, 29) and radiotherapy (50.4 Gy/28Fr)

Group Type: EXPERIMENTAL

Chemoradiotherapy

Intervention Type: RADIATION

Chemoradiotherapy

Chemoradiation therapy with involved field irradiation

Chemoradiotherapy consists of 5-FU (700 mg /m2, day1-4, day29-32), CDDP (70 mg /m2, day1,29) and radiotherapy (60 Gy/30Fr)

Group Type: ACTIVE_COMPARATOR

Chemoradiotherapy

Intervention Type: RADIATION

Chemoradiotherapy

Interventions

Chemoradiotherapy

Chemoradiotherapy

Intervention Type: RADIATION

Eligibility Criteria

Inclusion Criteria

1. Histologically proven squamous cell carcinoma, adenosquamous carcinoma, or basaloid cell carcinoma.

2. All lesions located in the thoracic esophagus. Secondary lesions with an absolute indication for endoscopic resection (EMR/ESD) may not be confined to the thoracic esophagus.

3. Clinical N0M0 with cervical to abdominal contrast-enhanced CT.

4. The deepest lesion is diagnosed as cT1b (SM1 / SM2 / SM3) with upper gastrointestinal endoscopy. If it is difficult to differentiate cT1a-MM and cT1b-SM1 clinically, the wall depth is diagnosed as cT1b-SM1.

5. Aged 20 years and older.

6. ECOG Performance status 0 or 1.

7. No previous therapy against esophageal cancer except for complete resection by EMR/ESD with either pT1a-LPM (pM2) / pT1a-MM (M3) disease or pT1a-MM (M3) disease without vascular infiltration.

8. No history of radiotherapy for the neck, chest, and upper abdomen for any cancers. No chemotherapy or hormone therapy with less than 3 years of disease-free interval for any cancers.

9. Major organ function is preserved. 1) WBC<=12,000/mm3 2) ANC>=1,500/mm3 3) Hb>=10.0 g /dL 4) PLT>=10,000/mm3 5) T-bil<=1.5 mg /dL 6) AST<=100 IU/L 7) ALT<=100 IU/L 8) SpO2>=95% 9) Ccr>=60 mL/min

10. Patients do not have a preference to receive a surgical resection as an initial therapy after receiving explanations.

11. Written informed consent is obtained.

Exclusion Criteria

1. Simultaneous or metachronous (within 5 years) double cancers, except for intramucosal tumor curable with local therapy.

2. Active infection requiring systemic therapy.

3. Fever over 38 degrees Celsius

4. Female during pregnancy, within 28 days of post parturition, or during lactation. Male who wants a partner's pregnancy.

5. Psychological disorder, which is difficult to participate in this clinical study.

6. Receiving continuous systemic corticosteroid or immunosuppressant treatment.

7. Positive for HBs antigen or HIV antigen.

8. Diabetes mellitus, which is uncontrollable with continuous use of insulin or hypoglycemic agents.

9. Uncontrolled arterial hypertension.

10. History of unstable angina pectoris within three weeks or myocardial infarction within six months before registration.

11. Uncontrolled valvular disease, dilated cardiomyopathy, and hypertrophic cardiomyopathy.

12. Severe emphysema, interstitial pneumonia or pulmonary fibrosis based on chest CT.

13. With a history of cerebrovascular disorder within 6 months.

14. Drug allergy for iodic drugs.

• Minimum Eligible Age: 20 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Center, Japan

OTHER_GOV

Sponsor Role: lead

Responsible Party

Ken Kato

National Cancer Center Hospital

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ken Kato, MD/PhD

Role: STUDY_CHAIR

National Cancer Center Hospital

Locations

National Cancer Center Hospital

Tokyo, , Japan

Site Status: RECRUITING

Countries

Japan

Central Contacts

Motoo Nomura, MD/PhD

Role: CONTACT

mnomura@kuhp.kyoto-u.ac.jp

81335422511

Facility Contacts

Ken Kato, M.D./Ph.D

Role: primary

Other Identifiers

JCOG1904

Identifier Type: -

Identifier Source: org_study_id