A Prospective Phase II Study of Individualized Neoadjuvant Chemoradiotherapy for Rectal Cancer Based on Recurrence Risk

NCT ID: NCT04664504

Last Updated: 2021-06-08

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-01

Study Completion Date

2025-12-01

Brief Summary

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A Prospective Phase II Study of Individualized Neoadjuvant Chemoradiotherapy for Rectal Cancer Based on Recurrence Risk

Detailed Description

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For patients with locally advanced rectal cancer, radiotherapy and chemotherapy combined with surgery can improve the curative effect. Rectal magnetic resonance imaging (MRI) can be used to stratify the risk of locally advanced rectal cancer before treatment. In this study, we planned to use rectal MRI parameters and the possibility of patients with anal preservation to group, and to observe the R0 resection rate and disease-free survival rate of patients with stage II / III rectal cancer after individualized preoperative radiotherapy and chemotherapy combined with radical surgery.

Conditions

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Rectal Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group CRT

concurrent chemoradiotherapy → TME → adjuvant chemotherapy (control group)

Group Type ACTIVE_COMPARATOR

Concurrent Chemoradiotherapy Radiotherapy

Intervention Type COMBINATION_PRODUCT

50Gy in 25 fractions to the primary tumor and to mesorectal, presacral,and internal iliac lymph nodes. Concurrent chemotherapy: Capecitabine 1650 mg/m2/d.

Adjuvant chemotherapy

Intervention Type DRUG

2 h) on day 1 and oral administration of capecitabine (1000 mg/m2 twice daily) from day 1 to day 14, is repeated every 3 weeks for 6 cycles. 6 courses\*3 weeks per course

TME

Intervention Type PROCEDURE

Total mesorectal excision

Group SCRT

Short-course radiotherapy→ consolidation chemotherapy → TME (experimental group)

Group Type EXPERIMENTAL

Short-course Radiotherapy

Intervention Type RADIATION

25Gy in 5 fractions to the primary tumor and to mesorectal, presacral,and internal iliac lymph nodes.

Consolidation chemotherapy

Intervention Type DRUG

Intravenous infusion of oxaliplatin (130 mg/m2 over 2 h) on day 1 and oral administration of capecitabine (1000 mg/m2 twice daily) from day 1 to day 14, is repeated every 3 weeks for 4 cycles. 4 courses\*3 weeks per course.

TME

Intervention Type PROCEDURE

Total mesorectal excision

Group es-SCRT

Local dose increase of Short-course radiotherapy→ consolidation chemotherapy → TME (experimental group)

Group Type EXPERIMENTAL

Local dose increase of Short-course Radiotherapy

Intervention Type RADIATION

25Gy in 5 fractions to the of primary tumor and to mesorectal, presacral,and internal iliac lymph nodes. And 4Gy in 1 fractions to the PGTV of primary tumor and to mesorectal, presacral,and internal iliac lymph nodes.

Consolidation chemotherapy

Intervention Type DRUG

Intravenous infusion of oxaliplatin (130 mg/m2 over 2 h) on day 1 and oral administration of capecitabine (1000 mg/m2 twice daily) from day 1 to day 14, is repeated every 3 weeks for 4 cycles. 4 courses\*3 weeks per course.

TME

Intervention Type PROCEDURE

Total mesorectal excision

Interventions

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Concurrent Chemoradiotherapy Radiotherapy

50Gy in 25 fractions to the primary tumor and to mesorectal, presacral,and internal iliac lymph nodes. Concurrent chemotherapy: Capecitabine 1650 mg/m2/d.

Intervention Type COMBINATION_PRODUCT

Short-course Radiotherapy

25Gy in 5 fractions to the primary tumor and to mesorectal, presacral,and internal iliac lymph nodes.

Intervention Type RADIATION

Local dose increase of Short-course Radiotherapy

25Gy in 5 fractions to the of primary tumor and to mesorectal, presacral,and internal iliac lymph nodes. And 4Gy in 1 fractions to the PGTV of primary tumor and to mesorectal, presacral,and internal iliac lymph nodes.

Intervention Type RADIATION

Consolidation chemotherapy

Intravenous infusion of oxaliplatin (130 mg/m2 over 2 h) on day 1 and oral administration of capecitabine (1000 mg/m2 twice daily) from day 1 to day 14, is repeated every 3 weeks for 4 cycles. 4 courses\*3 weeks per course.

Intervention Type DRUG

Adjuvant chemotherapy

2 h) on day 1 and oral administration of capecitabine (1000 mg/m2 twice daily) from day 1 to day 14, is repeated every 3 weeks for 6 cycles. 6 courses\*3 weeks per course

Intervention Type DRUG

TME

Total mesorectal excision

Intervention Type PROCEDURE

Other Intervention Names

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CRT SCRT es-SCRT XEOLX*4 courses XEOLX*6 courses

Eligibility Criteria

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Inclusion Criteria

1. Rectal adenocarcinoma confirmed by histopathology
2. MRI staging was stage II / III (cT3-T4N0 or cT2-4N+)
3. The age is 18-75 years old, no gender limit

3\) The distance between the lower limit of the lesion and the anal margin was less than or equal to 10 cm 4) Karnofsky score ≥ 80 or ECOG score 0-1

Exclusion Criteria

1. History of other malignant tumors;
2. They were allergic to 5-FU, platinum, etc;
3. The patient is in thrombolytic and anticoagulant therapy, and has bleeding quality or coagulation dysfunction; or in the past year, aneurysm, stroke, transient ischemic attack, arteriovenous malformation occurred;
4. After the previous renal history, proteinuria or clinical renal function were found to be abnormal;
5. History of gastrointestinal fistula, perforation or severe ulcer;
6. At present, there are active infection; clinical obvious heart disease; New York Heart Association (NYHA) ≥ grade II congestive heart failure; unstable symptomatic arrhythmia or peripheral vascular disease ≥ grade II; myocardial infarction and cerebrovascular accident occurred within 6 months before enrollment.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jing Jin, M.D.

UNKNOWN

Sponsor Role lead

Responsible Party

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Jing Jin, M.D.

Clinical Professor, Radiotherapy Department

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Yuan Tang, M.D.

Role: STUDY_DIRECTOR

Chinese Academy of Medical Sciences and Peking Union Medical College

Locations

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Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Beijing, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yuan Tang, M.D.

Role: CONTACT

+8615011304945

Facility Contacts

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Yuan Tang, MD

Role: primary

0086-15011304945

Other Identifiers

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3332019055

Identifier Type: -

Identifier Source: org_study_id

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