Preoperative Sequential Short-course Radiation Therapy and FOLFOX for Locally Advanced Rectal Cancer

NCT ID: NCT05673772

Last Updated: 2025-03-06

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

364 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-23

Study Completion Date

2029-12-31

Brief Summary

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The treatment protocol proposed in this study is to perform short-term radiation therapy and 4 cycles of FOLFOX chemotherapy for neoadjuvant treatment of locally advanced rectal cancer. Compared to conventional chemoradiation therapy, the preoperative radiotherapy period is shortened, and the cure rate of rectal cancer patients can be improved by early treatment of micrometastasis using systemic chemotherapy. The patients who are assigned to the study group will received the short-course radiotherapy and 4 cycles of FOLFOX and patients in the control will received conventional chemoradiotherapy for preoperative treatment. All patients are recommended to receive total mesorectal excision (TME) after neoadjuvant treatment and adjuvant chemotherapy will be given according to the pathological stage.

Detailed Description

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Conditions

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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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Study group

Short-course radiotherapy and 4 cycles of mFOLFOX6 followed by TME. Adjuvant chemotherapy will be given according to the pathological stage (CR\~pStageI: 6 cycles of capecitabine or 4 cycles of 5-FU with leucovorin, pStageII-III: 8 cycles of mFOLFOX6)

Group Type EXPERIMENTAL

short-course radiotherapy

Intervention Type RADIATION

25 Gy in 5 fractions for 5 days

mFOLFOX6

Intervention Type DRUG

Oxaliplatin 85 mg/m2, Levoleucovorin 200mg (or Leucovroin, Leucosodium 400mg)/m2, 5- FU 400 mg/m2, and continuous 5- FU 2,400 mg/m2 for 46 hours

TME surgery

Intervention Type PROCEDURE

TME surgery

Control group

Conventional chemoradiotherapy followed by TME. Adjuvant chemotherapy will be given according to the pathological stage (CR\~pStageI: 6 cycles of capecitabine or 4 cycles of 5-FU with leucovorin, pStageII-III: 8 cycles of mFOLFOX6)

Group Type ACTIVE_COMPARATOR

Chemoradiotherapy

Intervention Type RADIATION

45\~50.4 Gy/25fr with concurrent use of either capecitabine or 5-FU+leucovorin(or levoleucovorin or leucosodium)

TME surgery

Intervention Type PROCEDURE

TME surgery

Interventions

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short-course radiotherapy

25 Gy in 5 fractions for 5 days

Intervention Type RADIATION

mFOLFOX6

Oxaliplatin 85 mg/m2, Levoleucovorin 200mg (or Leucovroin, Leucosodium 400mg)/m2, 5- FU 400 mg/m2, and continuous 5- FU 2,400 mg/m2 for 46 hours

Intervention Type DRUG

Chemoradiotherapy

45\~50.4 Gy/25fr with concurrent use of either capecitabine or 5-FU+leucovorin(or levoleucovorin or leucosodium)

Intervention Type RADIATION

TME surgery

TME surgery

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Asian
* ECOG (Eastern Cooperative Oncology Group) performance status 0-2
* Pathologically confirmed rectal cancer (rectal cancer located 10 cm or low from the anal verge in pelvis MRI)
* Histologic type: adenocarcinoma, mucinous carcinoma, and signet ring cell carcinoma
* Locally advanced rectal cancer with one or more of the following factors based on pelvis MRI: cTanyN1-2, cT3-4N0, or presence of extramural vascular invasion

Exclusion Criteria

* Patients with appropriate organ (bone marrow, kidney, liver) function
* A person who understands the study and willing to provide informed consent


* Colon cancer or rectal cancer located more than 10 cm from the anal verge
* Stage I rectal cancer (clinical stage cT1-2N0)
* Clinically or pathologically diagnosed distant metastasis (cTanyNanyM1)
* Familial adenomatous polyposis
* Hereditary nonpolyposis colorectal cancer
* History of chemotherapy or radiotherapy within 6 months
* History of colorectal cancer or other type of malignancy within 5 years (except for cured nonmelanoma skin or in situ cervical cancer)
* Comorbidities that make it difficult to undergo chemotherapy or radiotherapy
* Bone marrow suppression with neutrophil count \<2 ×109/L or platelet count \<100 ×109/L prior to the first chemotherapy
* Peripheral sensory neuropathy with functional impairment (grade 2 or higher)
* Severe renal dysfunction (GFR ≤30ml/min by Wright or Cockroft formula)
* Severe hepatic dysfunction
* Genetic problems such as galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption
* Taking tegafur, gimeracil, and oteracil potassium complex and those within 7 days of discontinuation
* Taking sorivudine or brivudine
* Significant heart disease or myocardial infarction within the last 6 months
* Hereditary diseases or history of coagulopathy
* Central nervous system disorders with disability or mental disorders
* Pregnant or lactating women
* Currently participating in other clinical trials or receiving research medication
* Unhealed wounds, fractures, peptic ulcer, abscesses in the abdominal cavity
* Active gastrointestinal bleeding
* Active infections requiring antibiotics for injection
* Emergency Surgery
* History of hypersensitivity to the drugs in study protocol
* Patients with non-malignant tumor diseases
* Dihydropyrimidine dehydrogenase deficiency
* Not willing to participate
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Center, Korea

OTHER_GOV

Sponsor Role collaborator

Kyungpook National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Gyu-Seog Choi

M.D., Ph.D

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Gyu seog Choi

Daegu, , South Korea

Site Status RECRUITING

Chungnam National University Hospital

Daejeon, , South Korea

Site Status RECRUITING

Chonnam National University Hwasun Hospital

Gwangju, , South Korea

Site Status RECRUITING

Catholic University of Korea Incheon St. Mary's Hospital

Incheon, , South Korea

Site Status RECRUITING

Jeonbuk National University Hospital

Jeonju, , South Korea

Site Status RECRUITING

Asan Medical Center

Seoul, , South Korea

Site Status RECRUITING

, Korea University Anam Hospital

Seoul, , South Korea

Site Status RECRUITING

Gangnam Severance Hospital

Seoul, , South Korea

Site Status RECRUITING

Seoul National University Bundang Hospital

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Soo Yeun Park, M.D.

Role: CONTACT

+82-53-200-3867

Facility Contacts

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Soo Yeun Park, M.D.

Role: primary

+82-53-200-2166

Kyung Ha Lee, M.D.

Role: primary

Chang Hyun Kim, M.D.

Role: primary

Moon Jin Kim, M.D.

Role: primary

Gi Won Ha, M.D.

Role: primary

In Ja Park, M.D.

Role: primary

Ji-Seon Kim, M.D.

Role: primary

Eun Jung Park, M.D.

Role: primary

Hong-Min Ahn, M.D.

Role: primary

References

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Kang MK, Park SY, Park JS, Kim HJ, Kim JG, Kang BW, Baek JH, Cho SH, Seo AN, Kim DW, Kim J, Baek SJ, Kim JH, Kim JY, Ha GW, Park EJ, Park IJ, Kim CH, Kang H, Choi GS. Preoperative sequential short-course radiation therapy and FOLFOX chemotherapy versus long-course chemoradiotherapy for locally advanced rectal cancer: a multicenter, randomized controlled trial (SOLAR trial). BMC Cancer. 2023 Nov 3;23(1):1059. doi: 10.1186/s12885-023-11363-7.

Reference Type DERIVED
PMID: 37923987 (View on PubMed)

Other Identifiers

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KNUHCRC007

Identifier Type: -

Identifier Source: org_study_id

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