Involved Field Irradiation (IFI) Versus Elective Nodal Irradiation (ENI) for Esophageal Cancer - Full Text View

Purpose

This study examines contrast advantages and disadvantages of elective or prophylactic nodal irradiation in the treatment of esophageal cancer with three-dimensional conformed radiotherapy.

Condition	Intervention
Esophageal Squamous Cell Carcinoma	Radiation: Involved Field Irradiation(IFI) Drug: docetaxel and cisplatin Radiation: Elective Nodal Irradiation (ENI)


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment
Official Title:	Multicenter Prospective Randomized Phase III Trial Comparing Elective to Prophylactic Regional Lymph Node Irradiation for Thoracic Esophageal Cancer

Resource links provided by NLM:

MedlinePlus related topics: Esophageal Cancer

Drug Information available for: Docetaxel

Genetic and Rare Diseases Information Center resources: Esophageal Cancer

U.S. FDA Resources

Further study details as provided by Chengya Chou, The Second People's Hospital of Sichuan:

Primary Outcome Measures:

radiation pneumonitis and radiation esophagitis [ Time Frame: Acute and late toxicities of lung and esophagus were evaluated according to RTOG criteria with CT scans every 3 months for 1 years ]
radiation pneumonitis and radiation esophagitis,

Secondary Outcome Measures:

3-year Overall survival(OS) [ Time Frame: CT scans performed every 6 months for 3 years ]
3-year Overall survival(OS)
3-year Disease-free survival [ Time Frame: CT scans every 6 months for 3 years ]
3-year Disease-free survival
Quality of life(QoL) [ Time Frame: Evaluation of quality of life every week for 3 months ]
Quality of life(QoL)
Local control rate/ Inside irrational field recurrence rate [ Time Frame: 2 year ]
Evaluation after treatment 3 months and two years in the tumor local control and key observation radiation fields inside and outside the tumor recurrence and lymph node metastatic rate. To guide the rational clinical target volume of lymph node of esophageal cancer underwnet concurrent chemoradiotherapy and to Prolong the survival time, improve the quality of life of the patients.


Enrollment:	220
Study Start Date:	March 2012
Study Completion Date:	July 2017
Primary Completion Date:	July 2017 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Involved Field Irradiation(IFI) Involved Field Irradiation(IFI):The clinical target volume of regional lymph node (CTVn) of IFI included the nodal region(s) in which the involved lymph node(s) was/were located.chemothrapy:docetaxel and cisplatin.	Radiation: Involved Field Irradiation(IFI) Involved Field Irradiation(IFI):only irradiate positive lymph node by CT or PET-CT Radiation: IMRT IMRT is administered with chemotherapy from week 1 to week 8PTV-GTV（primary tumor）：66-70Gy/33~35F，once a day, 5 times per week PTV-CTV（Clinical target,primary tumor extended 3cm in Axial）：50-56Gy/33~35f，once a day, 5 times per week PTV-GTVnd（positive node）：66-70Gy/33~35F，once a day, 5 times per week. Drug: docetaxel and cisplatin Drug: docetaxel and cisplatin.Consists of docetaxel 60-80mg/m2 day 1 and cisplatin 25mg/m2 days 1 to 3, repeat every 3 weeks, for 2 cycles. Other Name: chemothrrapy
Active Comparator: Elective Nodal Irradiation (ENI) Elective Nodal Irradiation (ENI):The CTVn of ENI included the involved lymph node regions and clinically uninvolved lymph nodal stations according to the location of primary tumor. Lymph node station numbers 1/2/4/5/7, 2/4/5/7 and 4/5/7/16/17 were included for upper, middle and lower thoracic ESCC in the ENI arm respectively.chemothrapy:docetaxel and cisplatin.	Drug: docetaxel and cisplatin Drug: docetaxel and cisplatin.Consists of docetaxel 60-80mg/m2 day 1 and cisplatin 25mg/m2 days 1 to 3, repeat every 3 weeks, for 2 cycles. Other Name: chemothrrapy Radiation: Elective Nodal Irradiation (ENI) The CTVn of ENI included the involved lymph node regions and clinically uninvolved lymph nodal stations according to the location of primary tumor. Lymph node station numbers 1/2/4/5/7, 2/4/5/7 and 4/5/7/16/17were included for upper, middle and lower thoracic ESCC in the ENI arm respectively.

Arms

Assigned Interventions

Experimental: Involved Field Irradiation(IFI)

Involved Field Irradiation(IFI):The clinical target volume of regional lymph node (CTVn) of IFI included the nodal region(s) in which the involved lymph node(s) was/were located.chemothrapy:docetaxel and cisplatin.

Radiation: Involved Field Irradiation(IFI)

Involved Field Irradiation(IFI):only irradiate positive lymph node by CT or PET-CT Radiation: IMRT IMRT is administered with chemotherapy from week 1 to week 8PTV-GTV（primary tumor）：66-70Gy/33~35F，once a day, 5 times per week PTV-CTV（Clinical target,primary tumor extended 3cm in Axial）：50-56Gy/33~35f，once a day, 5 times per week PTV-GTVnd（positive node）：66-70Gy/33~35F，once a day, 5 times per week.

Drug: docetaxel and cisplatin

Drug: docetaxel and cisplatin.Consists of docetaxel 60-80mg/m2 day 1 and cisplatin 25mg/m2 days 1 to 3, repeat every 3 weeks, for 2 cycles.

Other Name: chemothrrapy

Active Comparator: Elective Nodal Irradiation (ENI)

Elective Nodal Irradiation (ENI):The CTVn of ENI included the involved lymph node regions and clinically uninvolved lymph nodal stations according to the location of primary tumor. Lymph node station numbers 1/2/4/5/7, 2/4/5/7 and 4/5/7/16/17 were included for upper, middle and lower thoracic ESCC in the ENI arm respectively.chemothrapy:docetaxel and cisplatin.

Drug: docetaxel and cisplatin

Drug: docetaxel and cisplatin.Consists of docetaxel 60-80mg/m2 day 1 and cisplatin 25mg/m2 days 1 to 3, repeat every 3 weeks, for 2 cycles.

Other Name: chemothrrapy

Radiation: Elective Nodal Irradiation (ENI)

The CTVn of ENI included the involved lymph node regions and clinically uninvolved lymph nodal stations according to the location of primary tumor. Lymph node station numbers 1/2/4/5/7, 2/4/5/7 and 4/5/7/16/17were included for upper, middle and lower thoracic ESCC in the ENI arm respectively.

Detailed Description:

Esophageal lymph node drainage area is rich, according to different sites, easy to metastasis to different regions. For patient underwent concurrent chemoradiotherapy, how reasonable design the clinical target volume of lymph node drainage area has always been controversial, one is to irradiate positive lymph nodes only, the other is to irradiate the easier involved lymph node area according to different sites, in order to contrast advantages and disadvantages of the two kind of target area design，so the study was designed.

Eligibility


Ages Eligible for Study:	18 Years to 80 Years (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Age ≥ 18 and ≤ 80
ECOG performance status 0-2
Weight is not less than 90% of it before treatment
Histologically proven primary thoracic esophageal squamous cell carcinoma previously untreated stage I-III
Chest and abdominal contrast enhanced CT within 2 weeks prior to registration(PET/CT scan is selective)
WBC ≥ 4.0X109/L ,Absolute neutrophil count (ANC) ≥ 2.0X109/L
Platelets ≥ 100X109/L
Hemoglobin ≥ 90g/L(without blood transfusion)
AST (SGOT)/ALT (SGPT) ≤ 2.5 x upper limit of normal, Bilirubin ≤ 1.5 x upper limit of normal
Creatinine ≤ 1.5 x upper limit of normal
Sign study-specific informed consent prior to study entry -

Exclusion Criteria:

Multiple primary esophageal tumors
Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 2 years (For example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible).
Severe, active comorbidity, defined as follows:
- Unstable angina and/or congestive heart failure requiring hospitalization within the last 3 months
- Transmural myocardial infarction within the last 6 months
- Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
- Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
- Acquired immune deficiency syndrome (AIDS) based upon current CDC definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive.
Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception.
Prior systemic chemotherapy, prior radiation therapy or prior target drug therapy

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01551589

Locations


China, Guangxi
Guangxi Tumor Hospital
Nanning, Guangxi, China, 530021
China, Guizhou
GuiZhou Cancer Hospital
Guiyang, Guizhou, China, 550000
China, Sichuan
The Second People's Hospital of Sichuan
Chengdu, Sichuan, China, 610000
China, Yunnan
Yunnan Tumor Hospital, The Third Affiliated Hospital of KUNMING Medical University
Kunming, Yunnan, China, 652100

Sponsors and Collaborators

Chengya Chou

Investigators


Study Chair:	JINYI LANG, M.D.	The Second People's Hospital of Sichuan

More Information


Responsible Party:	Chengya Chou, Chairman of Radiotherapy department, The Second People's Hospital of Sichuan
ClinicalTrials.gov Identifier:	NCT01551589 History of Changes
Other Study ID Numbers:	CSWOG0001 BT-IST-SCCHN-037 ( Other Identifier: BT-IST-SCCHN-037 )
Study First Received:	March 4, 2012
Last Updated:	July 25, 2017

Keywords provided by Chengya Chou, The Second People's Hospital of Sichuan:


Esophageal squamous cell carcinoma Concurrent chemoradiotherapy Clinical target volume Safety Prognosis

Additional relevant MeSH terms:


Carcinoma, Squamous Cell Esophageal Neoplasms Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Squamous Cell Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Head and Neck Neoplasms	Digestive System Diseases Esophageal Diseases Gastrointestinal Diseases Docetaxel Cisplatin Antineoplastic Agents Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on August 18, 2017