Fluorouracil, Cisplatin, Cetuximab, and Radiation Therapy in Treating Patients With Esophageal Cancer That Can Be Removed by Surgery
Esophageal Cancer
About this trial
This is an interventional treatment trial for Esophageal Cancer focused on measuring adenocarcinoma of the esophagus, squamous cell carcinoma of the esophagus, stage IIIA esophageal cancer, stage IIIB esophageal cancer, stage IIIC esophageal cancer, stage IV esophageal cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Inclusion criteria:
Histologically confirmed epidermoid or glandular carcinoma of the thoracic esophagus
- Invasive disease
- Only Siewert type I gastroesophageal carcinoma allowed
Resectable disease
- T1N+, T2N0, T2N+, T3N0, or T3N+ (stage II or III)
- No visceral metastases or mediastinal extensions compromising resectability
Exclusion criteria:
- Inoperable disease
- Invasion of the tracheo-bronchial tree
- Recurring esophageal paralysis
- Esopho-tracheal fistula
- Cervical esophageal carcinoma (< 19 cm above the dental arches)
- Multifocal esophageal carcinoma
- Superficial esophageal carcinoma (T1N0)
- Esophageal carcinoma in the lymph nodes that cannot be included in the radiotherapy field or cannot be completely surgically resected
- Proven metastatic disease
PATIENT CHARACTERISTICS:
Inclusion criteria:
- WHO performance status 0-1
- Weight loss < 15%
- Absolute neutrophil count ≥ 1,500/mm3
- Platelet count ≥ 100,000/mm3
- Creatinine ≤ 1.25 times upper limit of normal
- PTT ≥ 80%
- Albumin ≥ 35 g/L
- FEV1 > 1 L
- Not pregnant or nursing
- Fertile patients of must use effective contraception
Exclusion criteria:
- Known liver cirrhosis
- Renal insufficiency
- Respiratory insufficiency (i.e., severe dyspnea at rest or oxygen dependence)
- Progressive coronary insufficiency
- Myocardial infarction in the past 6 months
- Legally incapacitated
- Impossible to receive study therapy due to geographical, social, or psychological reasons
- Noncompliant within constraints of the study
- Hematologic malignancy or other cancer except carcinoma in situ of the uterine cervix, treated nonmelanoma skin cancer, or intramucous disease treated within the past 3 years
PRIOR CONCURRENT THERAPY:
Exclusion criteria:
- Prior anticancer chemotherapy or radiotherapy
- Treatment with endoprosthesis
- Surgery (esophagectomy) planned without thoracotomy
Sites / Locations
- Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz
- Hopital Saint Andre
- C.H.U. de Brest
- CHR Clermont Ferrand, Hotel Dieu
- Hopital Du Bocage
- Federation Francophone de Cancerologie Digestive
- Centre Oscar Lambret
- Centre Hospital Universitaire Hop Huriez
- CHU de la Timone
- Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
- Centre Hospitalier Lyon Sud
- Centre Hospitalier Regional de Purpan
- Centre Alexis Vautrin
Arms of the Study
Arm 1
Experimental
Neoadjuvant chemoradiotherapy
Weekly cetuximab (400 mg/m2 one week before start of radiotherapy RT and 250 mg/m2 during radiotherapyRT), and 5 FU (500 mg/m2 per day D1-D4) combined with cisplatin CDDP (40 mg/m2 D1) on week 1 and 5