Pre-op Chemo-RT w/CDDP/5FU vs Chemo w/ Docetaxel/Irinotecan in PET Non Responder Resectable Esophagus Cancer
Carcinoma of Esophagus
About this trial
This is an interventional treatment trial for Carcinoma of Esophagus focused on measuring Randomized trial,, Pre-operative chemo-RT with CDDP and 5-FU, Multicenter study
Eligibility Criteria
Inclusion Criteria:
- Histologically proven squamous cell or adenocarcinoma of the thoracic esophagus and gastro-esophageal junction.
- No distant metastases.
- Signed written informed consent.
- Age less than 75 years.
- Potentially resectable tumor (radiological evidence of resection with no residual disease).
- ECOG 0 to 2.
- Normal serum creatinine and adequate hepatic function, serum bilirubin less than 30 mmol/l, serum alkaline phosphatase less than 2 times upper limit of normal and ALT and AST of less than 4 upper limits of normal.
- Normal bone marrow function with absolute neutrophile count of more than 1500/ml, hemoglobin more than 80 gm/L and platelets more than 100,000 /ml
Exclusion Criteria:
- Serious underlying medical condition which could impair the patient ability to participate in the clinical trial or comply to follow up
- Prior treatment with other anti cancer therapy or radiation therapy.
- Legal incapacity.
- Previous malignancy within 5 years except adequately treated non melanomatous skin cancer or in situ cervical cancer.
- Psychiatric or mental disorder precluding the understanding of the information of the trial topics and giving valid informed consent.
Sites / Locations
- King Faisal Specialist Hospital & Research Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Arm A
Arm B
Arm A: will receive combination of irinotecan and docetaxel regimen for 2 cycles, recycling every 21 days Irinotecan 100 mg/m2 by intra venous infusion over 2 hours in day1 and docetaxel 40 mg/m2 over one hour will be given on day 1 Assessment by PET scan and CT chest and abdomen will be done 2-3 weeks after end of 2nd cycle of irinotecan and docetaxel
Arm B will receive combination of cisplatin, fluorouracil and concurrent radiation therapy 50 Gy in 25 fractions over 5 weeks with cisplatin 75 mg/m2 on first day of week 1 and week 5 and fluorouracil 750 mg/m2 daily by continuous intra venous infusion at Day 1 and Day 29 of Radiation therapy for 4 days. PET scan will be repeated 3-4 weeks after end of concurrent chemo-radiation therapy Patients in Arm A and B will go for esophagectomy 4-6 weeks after end of concurrent chemo-radiation therapy or chemotherapy