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Simultaneous Integrated Boost for Mediastinal Lymph Node Recurrence After Radical Surgery of Esophageal Cancer

Primary Purpose

Esophageal Cancer, Salvage Radiotherapy, Dose-escalation

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
treatment group(phase I)
treatment group (phase II)
Sponsored by
Ruijin Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophageal Cancer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Histo-pathologically proven diagnosis of esophageal squamous cell carcinoma. Age ≥18 and ≤80 ECOG performance status 0-1. Clinical diagnosis of ≤5 mediastinal lymph nodes recurrence after esophagectomy.

Patients without distant metastasis and life expectancy ≥ 3 months. adequate liver and renal function and adequate bone marrow reservation. Written, signed informed consent.

Exclusion Criteria:

Prior radiotherapy to recurrence site of esophageal cancer. Other co-existing malignancies or malignancies diagnosed within the last 5 years.

Pregnant women. Women who are breastfeeding a baby. Patients with uncontrolled serious medical or mental illnesses.

Sites / Locations

  • Ruijin Hospital Affiliated to Shanghai Jiaotong University School of MedicineRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment group

Arm Description

Outcomes

Primary Outcome Measures

Dose limiting toxicity(DLT) of Simulatianeous Integrated Boost (SIB)
DLT was defined as grade 4 or higher hematological toxicities and/or grade 3 or higher nonhematological toxicities.
Overall survival (phase II)
Survival time was measured from the date of study enrollment to the date of death or last follow-up;

Secondary Outcome Measures

Overall survival (phase I)
Survival time was measured from the date of study enrollment to the date of death or last follow-up;
Late toxicity (phase I)
late toxicity were grade according to RTOG and CTCAE criteria
Overall survival (phase II)
Survival time was measured from the date of study enrollment to the date of death or last follow-up;
acute Toxicity (phase II)
acute toxicity were grade according to CTCAE criteria
late Toxicity (phase II)
late toxicity were grade according to RTOG and CTCAE criteria
1-year local progression-free survival
From treatment initiation to first documented local progression or death or censor

Full Information

First Posted
June 16, 2019
Last Updated
September 21, 2022
Sponsor
Ruijin Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03990532
Brief Title
Simultaneous Integrated Boost for Mediastinal Lymph Node Recurrence After Radical Surgery of Esophageal Cancer
Official Title
Phase I/II Dose Escalation by Simultaneous Integrated Boost for Mediastinal Lymph Node Recurrence After Radical Surgery of Esophageal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 30, 2019 (Actual)
Primary Completion Date
April 30, 2024 (Anticipated)
Study Completion Date
April 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ruijin Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Esophageal cancer (EC) ranks the seventh most diagnosed malignant tumor (572,000 new cases) and the sixth cancer-related mortality (509,000 deaths) worldwide in 2018. The incidence of EC is strikingly varying among the regions and sexes. Approximately 70% of EC cases occur in men, and there is a 2-fold to 3-fold difference in incidence and mortality rates between regions worldwide. According to the latest reported in 2017, esophageal cancer ranks the sixth most common cancer and the fourth leading cause of cancer-mortality in China. Currently, esophagectomy is considered as the standard treatment for resectable EC patients. However, the prognosis of stage IIA-III esophageal cancer after esophagectomy remains poor, and local regional lymph node recurrence is the major patterns of recurrence, and mediastinal lymph node recurrence is one of the most common sites. Previous retrospective study has found that salvage chemoradiotherapy is a effective treatment option for these patients. However, the optimal dose remains unknown. In addition, no prospective trials have been conducted to investigate the efficacy and toxicities of salvage chemo-radiotherapy by using simultaneous integrated boost for the treatment of mediastinal lymph node recurrence after radical surgery of esophageal Cancer

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Cancer, Salvage Radiotherapy, Dose-escalation, Mediastinal Lymph Node Recurrence

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
46 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
treatment group
Arm Type
Experimental
Intervention Type
Radiation
Intervention Name(s)
treatment group(phase I)
Intervention Description
Dose-escalation plan (phase I) Radiotherapy: LEVEL 1: dose given at PTV-G will be 58.8Gy/28 fractions; 2.1Gy/per fraction; LEVEL 2: dose given at PTV-G will be 64.4Gy/28 fractions; 2.3Gy/per fraction; LEVEL 3: dose given at PTV-G will be 70Gy/28 fractions; 2.5Gy/per fraction Concurrent chemotherapy: 5-Fu/capecitabine/S-1+DDP or S-1 or Capecitabine
Intervention Type
Radiation
Intervention Name(s)
treatment group (phase II)
Intervention Description
Radiotherapy dose was prescribed according to phase I trial results; Concurrent chemotherapy: 5-Fu/capecitabine/S-1+DDP or S-1 or Capecitabine
Primary Outcome Measure Information:
Title
Dose limiting toxicity(DLT) of Simulatianeous Integrated Boost (SIB)
Description
DLT was defined as grade 4 or higher hematological toxicities and/or grade 3 or higher nonhematological toxicities.
Time Frame
up to 3 months
Title
Overall survival (phase II)
Description
Survival time was measured from the date of study enrollment to the date of death or last follow-up;
Time Frame
up to 1 year
Secondary Outcome Measure Information:
Title
Overall survival (phase I)
Description
Survival time was measured from the date of study enrollment to the date of death or last follow-up;
Time Frame
up to 1 year
Title
Late toxicity (phase I)
Description
late toxicity were grade according to RTOG and CTCAE criteria
Time Frame
up to 2 year
Title
Overall survival (phase II)
Description
Survival time was measured from the date of study enrollment to the date of death or last follow-up;
Time Frame
up to 2 year
Title
acute Toxicity (phase II)
Description
acute toxicity were grade according to CTCAE criteria
Time Frame
up to 3 months
Title
late Toxicity (phase II)
Description
late toxicity were grade according to RTOG and CTCAE criteria
Time Frame
up to 2 year
Title
1-year local progression-free survival
Description
From treatment initiation to first documented local progression or death or censor
Time Frame
up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histo-pathologically proven diagnosis of esophageal squamous cell carcinoma. Age ≥18 and ≤80 ECOG performance status 0-1. Clinical diagnosis of ≤5 mediastinal lymph nodes recurrence after esophagectomy. Patients without distant metastasis and life expectancy ≥ 3 months. adequate liver and renal function and adequate bone marrow reservation. Written, signed informed consent. Exclusion Criteria: Prior radiotherapy to recurrence site of esophageal cancer. Other co-existing malignancies or malignancies diagnosed within the last 5 years. Pregnant women. Women who are breastfeeding a baby. Patients with uncontrolled serious medical or mental illnesses.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wei-Xiang Qi, Dr.
Phone
+86-021-64370045
Email
qiweixiang1113@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
shengguang zhao, Dr.
Phone
+86-021-64370045
Email
zhaoshengguang@163.com
Facility Information:
Facility Name
Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200040
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wei-Xiang Qi
Phone
+86-021-13761059660
Email
qiweixiang1113@163.com

12. IPD Sharing Statement

Learn more about this trial

Simultaneous Integrated Boost for Mediastinal Lymph Node Recurrence After Radical Surgery of Esophageal Cancer

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