Status:

RECRUITING

A Randomized Controlled Trial Evaluating of Prophylactic Irradiation in CRT for cT1bN0M0 ESCC

Lead Sponsor:

National Cancer Center, Japan

Conditions:

Esophageal Squamous Cell Carcinoma

Eligibility:

All Genders

20+ years

Phase:

PHASE3

Brief Summary

This study is conducted to investigate whether modified chemoradiotherapy with elective nodal irradiation reduces the locoregional recurrence that cannot be completely resected by salvage endoscopic r...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Histologically proven squamous cell carcinoma, adenosquamous carcinoma, or basaloid cell carcinoma.
  • All lesions located in the thoracic esophagus. Secondary lesions with an absolute indication for endoscopic resection (EMR/ESD) may not be confined to the thoracic esophagus.
  • Clinical N0M0 with cervical to abdominal contrast-enhanced CT.
  • The deepest lesion is diagnosed as cT1b (SM1 / SM2 / SM3) with upper gastrointestinal endoscopy. If it is difficult to differentiate cT1a-MM and cT1b-SM1 clinically, the wall depth is diagnosed as cT1b-SM1.
  • Aged 20 years and older.
  • ECOG Performance status 0 or 1.
  • No previous therapy against esophageal cancer except for complete resection by EMR/ESD with either pT1a-LPM (pM2) / pT1a-MM (M3) disease or pT1a-MM (M3) disease without vascular infiltration.
  • No history of radiotherapy for the neck, chest, and upper abdomen for any cancers. No chemotherapy or hormone therapy with less than 3 years of disease-free interval for any cancers.
  • Major organ function is preserved. 1) WBC\<=12,000/mm3 2) ANC\>=1,500/mm3 3) Hb\>=10.0 g /dL 4) PLT\>=10,000/mm3 5) T-bil\<=1.5 mg /dL 6) AST\<=100 IU/L 7) ALT\<=100 IU/L 8) SpO2\>=95% 9) Ccr\>=60 mL/min
  • Patients do not have a preference to receive a surgical resection as an initial therapy after receiving explanations.
  • Written informed consent is obtained.
  • Exclusion criteria:
  • Simultaneous or metachronous (within 5 years) double cancers, except for intramucosal tumor curable with local therapy.
  • Active infection requiring systemic therapy.
  • Fever over 38 degrees Celsius
  • Female during pregnancy, within 28 days of post parturition, or during lactation. Male who wants a partner's pregnancy.
  • Psychological disorder, which is difficult to participate in this clinical study.
  • Receiving continuous systemic corticosteroid or immunosuppressant treatment.
  • Positive for HBs antigen or HIV antigen.
  • Diabetes mellitus, which is uncontrollable with continuous use of insulin or hypoglycemic agents.
  • Uncontrolled arterial hypertension.
  • History of unstable angina pectoris within three weeks or myocardial infarction within six months before registration.
  • Uncontrolled valvular disease, dilated cardiomyopathy, and hypertrophic cardiomyopathy.
  • Severe emphysema, interstitial pneumonia or pulmonary fibrosis based on chest CT.
  • With a history of cerebrovascular disorder within 6 months.
  • Drug allergy for iodic drugs.

Exclusion

    Key Trial Info

    Start Date :

    July 1 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    March 31 2030

    Estimated Enrollment :

    280 Patients enrolled

    Trial Details

    Trial ID

    NCT04328948

    Start Date

    July 1 2020

    End Date

    March 31 2030

    Last Update

    May 22 2025

    Active Locations (1)

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    1

    National Cancer Center Hospital

    Tokyo, Japan