Neoadjuvant Therapy vs Standard Therapy in Locally Advanced Rectal Cancer
Evaluation and Comparison of the Efficacy of a New Standard Pre-operative Chemotherapy for Stage II and III Colorectal Cancer According to the FOLFOX4 Regimen With Routine Chemoradiation Therapy
Lithuanian University of Health Sciences
250 participants
Jun 1, 2015
INTERVENTIONAL
Conditions
Summary
Phase II, Multicenter, Open-label, Randomized Study evaluating neoadjuvant chemotherapy (FOLFOX4) in patients with stage II and III colorectal cancer with standard chemoradiation Defined by Magnetic Resonance Imaging
Eligibility
Inclusion Criteria9
- diagnosed with rectal adenocarcinoma;
- radiologically measurable tumor size;
- general condition (ECOG 0-2 points);
- stage II or III rectal tumor clinically (pelvic MRI and endorectal ultrasound),
- in the absence of long-term spread of the disease (confirmed by radiological examinations (computed tomography of the thorax and abdomen));
- during preoperative proctoscopy, the tumor is detected 0 -15 cm from the anus;
- Blood tests 28 days before the start of treatment:
- and general blood count: neutrophils greater than 1.5x10 9 / l, platelets greater than 100 x 10 9 / l, Hemoglobin greater than 80 g / l, liver enzymes (Aspartate aminotransferase (AST/GOT), alanine aminotransferase (ALT/GPT) not more than 3 times upper limit), and renal function (creatinine up to 1.5 times the upper limit of normal) is normal; women of childbearing potential - negative pregnancy test;
- • A signed informed consent form.
Exclusion Criteria6
- patients with signs of intestinal obstruction at the start of treatment;
- previous lower abdominal radiation therapy;
- other tumors over a five-year period;
- pregnant or breastfeeding women;
- men and women of childbearing potential who do not agree to use adequate contraception;
- Patient co-morbidities that would make the patient unsuitable for this study or significantly interfere with the assessment of safety and toxicity.
Interventions
Radiotherapy 50 Gy 5 radiations per week of 2 Gy for 5 weeks
Fluorouracil 400 mg/m² D1-4 and folic acid 20mg/m2 D1-4 the first and fifth weeks of radiotherapy
oxaliplatin: 85 mg/m² in 2 hours at D1; folinic acid: 100 mg/m² simultaneously in 2 hours at D1 and D2 during the Oxaliplatin; bolus 5-fluorouracil (5-FU) 400mg/m² D1+D2; infusion 5-fluorouracil (5-FU): 600 mg/m² continuous infusion during 22hours at D1 and D2, every 14 days during 42 months (8 cycles).
Chemoradiotherapy 5 weeks (50 Grays (Gy), 2 Gy/session; 25 fractions) + fluorouracil/leucovorin 400 mg/m² 1-4 day the first and fifth weeks of radiotherapy. FOLOFX4 will be administrated for 8 cycles over a 16 week period. Patients will undergo re-staging within 6 weeks of their 8th cycle of FOLFOX. This will include MRI of the pelvis. If the reassessment reveals that there has been no disease progression compared to the pre-treatment evaluation and the patient remains a candidate for an R0 resection, the patient will proceed to definitive rectal cancer surgery within 8 weeks from the last chemotherapy dose. If the surgical oncologist's reassessment reveals that the patient is not a candidate for an R0 resection, the patient will proceed to standard pre-operative radiation with synchronous fluorouracil.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT05378919