Anal Cancer Clinical Trial
Official title:
A Phase II Evaluation of Dose-Painted Intensity-Modulated Radiation Therapy (IMRT) in Combination With 5-Fluorouracil (5-FU) and Mitomycin-C for Reduction of Acute Morbidity in Carcinoma of the Anal Canal
RATIONALE: Specialized radiation therapy that delivers a high dose of radiation directly to
the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in
chemotherapy, such as fluorouracil and mitomycin C, work in different ways to stop the growth
of tumor cells, either by killing the cells or by stopping them from dividing. Giving
radiation therapy together with 5-fluorouracil (5-FU) and mitomycin C may kill more tumor
cells.
PURPOSE: This phase II trial is studying the side effects and how well giving
intensity-modulated radiation therapy together with fluorouracil and mitomycin C works in
treating patients with invasive anal cancer.
OBJECTIVES:
Primary
- Determine if dose-painted, intensity-modulated radiation therapy (IMRT), fluorouracil,
and mitomycin C decreases the combined rate of gastrointestinal and genitourinary
adverse events (grade II or greater) by at least 15% in the first 90 days after the
start of treatment in patients with primary invasive carcinoma of the anal canal
compared to patients treated on the radiotherapy, fluorouracil, and mitomycin C arm on
clinical trial RTOG 98-11.
Secondary
- Determine the feasibility of performing IMRT in these patients in a cooperative group
setting.
- Evaluate adverse events experienced by patients treated with this regimen and to
decrease the grade 2 and higher and grade 3 and higher overall adverse event rates by
15% or 20% as compared to the radiotherapy and mitomycin C arm of RTOG 98-11.
- Evaluate the total duration of radiotherapy.
- Evaluate the efficacy of this regimen, in terms of locoregional failure, disease-free
survival, time to colostomy, colostomy-free survival, and overall survival of these
patients.
- Determine clinical complete response at 8 weeks after completion of study treatment.
OUTLINE: This is a multicenter study.
Patients receive mitomycin C IV over 10-30 minutes on days 1 and 29 and fluorouracil IV
continuously over 96 hours on days 1-4 and 29-32. Patients also undergo dose-painted
intensity-modulated radiation therapy once daily, 5 days a week, for 5½ to 6 weeks beginning
on day 1. Treatment continues in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed every 3 months for 1 year, every 6
months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 59 patients will be accrued for this study.
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