Colorectal Cancer Clinical Trial
Official title:
A Phase II Trial of Chemoradiotherapy and Local Excision for uT2uN0 Rectal Cancer
RATIONALE: Drugs used in chemotherapy, such as capecitabine and oxaliplatin, work in
different ways to stop the growth of tumor cells, either by killing the cells or by stopping
them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells.
Oxaliplatin may make tumor cells more sensitive to radiation therapy. Giving capecitabine and
oxaliplatin together with radiation therapy before surgery may shrink the tumor so it can be
removed.
PURPOSE: This phase II trial is studying how well giving capecitabine and oxaliplatin
together with radiation therapy works in treating patients who are undergoing surgery for
stage I rectal cancer.
OBJECTIVES:
Primary
- Determine the 3-year disease-free survival rate in patients with stage I adenocarcinoma
of the rectum treated with neoadjuvant chemoradiotherapy comprising capecitabine,
oxaliplatin, and radiotherapy followed by local excision.
Secondary
- Determine the rate of resectability with negative resection margins in patients treated
with this regimen.
- Determine the procedure-specific morbidity and mortality in patients treated with this
regimen.
- Determine the rate of pathologic complete response of the primary tumor in patients
treated with this regimen.
- Determine the impact of this regimen on anorectal function and quality of life in these
patients.
- Determine the feasibility of using molecular studies to assess surgical resection
margins and tumor response in patients treated with this regimen.
- Determine molecular markers associated with local tumor recurrence in patients treated
with this regimen.
OUTLINE: This is a non-randomized, multicenter study.
Patients undergo high-dose external beam radiotherapy once daily on days 1-5, 8-12, 15-19,
22-26, and 29-33. Patients also receive oral capecitabine twice daily on days 1-14 and 22-35
and oxaliplatin IV over 2 hours on days 1, 8, 22, and 29. Approximately 4-8 weeks after
completion of chemoradiotherapy, patients undergo local excision of the tumor. Patients with
T3 disease or positive resection margins after local excision undergo radical resection of
the rectum and receive additional chemotherapy and/or radiotherapy at the discretion of the
physician.
Quality of life is assessed at baseline and then 1 year after surgery.
After completion of study treatment, patients are followed at 1 month, every 4 months for 3
years, and then every 6 months for 2 years.
PROJECTED ACCRUAL: A total of 102 patients will be accrued for this study within 2.8 years.
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