Esophageal Cancer Clinical Trial
Official title:
Randomized Study of Pre-Operative Radio-Chemotherapy Versus Surgery Alone in Thoracic Esophageal Cancer Deemed to be Resectable
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
they stop growing or die. Giving combination chemotherapy with radiation therapy before
surgery may shrink the tumor so it can be removed during surgery. It is not yet known if
surgery is more effective with or without radiation therapy and chemotherapy in treating
esophageal cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of surgery with or without
radiation therapy and chemotherapy in treating patients who have esophageal cancer.
OBJECTIVES:
- Compare the overall survival of patients with resectable thoracic esophageal cancer
treated with neoadjuvant radio-chemotherapy and surgery versus surgery alone.
- Compare the disease-free survival of patients treated with these regimens.
- Compare the surgical mortality and morbidity of patients treated with these regimens.
- Compare the resectability of patients treated with these regimens.
- Determine the validation of new prognostic factors for survival of these patients and/or
the efficacy of this neoadjuvant treatment.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified
according to histology (epidermoid carcinoma vs adenocarcinoma vs undifferentiated
carcinoma), stage (I vs IIA vs IIB), tumor location (above the carina vs below the carina),
and participating center. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo radiotherapy daily 5 days a week for 5 weeks. Patients receive
fluorouracil IV continuously on days 1-4 and 29-32 and cisplatin IV on days 1 or 2 and
29 or 30 (or a lower dose on days 1-5 and 29-33). Within 4-8 weeks after completion of
radio-chemotherapy, patients undergo surgical resection.
- Arm II: Patients undergo surgical resection. Patients are followed every 4 months for 2
years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 380 patients (190 per treatment arm) will be accrued for this
study within 3 years.
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