Esophageal Cancer Clinical Trial
Official title:
A Phase II Trial of Preoperative Irinotecan, Cisplatin and Radiation in Esophageal Cancer
This phase II trial studies how well giving cisplatin and irinotecan hydrochloride together with radiation therapy works in treating patients with esophageal cancer or gastroesophageal junction cancer that can be removed by surgery. Drugs used in chemotherapy, such as cisplatin and irinotecan hydrochloride, 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. Giving combination chemotherapy together with radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
PRIMARY OBJECTIVES:
I. To determine the pathologic complete response rate in patients with surgically resectable
esophageal cancer treated pre-operatively with induction chemotherapy with weekly cisplatin
and irinotecan (irinotecan hydrochloride) followed by concurrent cisplatin/irinotecan and
radiation therapy.
SECONDARY OBJECTIVES:
I. To evaluate potential response or progression of disease during induction chemotherapy
with positron emission tomography (PET) scan.
II. To evaluate the toxicity and tolerability of therapy, including surgical morbidity and
mortality.
III. To determine the overall survival, disease free survival, and pattern of failure.
OUTLINE:
INDUCTION CHEMOTHERAPY (COURSES 1-2): Patients receive cisplatin intravenously (IV) over 30
minutes and irinotecan hydrochloride IV over 30-90 minutes on days 1 and 8 of courses 1 and
2. Treatment repeats every 21 days for 2 courses in the absence of disease progression or
unacceptable toxicity.
CHEMORADIOTHERAPY (COURSES 3-4): Beginning 2 weeks after completion of induction
chemotherapy, patients receive cisplatin and irinotecan hydrochloride as in induction
chemotherapy on days 1 and 8 of courses 3 and 4 and undergo radiotherapy daily 5 days a week
in course 3. Treatment repeats every 21 days for 2 courses in the absence of disease
progression or unacceptable toxicity.
SURGERY: Approximately 4-8 weeks after completion of chemoradiotherapy, patients undergo
surgery to remove the tumor.
After completion of study treatment, patients are followed up every 3 months for 2 years and
then every 6 months for 3 years.
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