View clinical trials related to Esophageal Neoplasms.
Filter by:The role of MRI in the management of esophageal cancer remains unclear and poorly studied. Recent technical advances suggest that MRI may become a powerful technique for the initial assessment of esophageal cancer, but also for the evaluation of response to neo-adjuvant treatment before surgery. This imaging study will be performed prospectively and consecutively in 60 patients included over a 18-month period in patients wîth newly diagnosed esophageal cancer. The aim of this study is to assess the accuracy of MRI to visualize esophageal tumors, to assess tumor burden and potential contact with adjacent structures as well as associated lymph nodes. If chemotherapy or radio-chemotherapy treatment is indicated before surgery, we will also evaluate whether MRI helps us to better evaluate the response to this treatment in comparison to PET-scan or echo. endoscopy which are the examinations currently performed to evaluate the effectiveness of these treatments. The images of the MRI exams will be interpreted by 1 expert radiologist with no knowledge of the other imaging modalities and transmitted to the doctors in charge for possible consideration for the treatment. Patients will then be followed for one year according to clinical management standards to study the data on treatment complications and cancer progression at one year. The main risk is the administration of a gadolinium chelate-based MRI contrast product used routinely. There is also a risk that the results of the MRI may influence the treatment initially planned for example by canceling a surgical procedure.
The investigators aimed to compare elective nodal irradiation versus involved field irradiation with or without concurrent chemotherapy and the addition of consolidation chemotherapy for patients with extensive lymphatic metastasis of esophageal cancer.
The purpose of this study is to assess the efficacy and safety of patients who receive apatinib plus radiotherapy and S-1 for treatment of refractory or metastatic esophageal squamous cell carcinoma.
This phase III trial is designed to explore a higher radiation dose by using IMRT simultaneous integrated boost technique with or without concurrent chemotherapy for esophageal carcinoma with limited lymph node metastasis.
There is no evidence available about which molecular profiling methods are currently used for cancer patients in Austrian clinical practice. The construction of the registry proposed as a completely independent research endeavor, will be helpful for scientific evaluation and the establishment of highly credible data.
Phase II study, randomized, open-label, multicentric, willing to establish the benefit of pursuing chemotherapy beyond 6 weeks for non progressive patients. The study will proceed in two successive phases : - non randomized phase in which all patients will undergo chemotherapy - second phase in which only non progressive patients are going to be randomized ("discontinuation design"). Patients that will show progression in their disease during the first 6 weeks will be released of the study
This is a single-center, single-arm, open-label, Simon 2-stage, phase II trial in up to 55 patients with a potentially resectable, histologically-proven, adenocarcinoma or poorly differentiated carcinoma of the stomach, esophagogastric junction (EGJ), or lower third of the esophagus. Patients will receive neoadjuvant therapy consisting of 4 cycles of avelumab added to the modified chemotherapy regimen of docetaxel, cisplatin, 5- fluorouracil. Following surgery, pathologic response will be assessed. Patients will then receive adjuvant therapy consisting of 4 cycles of mDCF + avelumab. Patients will be followed to assess two-year disease-free survival rates. The primary objective of this study is to assess the effect on pathologic complete response rate (pCR) of adding avelumab to an mDCF regimen. The secondary objectives of this study are to determine the safety of adding avelumab to an mDCF regimen and assess its effect on two-year disease-free survival.
This clinical trial is designed to be a multi-center prospective observational study which shall compare the effect of different postoperative home nutrition modes on recent nutritional index (weight/BMI) of patients with esophageal cancer and recent outcomes. Different postoperative home nutrition modes adopted in this study includes oral natural diet, oral nutrition supplement and tube feeding.
The purpose of this Phase II, Open-label, single arm, exploratory study is to evaluate the efficacy and the safety of Apatinib（500mg/d）for the second - line treatment of esophageal cancer or esophageal and gastric
Rationale: Current standard treatment of localized esophageal cancer (EC) with neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy with curative intent results in 30% complete, 40-60% partial and 20% no-response at pathologic examination. Clinical response of nCRT is usually evaluated with PET-CT. However, response measurements are currently still insufficient in optimizing EC treatment. Proper pre-surgical response prediction may allow individualized treatment with esophagus-preservation in complete responders or switching to an alternative treatment in non-responders. Interestingly, in many tumors, a subset of cells has been found to possess cancer stem cell (CSC) properties with associated signaling as drivers of tumor (re-)growth and therapy resistance. Response of CSC-derived tissue resembling in vitro cultured tumor organoids may reflect patient's tumors sensitivity to therapy. Objective: To create a patient derived organoid model for EC patients to predict the pathologic tumor response to nCRT in clinical practice. This will allow a more personalized approach in future treatment of locally advanced EC. Study design: Fresh esophageal tumor material will be collected during diagnostic endoscopic ultrasound (EUS) in participating patients. These biopsies will be used to select cancer stem cells, which will be cultured to derive organoids (esophageal cancer patient derived organoids; EC-PDO). When the EC-PDO contain sufficient cells, these cells will be treated with radiotherapy and/or chemotherapy in order to obtain dose-response curves. The response of these EC-PDOs will be compared to the actual tumor response to nCRT treatment in these EC patients, which will be assessed at the definitive pathologic examination of the resection specimen after esophagectomy with curative intent. Study population: All patients with curatively treatable and resectable esophageal cancer (adenocarcinoma or squamous cell carcinoma) can be included in this trial. Main study parameters/endpoints: The main endpoint is response prediction to chemoradiotherapy by EC-PDO; the steepness of the dose response survival curve in the organoids in relation to the pathologic response after resection in the clinical situation. Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The patients will be asked to undergo 3 to 6 additional biopsies during endoscopic ultrasonography (EUS) for the TNM staging of the tumor. The risk of these additional biopsies is not greater than the biopsies for the diagnosis of EC. The patient will not benefit from participation in this trial. For the future approach we can get more insight into the mechanism of (chemo)radiation response or resistance to nCRT, which might lead to a better patient selection and more individualized esophageal cancer treatment in the future. This improvement in selection and treatment can result in less over or under-treatment of these EC patients.