Gastric Cancer Clinical Trial
Official title:
Phase III Multicenter Randomized Controlled Trial of Adjuvant Chemoradiotherapy vs Chemotherapy for Radical Resected Advanced Gastric Carcinoma Concurrent With Lymph Node Metastasis and Lymphovascular Invasion
This Enriched-CRT 2017 trial is a prospective, multicenter trial for adjuvant chemoradiotherapy (CRT) and chemotherapy (CT) in radical resected advanced gastric cancer (GC) patients with lymph node metastasis (LN+) and lymphovascular Invasion (LVI+). The primary purpose of this study is to evaluate the 3-year overall survival (OS) of enrolled patients receiving adjuvant chemoradiotherapy compared with those receiving adjuvant chemotherapy. The second purpose is to evaluate 3-year disease free survival (DFS) and determine the safety of CRT compared with CT in the patients enrolled in this study.
Gastric cancer is an important health problem, being the fourth most common cancer and the
third leading cause of cancer-related death worldwide. Age standardized mortality rates for
gastric cancer are 14.3 per 100 000 in men and 6.9 per 100 000 in women. More than 679 000
new cases and 498,000 deaths occur every year in China.
Local recurrence is considered as the most common way of recurrence for advanced gastric
cancer, as well as an important factor for poor prognosis. Radiotherapy is a widely used
technique in Western countries, and has been identified to have a significant role in
decreasing local recurrence rate in breast cancer, and colon rectal cancer. At this moment,
several randomized controlled trials have been conducted to identify the role of radiotherapy
in advanced gastric cancer. Although the results from Europe (INT-0116), Dutch (CRITICS), and
Korea (ARTIST) did not find that radiotherapy could improve the overall survival of enrolled
patients, the sub-group analyses demonstrated that radiotherapy could improve the
disease-free survival in patients with lymph node metastasis. We also found that adjuvant
chemoradiotherapy could improve the survival of patients with lymph node metastasis or
lymphovascular Invasion based on a large cohort study from National Cancer Database.
Therefore, our hypothesis is that advanced gastric cancer patients with lymph node metastasis
or lymphovascular invasion are the group entity that could benefit from radiotherapy. At
present, a new clinical trial (ARTIST II), aiming at advanced gastric cancer with positive
lymph node metastasis, has been launched. China is one of the countries with the highest
incidence of gastric cancer, sand nearly 80% of patients are diagnosed with advanced stage.
So it's necessary to conduct the clinical research on this issue.
This Enriched-CRT 2017 trial is a prospective, multicenter trial for adjuvant
chemoradiotherapy (CRT) and chemotherapy (CT) in radical resected advanced gastric cancer
patients with lymph node metastasis and lymphovascular Invasion. The primary purpose of this
study is to evaluate the 3-year overall survival (OS), and the second purpose is to evaluate
3-year disease free survival (DFS) and determine the safety of CRT compared with CT in the
patients enrolled in this study.
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