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A Prospective Randomized Trial Comparing Standard Chemotherapy Followed By Resection Versus Infusional Chemotherapy In Patients With Resectable Adenocarcinoma Of The Oesophagus


Phase 3
N/A
N/A
Open (Enrolling)
Both
Esophageal Cancer

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Trial Information

A Prospective Randomized Trial Comparing Standard Chemotherapy Followed By Resection Versus Infusional Chemotherapy In Patients With Resectable Adenocarcinoma Of The Oesophagus


OBJECTIVES:

- Compare survival and quality of life of patients with resectable adenocarcinoma of the
esophagus treated prior to surgery with standard chemotherapy comprising cisplatin and
fluorouracil versus prolonged infusional chemotherapy comprising cisplatin, epirubicin,
and fluorouracil.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to one of two
treatment arms.

- Arm I (Standard chemotherapy): Patients receive cisplatin IV over 4 hours on days 1-4
and fluorouracil IV continuously on days 1-4. Treatment repeats every 21 days for 2
courses in the absence of disease progression or unacceptable toxicity.

- Arm II (Infusional chemotherapy): Patients receive cisplatin IV over 4 hours on day 1,
epirubicin IV on day 1, and fluorouracil IV continuously. Treatment repeats every 21
days for 4 courses in the absence of disease progression or unacceptable toxicity.

Patients undergo surgery 4-6 weeks after the last dose of fluorouracil in arm I or anytime
after the fluorouracil infusion is completed in arm II.

Quality of life is assessed at baseline, immediately before starting the last course of
chemotherapy, immediately before surgery, 6 weeks post-operatively, and at 6, 9, 12, 18, and
24 months after randomization.

Patients are followed every 3 months for 1 year, every 6 months for 5 years, and then
annually thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: Approximately 1,300 patients (650 per treatment arm) will be accrued for
this study.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed adenocarcinoma of the esophagus or type 1 or 2 tumors of the
gastroesophageal junction

- Stage IIB or greater by spiral or multi-slice CT scan and endoscopic ultrasound

- Amenable to primary surgery with curative intent

- No para-aortic/celiac lymphadenopathy greater than 1 cm on CT scan and/or greater
than 6 mm on endoscopic ultrasound

- No disease invading the airways, aorta, pericardium, or lung

- No liver, lung, or other distant metastases

PATIENT CHARACTERISTICS:

Age:

- Not specified

Performance status:

- WHO 0-1

Life expectancy:

- Not specified

Hematopoietic:

- WBC greater than 3,000/mm3

- Platelet count greater than 100,000/mm3

Hepatic:

- Liver function tests no greater than 1.5 times normal

Renal:

- Glomerular filtration rate greater than 60 mL/min

Cardiovascular:

- Ejection fraction greater than 50% OR

- Normal echocardiograph

Pulmonary:

- FEV1 greater than 1.5 L

Other:

- Not pregnant or nursing

- No prior primary malignancy

- No significant medical condition that would preclude study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- Not specified

Endocrine therapy:

- Not specified

Radiotherapy:

- Not specified

Surgery:

- See Disease Characteristics

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Primary Purpose: Treatment

Outcome Measure:

Survival

Safety Issue:

No

Principal Investigator

Derek Alderson, MD

Investigator Role:

Study Chair

Investigator Affiliation:

University Hospital Birmingham

Authority:

Unspecified

Study ID:

CDR0000069457

NCT ID:

NCT00041262

Start Date:

November 2004

Completion Date:

Related Keywords:

  • Esophageal Cancer
  • stage IIB esophageal cancer
  • stage IIIA esophageal cancer
  • stage IIIB esophageal cancer
  • adenocarcinoma of the esophagus
  • Adenocarcinoma
  • Esophageal Diseases
  • Esophageal Neoplasms

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