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Is Elective Nodal Irradiation (ENI) Necessary For Patients With Thoracic Esophageal Squamous Cell Carcinoma Who Undergo Esophagectomy And With Pathological Stage Of T1-2,N+,M0 -- A Randomized Phase Ⅲ Trial


Phase 3
18 Years
70 Years
Open (Enrolling)
Both
Esophageal Squamous Cell Carcinoma

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Trial Information

Is Elective Nodal Irradiation (ENI) Necessary For Patients With Thoracic Esophageal Squamous Cell Carcinoma Who Undergo Esophagectomy And With Pathological Stage Of T1-2,N+,M0 -- A Randomized Phase Ⅲ Trial


Patient Population:

Thoracic esophageal squamous cell carcinoma after esophagectomy with at least 15 lymph nodes
removed for adequate nodal staging.

R0 resection; T1-2, N+, M0.

Scheme:

After esophagectomy, patients are firstly stratified by numbers of lymph node metastasis (<3
or >=3). Then patients are randomized to 2 arms:

Arm A:

Adjuvant chemotherapy (4 cycles).

Arm B:

Adjuvant chemotherapy (4 cycles) + Elective Nodal Irradiation (bilateral supraclavicular
fossa and mediastinum).


Inclusion Criteria:



1. Age ≥ 18 and ≤70

2. ECOG performance status 0-1

3. Weight is not less than 90% of it before operation

4. Registration within 8 weeks after esophagectomy

5. Histologically proven primary thoracic esophageal squamous cell carcinoma

6. R0 resection and number of lymph nodes dissected ≥15 after esophagectomy

7. Stage T1-2N1-3M0 based pathological diagnosis

8. Chest and abdominal contrast enhanced CT within 6 weeks prior to registration(PET/CT
scan is selective)

9. Without supraclavicular nodes and abdominal regions nodes existed after surgery

10. Without neo-adjuvant chemotherapy and radiotherapy

11. WBC≥ 4.0X109/L ,Absolute neutrophil count (ANC) ≥ 2.0X109/L

12. Platelets ≥ 100X109/L

13. Hemoglobin ≥ 90g/L(without blood transfusion)

14. AST (SGOT)/ALT (SGPT) ≤ 2.5 x upper limit of normal, Bilirubin ≤ 1.5 x upper limit of
normal

15. Creatinine ≤ 1.5 x upper limit of normal

16. Sign study-specific informed consent prior to study entry

Exclusion Criteria:

1. Multiple primary esophageal tumors

2. Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free
for a minimum of 2 years (For example, carcinoma in situ of the breast, oral cavity,
or cervix are all permissible).

3. Severe, active comorbidity, defined as follows:

3.1 Unstable angina and/or congestive heart failure requiring hospitalization within
the last 3 months 3.2 Transmural myocardial infarction within the last 6 months 3.3
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of
registration 3.4 Chronic obstructive pulmonary disease exacerbation or other
respiratory illness requiring hospitalization or precluding study therapy at the time
of registration 3.5 Acquired immune deficiency syndrome (AIDS) based upon current CDC
definition; note, however, that HIV testing is not required for entry into this
protocol. The need to exclude patients with AIDS from this protocol is necessary
because the treatments involved in this protocol may be significantly
immunosuppressive.

4. Pregnancy or women of childbearing potential and men who are sexually active and not
willing/able to use medically acceptable forms of contraception.

5. Prior systemic chemotherapy, prior radiation therapy or prior target drug therapy

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall survival

Outcome Description:

To evaluate elective nodal irradiation (ENI) is better for the overall survival of patients with thoracic esophageal cancer after esophagectomy who with pathological stage of T1-2, N positive, M0

Safety Issue:

No

Authority:

People's Republic of China: State Food and Drug Administration

Study ID:

2011ESO_FU_02

NCT ID:

NCT01398449

Start Date:

April 2011

Completion Date:

December 2017

Related Keywords:

  • Esophageal Squamous Cell Carcinoma
  • thoracic esophageal squamous cell carcinoma
  • esophagectomy
  • elective nodal irradiation
  • adjuvant chemotherapy
  • Carcinoma
  • Carcinoma, Squamous Cell
  • Esophageal Diseases

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