Impact of PET Scan on the Curative Strategy of Colo-rectal Cancers : A Randomized Study (ITEP)
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Purpose
The risk of recurrence in stage III and IV of colorectal cancers (CRC) is high during the three years following the tumoral resection with curative aim. Therefore, a prolonged follow-up and an intense monitoring are recommended to detect these recurrences precociously. Nevertheless, current consensual morphological and biological examinations are not very contributory, of difficult interpretation and expensive. The metabolic imagery in tomoscintigraphy by emission of positron coupled with the scanner, called PET-TDM, allows to identify more specifically recurrences, analyzes the whole body, detects hepatic metastasis more precociously and give some benefice for early diagnosis of lymph nodes recurrence. The principle purpose of this study is to evaluate if the systematic follow-up per PET-TDM allows detecting more often recurrences accessible to a curative surgery. We make the hypothesis that the systematic practice of PET- tomodensitometry (TDM) during the follow-up of CRC allows to decrease non curative recurrences appearance during the 3 years follow-up after a curative surgery.
| Condition | Intervention |
|---|---|
|
Colorectal Cancer |
Other: semi-annual systematic PET-TDM Other: PET-TDM for current indication |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Impact of PET Scan on the Curative Strategy of Colo-rectal Cancers : A Randomized Study |
- Percentage of patients with a non removable recurrence [ Time Frame: at the end of the study ] [ Designated as safety issue: Yes ]
- Survival without non removable tumor [ Time Frame: At the end of the study ] [ Designated as safety issue: Yes ]
- Overall survival [ Time Frame: At the end of the study ] [ Designated as safety issue: Yes ]
- Cost of the strategy [ Time Frame: At the end of the study ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 240 |
| Study Start Date: | June 2008 |
| Estimated Study Completion Date: | January 2016 |
| Estimated Primary Completion Date: | January 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 2
Usual follow up : Pet-TDM for current indication (high isolated markers or before a metastasis curative resection)
|
Other: PET-TDM for current indication
PET-TDM for current indication (high isolated markers or before a metastasis curative resection)
Other Name: PET-TDM for current indication
|
|
Experimental: 1
Semi-annual systematic PET-TDM (M6, M12, M18, M24, M30 and M36 after initial surgery)
|
Other: semi-annual systematic PET-TDM
semi-annual systematic PET-TDM
Other Name: semi-annual systematic PET-TDM
|
Detailed Description:
Patients will be randomized in two groups: one (PET-TDM group) including a semi-annual systematic PET-TDM during usual follow-up (M6, M12, M18, M24, M30 and M36 after initial surgery) and the second (control group) in which one PET-TDM will be realized only for current indication (high isolated markers or before a metastasis curative resection) during usual follow-up. Will be included patients with a high risk of recurrence of a colorectal tumor N+ or M+ completely removed (R0 or R1) or tumor stage 4, no regional lymph node metastasis, no distant metastasis (T4N0M0) operated in emergency (tumoral perforation).
Patients will be followed-up during 3 years since the date of initial surgery. Conventional follow-up will be performed by consensual recommendations for all the patients. In the case of detecting a recurrence, the adapted treatment (surgery or chemotherapy or both) with curative aim will be implemented and the follow-up will be carried out in its term or death. In the case of non curable recurrence, the follow-up will be carried out in its term or death, and the PET-TDM will not be realised any more.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with a removed colorectal adenocarcinoma since less than 6 months, in total remission and for whom a monitoring is necessary to detect recurrences precociously.
- Patients with a removed colorectal tumour which is histologically proved and classified N+ and/or M+ (stage III or IV). Hepatic and/or pulmonary metastasis would have been totally removed since less 6 months before inclusion.
- Patients with a T4N0M0 tumour and operated in emergency (because of a tumoral perforation) can be included. (suppressed by amendment 1)
- 2 before criteria have been replaced by : Patients with colorectal adenocarcinoma which is histologically proved and classified stage II perforated, III or IV, totally removed, in total remission,
- if no metastatic, removed surgery must have been done since less 6 months;
- if metastatic, all metastasis would have been removed, the last surgery dating less 6 months.(amendment 1)
- Casual extension check-up would have been realized before initial surgery or during a period of 6 months after surgery performed in emergency.
- informed consent signed
- Age ≥ 18 years
- Patient in ability to undergone hepatic or pulmonary resection in case of recurrence during the follow-up (ECOG ≤ 2)
- Willingness to control visits
Exclusion Criteria:
- pregnant or breast feeding women, or with a reproductive potential and no practicing an effective method of contraception during the second part of ovarian cycle ( PET is realised during the first part of ovarian cycle)
- Cancer stage I or II (except T4 operated in emergency) or IV without possibility to remove metastasis or R2 after surgery.
- Performance status contraindicating a hepatic or pulmonary surgery in case of recurrence.
- Patients likely to undergone chemotherapy, surgery or radiotherapy during 2 weeks before PET-TDM.
Other progressive tumoral affection known, or colorectal cancer in progression.
• (Bad compliance to the study procedure.)(suppressed by amendment 1)
- Not balanced diabetes. (added by amendment 1)
- Patients included in others clinical trials of imagery.
- Inability to provide informed consent signed.
- No social assurance.
Contacts and Locations| Contact: Iradj Sobhani, MD, PhD | (0) 1 49 81 43 58 ext +33 | iradj.sobhani@hmn.aphp.fr |
| Contact: Amel Gouja, CRA | (0) 1 49 81 33 84 ext + 33 | amel.gouja@hmn.aphp.fr |
| France | |
| CHU Henri Mondor | Recruiting |
| Creteil, France, 94000 | |
| Contact: Iradj Sobhani, MD, PhD iradj.sobhani@hmn.aphp.fr | |
| Principal Investigator: Iradj Sobhani, MD, PhD | |
| Principal Investigator: | Iradj Sobhani, MD, PhD | Assistance Publique - Hôpitaux de Paris |
More Information
No publications provided
| Responsible Party: | Assistance Publique - Hôpitaux de Paris |
| ClinicalTrials.gov Identifier: | NCT00624260 History of Changes |
| Other Study ID Numbers: | P070142 |
| Study First Received: | February 15, 2008 |
| Last Updated: | December 10, 2012 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Colorectal cancer Recurrence Positron Emission Tomography |
Colorectal Cancer with high risk of recurrence stage III Colorectal Cancer with high risk of recurrence stage IV T4N0M0 operated in emergency( because of perforation) |
Additional relevant MeSH terms:
|
Rectal Neoplasms Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site |
Neoplasms Digestive System Diseases Gastrointestinal Diseases Intestinal Diseases Rectal Diseases Colonic Diseases |
ClinicalTrials.gov processed this record on May 23, 2013