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Preoperative Chemo-radiation With IG-IMRT Dose Escalation for Locally Advanced Rectal Cancers (RADICAL)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03200249
Recruitment Status : Completed
First Posted : June 27, 2017
Last Update Posted : June 24, 2020
Information provided by (Responsible Party):
Centre Georges Francois Leclerc

Brief Summary:

Hypothesis : Therapeutic intensification by increasing the dose delivered to the tumor by RCMI (conformational radiotherapy by intensity modulation) in order to reduce local relapse, often associated with poor prognosis

Primary objective: evaluate the rate of tumor sterilization and the toxicities of RTCT with concomitant boost in intensity modulation in patients with rectal cancer CT3-T4 and / or cN1-2.

Condition or disease Intervention/treatment Phase
Advanced Rectal Cancers Radiation: Preoperative chemo-radiation with IG-IMRT dose escalation Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 15 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Preoperative Chemo-radiation With IG-IMRT Dose Escalation for Locally Advanced Rectal Cancers: Phase 2 Study (RADICAL)
Actual Study Start Date : December 22, 2016
Actual Primary Completion Date : December 22, 2016
Actual Study Completion Date : January 7, 2020

Arm Intervention/treatment
Experimental: Treatment
  1. - Treatment : concomitant preoperative radio-chemotherapy (during 5 weeks)

    Chimiotherapy: Capecitabine 1600 mg/m2/j ; 5/7 days during the 5 weeks of radiotherapy

    Radiotherapy RT + SIB-IMRT (5 weeks ; 5 sessions/week ; 25 sessions): Pelvic prophylactic dose of 45 Gy (1,8 Gy/session); "boost" with a dose of 60 Gy on the tumor PTV (2,4 Gy/session) - Total dose: 60 Gy in 25 sessions during 5 weeks.

  2. - TME surgery (8 weeks after the end of treatment)
Radiation: Preoperative chemo-radiation with IG-IMRT dose escalation

Primary Outcome Measures :
  1. Complete histological response rate [ Time Frame: at 8 weeks after inclusion ]
    Absence of residual cancer cells on the final analysis of the tumor and lymph node

Secondary Outcome Measures :
  1. Tolerance [ Time Frame: at 1, 2, 3, 4, 5 and 13 weeks after inclusion and at 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33 and 36 months after surgery ]
    Toxicity is assessed according to the NCI-CTCAE toxicity scale version 4.0

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  1. Adenocarcinoma of the rectum cT3 or cT4 or cN+, M0 and for which CPR recommends preoperative radiochemotherapy
  2. Tumor <15 cm of the anal margin in rigid or subperitoneal rectoscopy at the MRI
  3. Tumor potentially resectable from the outset, or considered to be resectable after radiochemotherapy
  4. Operable Patient
  5. Age between 18 and 75
  6. OMS performance status 0-2
  7. No co-morbidity likely to prevent the delivery of treatment
  8. Adequate contraception for men, and for non-menopausal women
  9. Neurotrophic neutrophils 1500 / mm3, platelets 100 000 / mm3, and hemoglobin 10 g / dL
  10. Bilirubin ≤ 1.5 times the upper limit of normal (LNS), ASAT and ALAT ≤ 1.5LNS, Alkaline phosphatase ≤ 1.5 LNS
  11. Creatinine clearance> 50 mL / min
  12. Patient must have been informed and must have signed the specific informed consent form.
  13. Patient must be affiliated to a Social Health Insurance.

Exclusion Criteria:

  1. Remote metastasis
  2. Cancer not resectable
  3. Contraindication to capecitabine and its excipients
  4. Previous history of pelvic radiotherapy or previous chemotherapy
  5. History of inflammatory bowel or rectum disease
  6. History of angina pectoris monitored or myocardial infarction or heart failure
  7. Active active infection or other serious underlying condition that may prevent the patient from receiving treatment
  8. Other concomitant cancer, or history of cancer other than in situ cancer of the treated cervix or basal cell carcinoma or squamous cell carcinoma
  9. Patient already included in another therapeutic trial with an experimental molecule
  10. Pregnant woman, likely to be pregnant or nursing
  11. Persons deprived of their liberty or under guardianship
  12. Patient unable to comply with the required medical follow-up for geographic, social or psychological reasons

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03200249

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CHRU de Besançon
Besançon, France, 25030
Centre Gf Leclerc
Dijon, France, 21000
Sponsors and Collaborators
Centre Georges Francois Leclerc
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Responsible Party: Centre Georges Francois Leclerc Identifier: NCT03200249    
Other Study ID Numbers: 2016-A01083-48
First Posted: June 27, 2017    Key Record Dates
Last Update Posted: June 24, 2020
Last Verified: January 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Centre Georges Francois Leclerc:
dose escalation, chemo-radiation, rectum cancer, phase 2
Additional relevant MeSH terms:
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Rectal Neoplasms
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Intestinal Diseases
Rectal Diseases