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A Study of Substitution of 5-FU (Fluorouracil) by Capecitabine in Scheme of Chemo-radiotherapy in Patients With Squamous Cell Carcinoma of the Anal Canal.

Phase 2
Completed
Conditions
Anal Canal Cancer.
Interventions
Radiation: Radiotherapy
Registration Number
NCT01941966
Lead Sponsor
Instituto do Cancer do Estado de São Paulo
Brief Summary

The squamous cell carcinoma (SCC) of the anal canal is an uncommon neoplasia which corresponds to 1-5% of intestinal tumors. However the risk of SCC of the anal canal has been growing recently. The standard treatment of anal cancer stage II-III is multimodal and consists of combined chemotherapy (infusional 5-fluorouracil and mitomycin) and radiotherapy. This scheme currently used was proposed in 1974, and since then no other effective treatment has been developed.

The purpose of this study is to determine the efficacy and toxicity of the combination of capecitabine and mitomycin with radiotherapy in patients with carcinoma of the anal canal. For this will be selected 51 patients to be treated with chemo-radiotherapy.

The primary endpoint will be local control rate after 6 months of the end of radiotherapy and chemotherapy, defined by the rate of radiological and clinical neoplasia.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
51
Inclusion Criteria
  • Invasive anal canal SCC histologically confirmed, T2-4 N0 M0, T (anyone) N1-3 M0 - according to TNM staging system.
  • Age ≥ 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2.
  • Adequate medullar function, defined as: Absolute neutrophil count ≥ 1,5×109/L; platelets ≥100×109/L; hemoglobin ≥10g/dl.
  • Serum AST (aspartato aminotransferase) and ALT (alanine aminotransferase) < 3 × ULN (upper limit of normal).
  • Serum Creatinine ≤ 1,5 ULN and clearance of creatinine estimated (Cockcroft- Gault) ≥ 50 ml/min.
  • Signed written informed consent.
Exclusion Criteria
  • Major surgical procedure within 4 weeks of the beginning of the treatment.
  • History of severe systemic or psychiatric disease.
  • Previous treatment for anal canal carcinoma or other cancer.
  • For female patients, current pregnancy and/or lactation
  • Unstable angina or acute myocardial infarction within 6 months.
  • Concomitant use of oral anticoagulants
  • HIV positive with result of CD4 ≤ 200.
  • Previously pelvic radiotherapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Chemo-radiotherapyCapecitabineCapecitabine, PO, 825mg/m2 Mitomycin C, IV, 15 mg/m2 Radiotherapy - 50,4 - 54 Gy
Chemo-radiotherapyMitomycinsCapecitabine, PO, 825mg/m2 Mitomycin C, IV, 15 mg/m2 Radiotherapy - 50,4 - 54 Gy
Chemo-radiotherapyRadiotherapyCapecitabine, PO, 825mg/m2 Mitomycin C, IV, 15 mg/m2 Radiotherapy - 50,4 - 54 Gy
Primary Outcome Measures
NameTimeMethod
The primary endpoint will be local control rate after 6 months of the end of radiotherapy and chemotherapy, defined by the rate of radiological and clinical neoplasia.6 months of the end of radiotherapy and chemotherapy.
Secondary Outcome Measures
NameTimeMethod
Treatment ToxicityWeekly during the treatment and ultil 28 days after the last dose of capecitabine or ultil the resolution of all adverse events.

Adverse events grade 3 and 4 according to CTCAE 3.0 (Common Toxicity Criteria for Adverse Effects).

Complete Response4 weeks after the end of the treatment

Complete response rate 4 weeks after completion of chemotherapy and radiation therapy.

Progression-free survivalA chest x-ray and computerized tomography of abdomen and pelviswill be performed after 6 weeks of the end of treatment and 6 months after.
Colostomy rateWithin 1 year after the end of the treatment.
Overall survivalEvery 3 months during the first year after the end of the treatment, then every 6 months in the second and third year, and after the fourth year the visit will be annual.

Trial Locations

Locations (1)

ICESP

🇧🇷

Sao Paulo, SP, Brazil

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