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Phase III Study Comparing 3D Conformal Radiotherapy and Conformal Radiotherapy IMRT to Treat Endometrial Cancer

Not Applicable
Terminated
Conditions
Endometrial Cancer
Interventions
Radiation: 3D conformational radiation
Radiation: IMRT
Registration Number
NCT01641497
Lead Sponsor
Centre Oscar Lambret
Brief Summary

Comparison of radiotherapy tolerance (two types of radiotherapy) for patients over 70 years with a endometrial cancer.

Detailed Description

Endometrial cancer is the most common form of gynecological cancer in France with 6560 new cases in 2010. Endometrial cancers occurs generally after menopause but are sometimes diagnosticated before 40 years. The 5 years Overall survival of endometrial cancer is 76% (95% for non locally advanced or non metastatic disease).

Some factors are involved in disease prognostic: age, geographical origin, physical status, tumor grade, tumor histology and probably biomarkers. Some studies demonstrated that advanced age is a negative prognostic factor due to higher relapse risk and higher specific mortality. Unfortunately, Incidence of endometrial cancer will probably increase in future due to aging of the occidental population.

Current treatment of endometrial cancer is based on post-operative radiation therapy: adjuvant brachytherapy or adjuvant external beam radiation therapy. However these techniques lead to serious toxicity (digestive toxicity, ileitis...) in elder patient. Consequently, pelvic radiation therapy is difficult to organize before 75 years and dangerous to perform after 80 years.

However a new technique called: Intensity-modulated radiation therapy (IMRT) can make the difference. IMRT is a new high precision radiotherapy technique probably well adapted for old people, with less toxicity than current radiotherapy.

Nevertheless, IMRT is not recognized as a standard radiation therapy procedure in France and Europe.

Thus, goal of TOMOGYN study is to compare the tolerance of old women (at least 70 years), with endometrial cancer, treated with external beam radiation therapy or IMRT.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
26
Inclusion Criteria
  • endometrial adenocarcinoma histologically proven
  • post op pelvic radiotherapy
  • age ≥ 70
  • performance status ≤ 2
  • MMSE ≥ 10
  • life expectancy ≥ 3 months
  • social security covered
  • signed informed consent
Exclusion Criteria
  • type I stade IAGI and stade IAGIII without myometer infiltration, stade IIIc2 and IV adenocarcinoma
  • uterine sarcoma
  • surgery not in accordance with recommendations of Inca
  • previous uncontrolled or less than 5 years prior to diagnosis cancer
  • cons-indication for radiotherapy
  • diarrhea ≥ 3 per day
  • pelvic lymph nodes > 1cm not resected during staging
  • previous sigmoid diverticulitis, crohn disease, systemic disease, ulcerative haemorrhagic, collagenosis, infectious peritonitis
  • IMRT other than tomotherapy
  • photon energy < 10MV
  • patient under guardianship

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
3D conformational radiotherapy3D conformational radiation25 \* 1.8 Gy in 5 weeks (=45 Gy). 3D conformational radiation
Intensity-Modulated Radiation TherapyIMRT25 \* 1.8 Gy in 5 weeks (=45 Gy). IMRT
Primary Outcome Measures
NameTimeMethod
change from baseline in acute toxicity all along the radiationbaseline, Day 5, Day 10, Day 15, Day 20, Day 25, 1 Week after end of treatment, 8 Weeks after end of treatment

NCI CTCAE v 4.0 tox \> grade 2 will be compared

Secondary Outcome Measures
NameTimeMethod
geriatric repercussionbaseline, 6 months after end of treatment

scales : Activities in Daily Living (ADL), Instrumental Activities in Daily Living (IADL), Mini Nutritionnal Assessment (MNA), Geriatric Depression Scale (GDS), cognitive evaluation, Cumulative Illness RAting Scale-Geriatrics (CIRS-G), sociocultural questionnaire, walking and balance

geriatric interventionup to 6 months

number of intervention, consequences in terms of base treatment change, intervention of other specialists (except cancer)

quality of lifebaseline, Day 5, Day 10, Day 15, Day 20, Day 25, 1 week and 8 weeks after end of treatment, 6, 12, 18 and 24 months after end of treatment

QLQ C30 questionnaire

late major toxicity1 week, 8 weeks, 6, 12, 18 and 24 months after the end of treatment

NCI CTCAE v 4.0

progression free survivalan average period of 2 years

median time between date of inclusion and date of clinical or radialogical progression

duration of the radiationup to 5 weeks and a half

interval between first day and last day of treatment

Trial Locations

Locations (7)

François Baclesse Center

🇫🇷

Caen, France

Bergonie Institut

🇫🇷

Bordeaux, France

Oscar Lambret Center

🇫🇷

Lille, France

Centre Leon Berard

🇫🇷

Lyon, France

Institut Jean Godinot

🇫🇷

Reims, France

René Gauducheau Center

🇫🇷

Saint Herblain, France

Paul Strauss Center

🇫🇷

Strasbourg, France

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