Radiation Therapy and Chemotherapy Followed by Surgery and Combination Chemotherapy in Treating Patients With Rectal Cancer
- Conditions
- Colorectal Cancer
- Interventions
- Procedure: conventional surgeryRadiation: radiation therapy
- Registration Number
- NCT00021398
- Lead Sponsor
- Fox Chase Cancer Center
- Brief Summary
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining radiation therapy and chemotherapy may shrink the tumor so that it can be removed during surgery.
PURPOSE: Phase II trial to study the effectiveness of radiation therapy and chemotherapy followed by surgery and combination chemotherapy in treating patients who have stage II or stage III rectal cancer.
- Detailed Description
OBJECTIVES: I. Determine the local recurrence rate, disease-free survival, and overall survival of patients with stage II or III rectal cancer treated with neoadjuvant radiotherapy and fluorouracil followed by surgical resection and adjuvant fluorouracil and leucovorin calcium. II. Determine the toxicity rate in patients treated with this regimen. III. Correlate failure-free survival with ultrasound-determined preoperative staging in patients treated with this regimen. IV. Determine the quality of life of patients treated with this regimen. V. Determine if toxicity due to treatment, daily stool frequency, sexual dysfunction, and disease-free survival correlates with quality of life parameters in patients treated with this regimen. VI. Correlate clinical selection criteria with ability to perform sphincter-sparing surgery in patients treated with this regimen. VII. Determine post-chemoradiotherapy pathological response, margin status, and lymph node status and correlate these factors with initial clinico-pathologic findings in patients treated with this regimen.
OUTLINE: Patients undergo pelvic radiotherapy once daily five days a week for 5 weeks followed by boost radiotherapy twice daily for 7 days. Patients also receive neoadjuvant fluorouracil IV continuously over days 1-4 and 36-40. Patients undergo surgical resection 4-6 weeks after completion of radiotherapy. At 4 weeks after surgery, patients receive adjuvant leucovorin calcium IV and fluorouracil IV once daily five days a week. Treatment continues every 4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline, at the completion of pelvic and boost radiotherapy, at 4 weeks after completion of chemoradiotherapy (prior to surgery), and then at 3, 6, and 12 months after completion of study therapy. Patients are followed every 3 months for 2 years, every 4 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 23-41 patients will be accrued for this study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 23
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Radiation Therapy, Chemotherapy and Surgery fluorouracil - Radiation Therapy, Chemotherapy and Surgery leucovorin calcium - Radiation Therapy, Chemotherapy and Surgery conventional surgery - Radiation Therapy, Chemotherapy and Surgery radiation therapy -
- Primary Outcome Measures
Name Time Method Frequency of toxicity weekly during treatment tolerated dose of preoperative hyperfractionated radiation and concurrent chemotherapy during radiation therapy and chemotherapy
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (17)
Community Medical Center
🇺🇸Toms River, New Jersey, United States
Reading Hospital and Medical Center
🇺🇸Reading, Pennsylvania, United States
Kimball Medical Center
🇺🇸Lakewood, New Jersey, United States
Pottstown Memorial Regional Cancer Center
🇺🇸Pottstown, Pennsylvania, United States
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Pinnacle Health Hospitals
🇺🇸Harrisburg, Pennsylvania, United States
Saint Mary Regional Center
🇺🇸Langhorne, Pennsylvania, United States
Southern Chester County Medical Center
🇺🇸West Grove, Pennsylvania, United States
Hunterdon Regional Cancer Center
🇺🇸Flemington, New Jersey, United States
Fox Chase Cancer Center at Virtua Memorial Hospital Burlington County
🇺🇸Mount Holly, New Jersey, United States
Riverview Medical Center
🇺🇸Red Bank, New Jersey, United States
St. Francis Medical Center
🇺🇸Trenton, New Jersey, United States
Bon Secours-Holy Family Health System
🇺🇸Altoona, Pennsylvania, United States
Conemaugh Memorial Hospital
🇺🇸Johnstown, Pennsylvania, United States
Delaware County Memorial Hospital
🇺🇸Drexel Hill, Pennsylvania, United States
North Penn Hospital
🇺🇸Lansdale, Pennsylvania, United States
Paoli Memorial Hospital
🇺🇸Paoli, Pennsylvania, United States