Neoadjuvant Chemoradiotherapy and Adjuvant Chemotherapy With 5-Fluorouracil and Oxaliplatin Versus 5-Fluorouracil Alone in Rectal Cancer
- Registration Number
- NCT00349076
- Lead Sponsor
- University of Erlangen-Nürnberg Medical School
- Brief Summary
Standard treatment for locally advanced cancer of the rectum is preoperative chemoradiotherapy with 5-Fluorouracil (5-FU) plus 4 cycles of postoperative chemotherapy with 5-FU. According to our previous study (CAO/ARO/AIO-94, published in the New England Journal of Medicine 2004; 351:1731-40) this treatment results in only 6% of local failures, yet, still 36% of all patients develop distant metastasis. Therefore, our new study (CAO/ARO/AIO-04) incorporates new drugs, i.e. 5-FU + oxaliplatin, in an effort to improve the control of distant metastases. It is our hypothesis that the rate of disease free survival will improve by 5 to 8% after 3 years of follow-up.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1256
- Minimum age: 18 years
- Histologically proven, advanced primary carcinoma of the rectum (tumor ? 12cm from the anal verge, with clinically staged T3/4 or any node-positive disease
- No prior therapy except a diverting stoma
- ECOG PS less than or equal 2
- Adequate bone marrow function: Leukocytes > 3,5 x 10^9/L Absolute neutrophil count > 1,5 x 10^9/L Platelet count > 100 x 10^9/L Hemoglobin > 10 g/dl
- Adequate hepatic function: Total bilirubin < 2,0 mg/dl ALAT, ASAT, alkaline phosphatase, gamma-GT < 3 x ULN 7. Serum creatinine < 1,5 mg/dl, creatinine-clearance > 50 ml/min
- Written informed consent before randomization
- Pregnant or breast feeding women
- Fertile patients without adequate contraception during therapy
- Past or ongoing drug abuse or alcoholic excess
- Prior chemotherapy
- Prior radiotherapy to the pelvis
- Prior (within 4 weeks) or concurrent treatment with any other investigational agent
- Psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
- History of severe somatic or psychological diseases: - instable cardiac disease not well controlled with medication, myocardial infarction within the last 6 months:* Central nervous system disorders or psychiatric disability including dementia or epileptic disease; * active uncontrolled intercurrent infections or sepsis
- Peripheral neuropathy > 2 (NCI CTC AE grading)
- Previous or concurrent malignancies, with the exception of adequately treated basal cell carcinoma of the skin or in situ carcinoma of the cervix. The inclusion of patients with other adequately treated tumors within the last 5 years has to be discussed with the principal investigator
- Chronic diarrhea (> NCI CTC AE-Grad 1)
- Known allergy to substances containing platinum compounds
- Concurrent use of the antiviral agent sorivudine or chemically related analogues
- Known deficiency of dehydropyrimidindehydrogenase (DPD)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 1 5-FU and oxaliplatin Preoperative simultaneous radiochemotherapy: 5-Fluorouracil und Oxaliplatin: Radiotherapy starts on day 1 of chemotherapy; 28 fractions; single dose: 1,8 Gy once per day, monday through friday; Total dose: 50,4 Gy; Oxaliplatin: 50 mg/m² i.v., days 1, 8, 22 und 29; 5-Fluorouracil: 250 mg/m²/d continuous infusion, days 1-14 and 22-35 Adjuvant Chemotherapy: Oxaliplatin: 100 mg/m² i.v. on day 1; Calciumfolinate: 400 mg/m² on day 1; 5-Fluorouracil: 2400 mg/m² continuous infusion for 46 hours; repeat day 15, 8 cycles 2 5-FU Preoperative simultaneous radiochemotherapy: 5-Fluorouracil Radiotherapy starts on day 1 of chemotherapy; 28 fractions; single dose: 1,8 Gy once per day, monday through friday; Total dose: 50,4 Gy; 5-Fluorouracil: Days 1-5 and 29-33: 120h-continuous infusion 1000 mg/m²/d Adjuvant Chemotherapy: 5-Fluorouracil: 500 mg/m² on 5 consecutive days (day 1-5) i.v. bolus fot 2-5 minutes; repeat day 29, 4 cycles
- Primary Outcome Measures
Name Time Method Disease free survival at 3 years defined as the interval from randomization to locoregional or metastatic recurrence or the appearance or a secondary colorectal cancer or death, whichever occurs first. 3 years
- Secondary Outcome Measures
Name Time Method Resection rate, rate of sphincter preservation, tumor regression, cumulative incidence of local and distant recurrences, overall survival, toxicity, quality of life 5-year follow up
Trial Locations
- Locations (85)
Kreiskliniken Altötting-Burghausen
🇩🇪Altötting, Germany
Krankenhaus Marienwörth
🇩🇪Bad Kreuznach, Germany
Gesundheitszentrum St. Marien
🇩🇪Amberg, Germany
Onkologische Gemeinschaftspraxis
🇩🇪Ansbach, Germany
Caritas-Krankenhaus
🇩🇪Bad Mergentheim, Germany
Onkologische Schwerpunktpraxis
🇩🇪Kronach, Germany
Klinik Bad Trissl-Oberaudorf
🇩🇪Bad Trissl, Germany
Klinikum Bayreuth GmbH
🇩🇪Bayreuth, Germany
Aerzteforum Hennigsdorf
🇩🇪Berlin, Germany
Städtische Kliniken
🇩🇪Bielefeld, Germany
St.-Agnes-Hospital Bocholt
🇩🇪Bocholt, Germany
St. Josef-Hospital
🇩🇪Bochum, Germany
Ruhr-Universität Bochum; Knappschaftskrankenhaus
🇩🇪Bochum, Germany
Klinikum Bremen-Mitte
🇩🇪Bremen, Germany
Onkologische Praxis
🇩🇪Buchholz, Germany
Praxis für Hämatologie und Onkologie
🇩🇪Köln, Germany
Klinikum Coburg gGmbH
🇩🇪Coburg, Germany
Onkologisches Versorgungszentrum Rehling-Donauwörth-Dachau
🇩🇪Donauwörth, Germany
Universitätsklinikum Carl Gustav Carus
🇩🇪Dresden, Germany
Katholisches Krankenhaus St. Nepomuk
🇩🇪Erfurt, Germany
Dept. of Radiation Therapy, University of Erlangen
🇩🇪Erlangen, Germany
Alfried Krupp Krankenhaus
🇩🇪Essen, Germany
Universitätsklinikum Essen
🇩🇪Essen, Germany
Klinikum Esslingen a.N.
🇩🇪Esslingen, Germany
Universitätsklinikum
🇩🇪Frankfurt/Main, Germany
Universitätsklinikum Freiburg
🇩🇪Freiburg, Germany
Kliniken an der Paar, Krankenhaus Friedberg
🇩🇪Friedberg, Germany
Klinikum Fulda
🇩🇪Fulda, Germany
SRH-Waldklinikum
🇩🇪Gera, Germany
Wilhelm-Anton-Hospital
🇩🇪Goch, Germany
Universitätsklinikum Greifswald
🇩🇪Greifswald, Germany
Georg-August-Universität Göttingen
🇩🇪Göttingen, Germany
St. Elisabeth und St. Barbara Krankenhaus
🇩🇪Halle, Germany
Asklepios Klinik Hamburg-Harburg
🇩🇪Hamburg, Germany
Diakonie Klinikum Hamburg
🇩🇪Hamburg, Germany
Praxis für Hämatologie und Onkologie, Hamm
🇩🇪Hamm, Germany
Marienhospital
🇩🇪Herne, Germany
Universitätsklinikum des Saarlandes
🇩🇪Homburg/Saar, Germany
Klinikum der Friedrich Schiller Universität
🇩🇪Jena, Germany
Klinik für Knochenmarkstransplantation und Hämatologie/Onkologie GmbH
🇩🇪Idar-Oberstein, Germany
Innere Medizin, Hämatologie und Int. Onkologie
🇩🇪Kassel, Germany
Universitätsklinikum Schleswig-Holstein, Campus Kiel
🇩🇪Kiel, Germany
Gemeinschaftspraxis für Hämatologie und Internistische Onkologie
🇩🇪Köln, Germany
Gemeinschaftspraxis Onkologie
🇩🇪Muhr am See, Germany
Klinikum Landshut
🇩🇪Landshut, Germany
Phillips-Universität Marburg
🇩🇪Marburg, Germany
Universitätsklinikum Leipzig
🇩🇪Leipzig, Germany
Universitätsklinikum - St. Hildegardis-Krankenhaus Mainz
🇩🇪Mainz, Germany
Universitätsklinikum Schleswig-Holstein, Campus Lübeck
🇩🇪Lübeck, Germany
Klinikum Schwäbisch Gmünd, Stauferklinik
🇩🇪Mutlangen, Germany
Kliniken Maria Hilf
🇩🇪Mönchengladbach, Germany
Klinikum rechts der Isar, Technische Universität
🇩🇪München, Germany
Universitätsklinikum Großhadern
🇩🇪München, Germany
Clemenshospital Münster
🇩🇪Münster, Germany
Universitätsklinikum Münster
🇩🇪Münster, Germany
Darmzentrum Ortenau
🇩🇪Offenburg, Germany
Klinikum Oldenburg; Pius Hospital Oldenburg
🇩🇪Oldenburg, Germany
Paracelsus-Krankenhaus Ruit
🇩🇪Ostfildern, Germany
Hämatologisch-onkologische Schwerpunktpraxis Northeim
🇩🇪Northeim, Germany
Klinikum Nürnberg
🇩🇪Nürnberg, Germany
St. Josefs Krankenhaus
🇩🇪Potsdam, Germany
St. Vincenz Krankenhaus
🇩🇪Paderborn, Germany
Klinikum Passau
🇩🇪Passau, Germany
Universitätsklinikum Regensburg
🇩🇪Regensburg, Germany
Schwerpunktpraxis für Hämatologie und Onkologie mit Tagesklinik
🇩🇪Regensburg, Germany
Krankenhaus Barmherzige Brüder
🇩🇪Regensburg, Germany
Klinikum Rosenheim
🇩🇪Rosenheim, Germany
Medizinische Fakultät der Universität Rostock
🇩🇪Rostock, Germany
Kreiskrankenhaus Rottweil
🇩🇪Rottweil, Germany
Thüringen-Kliniken Saalfeld-Rudolstadt
🇩🇪Saalfeld, Germany
Hämatologisch-Onkologische Schwerpunktpraxis
🇩🇪Singen, Germany
Onkologische Praxisgemeinschaft Stade
🇩🇪Stade, Germany
Klinikum Traunstein
🇩🇪Traunstein, Germany
Onkologische Schwerpunktpraxis Traunstein
🇩🇪Traunstein, Germany
Krankenhaus der Barmherzigen Brüder
🇩🇪Trier, Germany
Universitätsklinikum Ulm
🇩🇪Ulm, Germany
Marienhaus Klinikum, St. Elisabeth Klinik Saarlouis, St. Michael Krankenhaus Völklingen
🇩🇪Völklingen, Germany
Klinikum Wetzlar-Braunfels
🇩🇪Wetzlar, Germany
Reinhard-Nieter-Krankenhaus
🇩🇪Wilhelmshaven, Germany
Asklepios Paulinen Klinik
🇩🇪Wiesbaden, Germany
Universitätsklinikum Würzburg
🇩🇪Würzburg, Germany
Juliusspital
🇩🇪Wuerzburg, Germany
Missionsärztliche Klinik
🇩🇪Würzburg, Germany
Klinik am Eichert
🇩🇪Göppingen, Germany
Weisseritztal-Kliniken
🇩🇪Freital, Germany