A Multicenter Randomized Controlled Study of Modalities of Adjuvant Radiotherapy and Chemotherapy for Stage Ⅲ Endometrial Cancer
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 654
- 试验地点
- 1
- 主要终点
- Progress-free survival
研究概览
简要总结
Endometrial cancer is the most common gynecological malignancy affecting women's health. About 15% of the patients will have local late disease (stage III) with high risk of recurrence and tumor related mortality. There is a consensus that adjuvant radiochemotherapy is needed for stage Ⅲ endometrial cancer, but the best modality of radiochemotherapy is still uncertain. The retrospective data of our center showed that the sequential radiochemotherapy of "chemotherapy-radiotherapy-chemotherapy" in the "sanwich" mode could improve the survival outcome in patients with advanced endometrial cancer. A multicenter, prospective, randomized controlled study to compare the "sanwich" mode of radiochemotherapy and the "concurrent chemoradiotherapy followed by chemotherapy" mode will be carried out to determine the better modality of radiochemotherapy in stage III endometrial adenocarcinoma.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •patients of primary treatment
- •All patients must have undertaken comprehensive staging operation（Surgery must have included a hysterectomy and bilateral salpingooophorectomy and surgical staging).
- •Patients with endometrial adenocarcinoma confirmed by postoperative patholog.
- •All patients with Surgical Stage III endometrial carcinoma according to FIGO 2009 staging criteria.
- •Entry into the study is limited to no more than 8 weeks from the date of surgery.
- •Patients with adequate organ function, reflected by the following parameters:
- •WBC ≥ Normal value of the institution;
- •Absolute neutrophil count (ANC) ≥ Normal value of the institution;
- •Platelet count ≥ 100,000/mcl;
- •SGOT, SGPT, and alkaline phosphatase ≤ 1.25 X upper limit of normal (ULN) ;
- •Bilirubin ≤ 1.5 X ULN;
- •Creatinine ≤ institutional ULN.
- •Patients with a Karnofsky score≥
- •The patients should voluntarily join the study, sign an approved informed consent with good compliance and cooperation with the follow-up.
排除标准
- •Patients who have received prior adjuvant therapy (radiotherapy or chemotherapy or endocrine therapy).
- •Patients with residual tumor after surgery.
- •Patients with other invasive malignancies.
- •Patients with contraindications of radiotherapy and chemotherapy (with a history of myocardial infarction within 3 month, unstable angina pectoris or history of uncontrolled arrhythmia s from the date of registration) and who cannot receive postoperative adjuvant radiotherapy and chemotherapy.
- •Patients with an estimated survival of less than 6 months.
- •Those who are unable or unwilling to comply with the research requirements
研究组 & 干预措施
sequential radiochemotherapy in a "sanwich" mode
Two courses of TC regimen chemotherapy (paclitaxel 135-175mg / m2; carboplatin AUC = 5; once every 21 days) will be given first, followed by external pelvic radiation (± vaginal brachytherapy), and then four courses of the same regime consolidation chemotherapy.
干预措施: sequential radiochemotherapy in a "sanwich" mode (Other)
concurrent chemoradiotherapy followed by chemotherapy
External pelvic radiation (± vaginal brachytherapy) will be given after operation. On the first day and the 29th day of radiotherapy, concurrent intravenous cisplatin (50mg/m2) will be given. After the concurrent radiochemotherapy, four courses of TC regimen (paclitaxel 135-175mg / m2; carboplatin AUC = 5; once every 21 days) chemotherapy will be given.
干预措施: sequential radiochemotherapy in a "sanwich" mode (Other)
结局指标
主要结局
Progress-free survival
时间窗: From the date of randomization until the date of first documented progression or date of death from any cause, whichever came first,assessed up to 60 months
To determine if treatment with radiochemotherapy in "sanwich" mode (carboplatin and paclitaxel for 2 cycles, then radiotherapy, and then carboplatin and paclitaxel for 4 cycles)(experimental arm) reduces the rate of recurrence or death (i.e., increases disease-free survival) when compared to concurrent cisplatin and radiation followed by carboplatin and paclitaxel for 4 cycles (control arm) in patients with stages III endometrial adenocarcinoma.
次要结局
- adverse effect(through study completion,an average of 1 year)
- Overall survival(From the date of randomization until the date of death from any cause, assessed up to 60 months)
- patient-reported Quality of Life(3 months after treatment and 1 year after treatment)