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Brief Title: Radiation Therapy, Surgery, and Chemotherapy in Treating Patients With Rectal Cancer That Can Be Surgically Removed
Official Title: FOUR ARMS PHASE III CLINICAL TRIAL FOR T3-T4 RESECTABLE RECTAL CANCER COMPARING PRE-OPERATIVE PELVIC IRRADIATION TO PRE-OPERATIVE IRRADIATION COMBINED WITH FLUOROURACIL AND LEUCOVORIN WITH OR WITHOUT POST-OPERATIVE ADJUVANT CHEMOTHERAPY
Study ID: NCT00002523
Brief Summary: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug, giving the drugs in different ways, and combining radiation therapy and surgery with chemotherapy may kill more tumor cells. PURPOSE: Randomized phase III trial to compare radiation therapy alone before surgery with radiation therapy plus fluorouracil and leucovorin before surgery, with and without fluorouracil and leucovorin after surgery in patients with rectal cancer that can be surgically removed.
Detailed Description: OBJECTIVES: * Compare the disease-free and overall survival in patients with resectable adenocarcinoma of the rectum treated with preoperative radiotherapy with or without preoperative fluorouracil (5-FU) combined with leucovorin calcium (CF) and/or postoperative 5-FU/CF. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center, sex, tumor location (0-5 vs 6-10 vs 11-15 cm from anal margin), and stage (T3 vs T4). Patients are randomized to 1 of 4 treatment arms. * Arm I: Patients undergo involved-field radiotherapy 5 days a week for 5 weeks followed 3-10 weeks later by abdominoperineal resection or anal-sparing resection according to local practice in the absence of disease progression or unacceptable toxicity. * Arm II: Patients undergo radiotherapy as in arm I beginning on day 1 and leucovorin calcium (CF) IV followed by fluorouracil (5-FU) IV (1 hour before radiotherapy) on days 1-5 and 29-33, followed 3-10 weeks later by resection as in arm I in the absence of disease progression or unacceptable toxicity. * Arm III: Patients undergo radiotherapy followed 3-10 weeks later by resection as in arm I. Within 3-10 weeks after resection, patients receive CF followed by 5-FU on days 1-5. Chemotherapy continues every 4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. * Arm IV: Patients undergo preoperative radiotherapy with concurrent chemotherapy followed by resection as in arm II and postoperative chemotherapy as in arm III. Patients are followed every 6 months. PROJECTED ACCRUAL: A total of 992 patients will be accrued for this study within 4 years.
Minimum Age:
Eligible Ages: CHILD, ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Institut Jules Bordet, Brussels, , Belgium
Hopital Universitaire Erasme, Brussels, , Belgium
Hopital Civil de Charleroi, Charleroi, , Belgium
Centre Hospitalier Universitaire de Tivoli, La Louviere, , Belgium
Clinique Sainte Elisabeth, Namur, , Belgium
Centre Paul Papin, Angers, , France
Institut Sainte Catherine, Avignon, , France
Centre Hospitalier General, Belfort, , France
CHR de Besancon - Hopital Jean Minjoz, Besancon, , France
C.H.U. de Brest, Brest, , France
Centre Hospitalier Universitaire Henri Mondor, Creteil, , France
Centre de Lutte Contre le Cancer, Georges-Francois Leclerc, Dijon, , France
CHR de Grenoble - La Tronche, Grenoble, , France
Centre Oscar Lambret, Lille, , France
Centre Hospital Regional Universitaire de Limoges, Limoges, , France
Service Cancerologie Polyclinique Clairval, Marseille, , France
CRLCC Nantes - Atlantique, Nantes-Saint Herblain, , France
Clinique De Valdegour, Nimes, , France
Hopital Jean Bernard, Poitiers, , France
Clinique Sainte Clotilde, Sainte Clotilde, , France
Centre Paul Strauss, Strasbourg, , France
Centre Hospitalier Universitaire Bretonneau de Tours, Tours, , France
Centre Saint-Yves, Vannes, , France
Krankenhaus des Kreises Hameln-Pyrmont, Hameln, , Germany
Rambam Medical Center, Haifa, , Israel
University Medical Center Nijmegen, Nijmegen, , Netherlands
Dr. Bernard Verbeeten Instituut, Tilburg, , Netherlands
Medical University of Gdansk, Gdansk, , Poland
Institute of Oncology and Radiology of Serbia, Belgrade, , Serbia
Hospital General Universitari Vall d'Hebron, Barcelona, , Spain
Institut Catala d'Oncologia - Hospital Duran i Reynals, Barcelona, , Spain
Hospital General Gregorio Maranon, Madrid, , Spain
Kantonsspital Basel, Basel, , Switzerland
UniversitaetsSpital, Zurich, , Switzerland
Dokuz Eylul University School of Medicine, Izmir, , Turkey
Name: Jean-Francois Bosset, MD
Affiliation: Hopital Jean Minjoz
Role: STUDY_CHAIR