Colorectal Cancer, Para-aortic Lymph Node Metastasis, Retroperitoneal Lymph Node Metastasis
Conditions
Keywords
Chemoradiotherapy, retroperitoneal lymphadenectomy, IMRT, SBRT
Brief summary
The study aims to compare the effects of chemoradiation versus radical surgery in treating retro-peritoneal or para-aortic lymph node metastasis in colorectal cancer. By prolonging patients' progression-free survival, local control rate and overall survival, investigators can conclude the best regimen for colorectal cancer patients.
Interventions
PROCEDURElymphadenectomy
The retroperitoneal lymphadenectomy includes all lymph, fat, and connective tissue in the retroperitoneal space.
RADIATIONchemoradiotherapy
Radiation therapy is highly appropriate, based on the characteristics of the lesion and the surrounding critical organs, and select IMRT or stereotactic radiotherapy (SBRT).
Sponsors
Fudan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* A medical history of colorectal cancer * Pathological or clinical diagnosis of retroperitoneal/para-vascular lymph node metastases, and located below the level of renal veins. * The treatment target is no evidence of disease (NED), including 3 cohorts: A. Initial treatment (primary lesion + retroperitoneal LN oligometastasis); B. Postoperative retroperitoneal/paravascular LN oligometastase; C. Postoperative retroperitoneal/paravascular LN metastasis with other organ metastases (up to NED) * ECOG PS 0-2 * Ability to follow the program during the study period * Signing written informed consent
Exclusion criteria
* Retroperitoneal LN metastasis is above the level of the renal vein. * Unable to reach NED. * Previous pelvic radiotherapy, the field of irradiation overlaps with this time. * Pregnancy or breastfeeding women. * Those with other history of malignant disease in the last 5 years, except for cured skin cancer and cervical carcinoma in situ. * If there is an uncontrolled history of epilepsy, central nervous system disease or mental disorder, the investigator may determine that the clinical severity may hinder the signing of informed consent or affect the patient's oral medication compliance. * Clinically severe (ie, active) heart disease, such as symptomatic coronary heart disease, New York Heart Association (NYHA) class II or more severe congestive heart failure or severe arrhythmia requiring medication intervention, Or a history of myocardial infarction in the last 12 months * Organ transplantation requires immunosuppressive therapy * Severe uncontrolled recurrent infections, or other serious uncontrolled concomitant diseases * Subjects Blood routine and biochemical indicators do not meet the following criteria: hemoglobin ≥ 90g / L; absolute neutrophil count (ANC) ≥ 1.5 × 109 / L; platelets ≥ 100 × 109 / L; ALT, AST≤2.5 times normal upper limit; ALP≤2.5 times normal upper limit; serum total bilirubin \<1.5 times normal upper limit; serum creatinine \<1 times normal upper limit; serum albumin ≥30g/L
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-free survival | From date of randomization until the date of disease progressed for any reason, assessed up to 5 years | The length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse. In a clinical trial, measuring the progression-free survival is one way to see how well a new treatment works. Also called PFS. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| overall survival | From date of randomization until the date of death from any cause, assessed up to 5 years | The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the overall survival is one way to see how well a new treatment works. Also called OS. |
| local control rate | From date of randomization until the date of disease recurrece, assessed up to 5 years | no recurrence of the retroperitoneal or paraaortic lymph node region. |
Countries
China
Contacts
Primary ContactJi Zhu, MD
Outcome results
None listed