ROCS (Radiotherapy After Oesophageal Cancer Stenting) Study | Recruiting
ROCS (Radiotherapy After Oesophagea... | Recruiting
ROCS (Radiotherapy After Oesophageal Cancer Stenting) Study
ROCS

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Medical Conditions
  • Oesophageal Cancer
Primary Contact Details
Lisette S Nixon, PhD
+44(0)2920 687458
See all trial contact details
Recruitment Status
Recruiting
Trial source and source ID number
NCT01915693
This information is designed to help you decide whether this trial is of interest. In some cases it is provided as a link to more detailed patient information or it may still be awaited from the organisation running the trial. Please look again shortly if the information you need is not here or, if named, contact the researcher named above.
Summary
The single most distressing symptom for more than 70% of patients with oesophageal cancer is difficulty in swallowing (dysphagia) caused by blockage of the gullet by a tumour. This causes severe restrictions on food intake, physical activity, social functioning and overall quality of life. Amongst the more effective treatments for improving swallowing, is the insertion of a metal stent across the blocked part, which then self-expands to open up the gullet (Self Expanding Metal Stent or SEMS). The addition of radiotherapy may help to improve the problems caused by dysphagia and provide an additional survival benefit.

The purpose of this study is to test the impact of adding radiotherapy to SEMS on:

- the length of time swallow remains improved for

- quality of life

- survival
Research Details
  • The primary objective of the study is to assess the impact of radiotherapy in addition to self-expanding metal stent (SEMS) placement on time to progression of patient-reported dysphagia in a patient population unable to undergo surgery.

    Patients will be eligible to take part in the trial if they have oesophageal cancer, are in need of SEMS because of dysphagia, are aged 16 years or older, have been clinically assessed to be able to receive radiotherapy, have an expected survival of at least 12 weeks and are able to give written informed consent.

    496 patients will be randomised to receive either SEMS alone or SEMS with radiotherapy. The radiotherapy will be given as an outpatient either as five treatments (one per day) over one week, or ten treatments over two weeks. Questionnaires will be completed before treatment, and at weeks two and four and then monthly for up to one year to assess quality of life and cost effectiveness. Interviews will be held with trial participants at three time points to explore their experiences while on the trial. Interviews will also be held with patients who do not consent to take part in the trial to explore their reasons for non-consent.

    Treatments:

    Arm A: Self-expanding metal stents (SEMS) (Control Arm) SEMS insertion will be undertaken in accordance with standard local protocols. Covered or partially covered metal stents will be used and the length type and mode of stent placement will be selected by the clinician. Insertion will occur within two weeks of randomisation.

    Arm B: SEMS plus external beam radiotherapy (Intervention Arm) External beam radiotherapy (EBRT) is routinely available at regional cancer centres across the UK. For palliation of dysphagia in oesophageal cancer, a radiotherapy course delivering a tumour absorbed dose of 20Gy in 5 fractions or 30Gy in 10 fractions within 4 weeks of SEMS insertion.

    There will also be a qualitative component of the trial will have two aims: i) to explore the feasibility of patients' recruitment to the trial and ii) to explore participants' experience of the trial interventions. It will examine their experience of consent and recruitment including reasons for declining, and examine patients' motivation to accept randomisation to an intervention which may include extra radiotherapy. This is an optional component and will require separate consent. Patients who do not consent to the trial, but who do consent to the qualitative component, will be interviewed about their reasons for not-consenting as soon as possible after the approach to participate.

    Trial participants who consent to the qualitative component will be interviewed three times: at weeks one and four to capture initial decision-making thoughts and then after the interventions (week 8) to explore patients' experience of interventions and perceptions of benefit or detriment.
Phase
Phase 3
Study Design
Sorry, this information is not available
Study Type
Interventional
Intervention
Radiation : Radiotherapy

Study Arm Groups : Arm B: SEMS plus external beam radiotherapy (Intervention Arm)

Intervention Type
See Interventions above
Primary Outcome Measures
    patient-reported dysphagia; within one year
Secondary Outcome Measures
    quality of life; within one year; overall survival; one year; morbidity; one year; re-intervention rate; one year; cost; one year
Publication(s)
Sorry, this information is not available
Result Reports
Check availability of results on the Clinicaltrials.gov website
This information is designed to help you decide whether this trial is of interest. In some cases it is provided as a link to more detailed patient information or it may still be awaited from the organisation running the trial. Please look again shortly if the information you need is not here or, if named, contact the researcher named above.
Gender
All
Age Range
16 Years - N/A
Who Can Participate
Patients
Number of Participants
496
Participant Inclusion Criteria
    Inclusion Criteria:

    1. Histological confirmation of oesophageal carcinoma excluding small cell histology

    2. Not suitable for radical treatment (oesophagectomy or radical chemoradiotherapy) either because of patient choice or medical reasons

    3. Dysphagia clinically assessed as needing stent as primary treatment of the dysphagia

    4. Age 16 years or over

    5. Discussion and treatment decision for stent placement made by an upper GI multi-disciplinary team

    6. Clinician assessment of ability to attend for radiotherapy

    7. Expected survival of at least 12 weeks

    8. Written informed consent

    9. Patient has completed baseline Quality of Life Questionnaires (please note, as a minimum patients must have completed OG25)

    Exclusion Criteria:

    1. Histology of small cell carcinoma type

    2. Tumour length of greater than 12 cm

    3. Tumour growth within 2 cm of the upper oesophageal sphincter

    4. Endoscopic treatment of the tumour, other than dilatation, planned in the peri-stent period

    5. Presence of a tracheo-oesophageal fistula

    6. Presence of a pacemaker in proposed radiotherapy field

    7. Previous radiotherapy to the area of the proposed radiotherapy field

    8. Planned endoscopic treatment of the tumour (e.g. laser) in the immediate peri-stenting period

    9. Female patient who is pregnant
Participant Exclusion Criteria
This is in the inclusion criteria above
This information is designed to help you decide whether this trial is of interest. In some cases it is provided as a link to more detailed patient information or it may still be awaited from the organisation running the trial. Please look again shortly if the information you need is not here or, if named, contact the researcher named above.
Trial Location(s)
Weston General Hospital
Weston-super-Mare
England
BS23 4TQ
Velindre Cancer Center at Velindre Hospital
Cardiff
Wales
CF14 2TL
Glan Clwyd Hospital
Rhyl
Wales
LL 18 5UJ
Dundee
DD1 9SY
Sheffield
Doncaster
DN2 5LT
Cancer Research Centre at Weston Park Hospital
England
S1O 2SJ
Bristol
BS2 8ED
Southend NHS Trust Hospital
Southend-on-Sea
England
SS0 0RY
Brook Lane Surgery
Southampton
Taunton
TA1 5DA
Ysbyty Gwynedd
Bangor
Wales
LL57 2PW
Middlesbrough
TS4 3BW
Royal Gwent Hospital
Wales
NP9 2UB
Wrexham Maelor Hospital
Wrexham
LL13 7TD
George Eliot Hospital
Nuneaton
England
CV10 7DJ
Conquest Hospital
Hastings
England
TN37 7RD
Trial Contact(s)
Primary Trial Contact
Lisette S Nixon, PhD
+44(0)2920 687458
Other Trial Contacts
Sorry, this information is not available
Countries Recruiting
United Kingdom
This information is designed to help you decide whether this trial is of interest. In some cases it is provided as a link to more detailed patient information or it may still be awaited from the organisation running the trial. Please look again shortly if the information you need is not here or, if named, contact the researcher named above.
Scientific Title
Palliative Radiotherapy in Addition to Self-expanding Metal Stent for Improving Dysphagia and Survival in Advanced Oesophageal Cancer: ROCS (Radiotherapy After Oesophageal Cancer Stenting) Study.
EudraCT Number
Not available for this trial
Funder(s)
    Sorry, this information is not available
Other Study ID Numbers
WCTU030
Sponsor(s)
Lisette Nixon
Key Dates

Recruitment Start Date

Oct 2013

Recruitment End Date

Sep 2018

Trial Start Date
Date Not Available
Trial End Date
Date Not Available
Date added to source

31 Jul 2013

Date updated in source

15 Apr 2016