Study of High-Dose-Rate Endorectal Brachytherapy (HDRBT) in the Treatment of Locally Advanced Low Rectal Cancer

Last updated: February 14, 2025
Sponsor: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Overall Status: Completed

Phase

N/A

Condition

Digestive System Neoplasms

Rectal Disorders

Colorectal Cancer

Treatment

High-dose endorectal brachytherapy (HDRBT)

Clinical Study ID

NCT01226979
J0977
NA_00029263
  • Ages 18-100
  • All Genders

Study Summary

This research is being done to see how effective high-dose rate endorectal brachytherapy (HDRBT) is in treating cancer of the lowest part of the bowel (rectum). In this study we want to try to decrease side effects and shorten the course of radiation treatment for patients with cancer of their rectum by using a high-dose rate endorectal brachytherapy (HDRBT). This is a different form of radiation than what is normally given (CRT). With HDRBT, the radiation is given through an applicator placed into the bowel next to the tumor. The radiation is directed at the tumor and a small area around it.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients with histologically confirmed adenocarcinoma of the rectum

  • Able to undergo local staging of the rectal tumor performed by MRI and/or endoscopicultrasonography (EUS) demonstrating a T2N1 or T3N0-1 tumor

  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

  • Participants are willing to undergo initial therapy and if needed subsequent therapyprior to resection at Johns Hopkins Medical Institutions

  • English as a primary language in order to complete the quality of lifequestionnaires

Exclusion

Exclusion Criteria:

  • Patients with tumors >12 cm from the anal verge.

  • Near obstructing or bulky tumors which will not allow application of the endorectalprobe

  • Patients with distant metastatic disease

  • Any pelvic lymph nodes outside of the mesorectum (iliac or inguinal)

  • Prior history of radiation therapy to the pelvis

  • Prior history of chemotherapy for rectal cancer

  • Active connective tissue disease such as scleroderma or Crohn's disease

Study Design

Total Participants: 16
Treatment Group(s): 1
Primary Treatment: High-dose endorectal brachytherapy (HDRBT)
Phase:
Study Start date:
October 26, 2010
Estimated Completion Date:
July 31, 2018

Study Description

This study is a pilot study open to patients with clinical stage T2N1 or T3N0-1 resectable rectal cancer. The investigational tool being evaluated is high-dose endorectal brachytherapy (HDRBT) which is an FDA approved method to administer endoluminal radiation for low rectal cancer. This study assumes that the rate of pathological response to HDRBT will be similar to historical controls (conventional neoadjuvant chemoradiation). All patients will receive postoperative standard 5-fluorouracil (FU) based chemotherapy (at the discretion of the medical oncologist). The clinical response will be assessed with endoscopic/ultrasound, pelvic MRI and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. In addition, tissue and serum will be collected to evaluate for biological predictors of response to therapy. The endpoints of this study include adverse events (gastrointestinal toxicity), quality of life as measured by the quality of life questionnaire (QLQ)-C30, and tumor regression/response.

Connect with a study center

  • Johns Hopkins Medical Institutions

    Baltimore, Maryland 21231
    United States

    Site Not Available

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