A Study of SBRT for OligoMetastatic ESCC

Study Overview
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Brief Summary
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The aim of this phase II trial is to assess progress-free survival, local control, overall survival, safety and tolerability of SBRT to treat patients with oligometastases in esophageal squamous cell carcinoma.

Official Title
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A Phase 2 Study of Stereotactic Body Radiotherapy (SBRT) for the Treatment of OligoMetastatic Esophageal Squamous Cell Carcinoma

Conditions
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Esophageal Squamous Cell Carcinoma Metastatic

Intervention / Treatment
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* Radiation: SBRT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with metastatic esophageal squamous cell carcinoma who have received initial treatment for the primary site including surgery or chemoradiotherapy. Primary tumor site without progression at registration. The sites of allowed metastases are: peripheral lung, central lung, medistinal/cervical lymph node, liver, spinal/paraspinal, osseous, and abdominal-pelvic lymph node. All metastases not resected must be amenable to SBRT. 1-4 radiographically distinct metastases of any distribution in 2 or less allowed anatomical sites. The diameters of lesions should be less than or equal to 5cm. Initial treatment should be completed at least 3 months prior to study registration. All the metastases treated with SBRT should not be treated with surgery, radiation, radio frequency ablation or other regional therapeutic modalities prior to study registration. The other (s) lesions should have been surgically removed. Age ≥ 18. PS ECOG 0-2，wight loss<30% during the latest 6 months. Evaluation by a radiation oncologist that the patient could tolerate the treatment of SBRT. Patient must provide study specific informed consent prior to study entry. For females of child-bearing potential, negative serum/urine pregnancy test within 14 days prior to study registration. Exclusion Criteria: Progression of primary tumor site at time of registration. Metastases with indistinct borders making targeting not feasible. Known brain metastases. Prior palliative radiotherapy to metastases. Metastases located within 3 cm of the previously irradiated structures: a).Spinal cord previously irradiated >80Gy(Biological equivalent dose with α/β=2), b).Brachial plexus previously irradiated to > 100Gy(Biological equivalent dose with α/β=2), c).Small intestine, large intestine, or stomach previously irradiated to > 90Gy (Biological equivalent dose with α/β=2), d).Whole lung previously irradiated with prior V20Gy > 30% (delivered in ≤ 3 Gy/fraction), e)Metastasis irradiated with SBRT. Pregnant or breast-feeding women or people during the birth-period who refused to take contraceptives. Drug addiction,Alcoholism or AIDS. Patients with severe organ dysfunction or Acute bacterial or fungal infection who are considered not suitable to enroll the study at the time of registration.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Arm<br>Patients in this arm will receive a treatment of SBRT for their oligometastatic lesions. | Radiation: SBRT<br>* Patients with 1-4 metastases located in less than 2 organs/ lymphatic drainage regions that are 5 cm or less from each other and simultaneously treated with SBRT.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free survival | progression-free survival will be measured as time to either progression or death | The survival time from the date each patient enrolled to the date of progression or date of death from any cause, whichever came first, assessed up to 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Local control | Local control will be measured as time to local recurrence | the time from the date each patient enrolled to the date of local failure or the last follow-up, assessed up to 5 years. | 
| overall survival | Overall survival will be measured as time until death from any cause | The survival time from the date each patient enrolled to the date of death or the last follow-up, assessed up to 5 years. |