CMISG1701: a multicenter prospective randomized phase III clinical trial comparing neoadjuvant chemoradiotherapy to neoadjuvant chemotherapy followed by minimally invasive esophagectomy in patients with locally advanced resectable esophageal squamous cell carcinoma (cT3-4aN0-1M0) (NCT03001596)
Han Tang,
Lijie Tan,
Yaxing Shen,
Hao Wang,
Miao Lin,
Mingxiang Feng,
Songtao Xu,
Weigang Guo,
Cheng Qian,
Tianshu Liu,
Zhaochong Zeng,
Yingyong Hou,
Zhentao Yu,
Hongjing Jiang,
Zhigang Li,
Chun Chen,
Changhong Lian,
Ming Du,
Hecheng Li,
Deyao Xie,
Jun Yin,
Naiqing Zhao,
Qun Wang
Affiliations
Han Tang
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Lijie Tan
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Yaxing Shen
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Hao Wang
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Miao Lin
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Mingxiang Feng
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Songtao Xu
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Weigang Guo
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Cheng Qian
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Tianshu Liu
Department of Medical Oncology, Zhongshan Hospital, Fudan University
Zhaochong Zeng
Department of Radiotherapy, Zhongshan Hospital, Fudan University
Yingyong Hou
Department of Pathology, Zhongshan Hospital, Fudan University
Zhentao Yu
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin City
Hongjing Jiang
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin City
Zhigang Li
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University
Chun Chen
Department of Thoracic Surgery, Fujian Medical University Fujian Union Hospital
Changhong Lian
Department of General Surgery, Heping Hospital, Changzhi Medical College
Ming Du
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University
Hecheng Li
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine
Deyao Xie
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University
Jun Yin
Department of Cardiothoracic Surgery, Affiliated People’s Hospital of Jiangsu University
Naiqing Zhao
Department of Biostatistics, School of Public Health, Fudan University
Qun Wang
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University
Abstract Background Neoadjuvant chemoradiation is not recommended as an approach for treatment of esophageal squamous cell carcinoma due to its significant postoperative mortality. However, it is assumed the combination of neoadjuvant chemoradiation with minimally invasive esophagectomy (MIE) may reduce postoperative mortality, which can revive preoperative chemoradiation. No randomized controlled studies comparing neoadjuvant chemoradiation plus MIE with neoadjuvant chemotherapy plus MIE have been performed so far. The present trial is initiated to obtain valid information whether neoadjuvant chemoradiation plus MIE yields better survival without worse postoperative morbidity and mortality in the treatment of locally advanced resectable esophageal squamous cell carcinoma(cT3-4aN0-1M0). Methods/design CMISG1701 is a multicenter, prospective, randomized, phase III clinical trial, investigating the safety and efficacy of neoadjuvant chemoradiation plus MIE compared with neoadjuvant chemotherapy plus MIE. Patients with locally advanced resectable esophageal squamous cell carcinoma (cT3-4aN0-1M0) are eligible for the study. A total of 264 patients are randomly assigned to neoadjuvant chemoradiation (arm A) or neoadjuvant chemotherapy (arm B) with a 1:1 allocation ratio. The primary outcome is overall survival assessed with a minimum follow-up of 36 months. Secondary outcomes are progression-free survival, recurrence-free survival, postoperative pathologic stage, treatment-related complications, postoperative mortality as well as quality of life. Discussion The objective of this trial is to identify the superior protocol with regard to patient survival, treatment morbidity/mortality and quality of life between neoadjuvant chemoradiation plus MIE and neoadjuvant chemotherapy plus MIE. Trial registration NCT03001596 (December 17, 2016).