Table 1.
Inclusion and exclusion criteria for the SCOPE1 trial
Inclusion Criteria Patients meeting the following criteria can be included in the trial: |
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1. Histologically confirmed carcinoma of the oesophagus (adenocarcinoma or squamous cell or undifferentiated carcinoma) or Siewert Type 1 tumour of the gastro-oesophageal junction (GOJ) or Siewert Type 2 with no more than 2 cm mucosal extension into the stomach. |
2. Age 18 or over |
3. Have been selected to receive potentially curative definitive CRT by a specialist Upper GI MDT including a designated Upper GI surgeon. |
4. Not suitable for surgery either for medical reasons or through patient choice. |
5. Tumours staged with both endoscopic ultrasound (EUS) and spiral CT scan to be T1-4, N0-1 confirming localised, non-metastatic disease (both within 7 weeks prior to randomisation, but the most recent within 4 weeks). An attempted but failed or contra-indicated EUS is acceptable. Tumours should be staged according to the 6th edition of the American Joint Committee on Cancer's (AJCC) Cancer Staging Manual |
6. Total disease length (primary and lymph nodes) less than or equal to 10 cm defined by EUS or CT if EUS attempted but failed or contra-indicated. |
7. WHO Performance status 0-1 |
8. Adequate cardiovascular function for safe delivery of CRT in the opinion of the principal investigator |
9. Adequate respiratory function for safe delivery of CRT in the opinion of the Principal Investigator |
10. Adequate bone marrow and hepatic function (within 1 week prior to randomisation): |
• Absolute neutrophil count (ANC) ≥ 1.5 × 109/L |
• White blood cell count ≥ 3 × 109/L |
• Platelets ≥ 100 × 109/L |
• Haemoglobin (Hb) ≥ 10 g/dL (patients' Hb should be corrected to > 10 g/dl before treatment) |
• Adequate liver function (within 1 week prior to randomisation) |
• Serum bilirubin ≤ 1.5× ULN |
• ALT/AST ≤ 2.5× ULN |
• ALP ≤ 3× ULN |
11. Adequate renal function (within 1 week prior to randomisation): Glomerular filtration rate (GFR) assessed by EDTA clearance to be > 40 mL/min (or estimated by Cockcroft-Gault formula to be > 60 mL/min) |
12. Patients who are fit to receive all protocol treatment. |
13. Patients who are able and willing to administer capecitabine. |
14. Patients who are of child bearing age are willing to use contraception. |
15. Patients who have completed baseline quality of life questionnaires |
16. Patients who have provided written informed consent prior to randomisation |
Exclusion Criteria If any of the following criteria apply, patients cannot be included in the trial: |
1. Patients who have had previous treatment for invasive oesophageal carcinoma or gastro-oesophageal junction carcinoma (not including PDT or laser therapy for high grade dysplasia/carcinoma in-situ). |
2. Patients with metastatic disease i.e. M1a or M1b according to UICC TNM version 6. |
3. Patients with any previous treatment for malignancy which will compromise ability to deliver definitive mediastinal CRT or may compromise survival (does not include patients with squamous cell carcinoma). |
4. Patients who have had a previous malignancy during the previous 5 years |
5. Patients with significant (> 2 cm) extension of tumour into the stomach |
6. Patients with unstable angina or uncontrolled hypertension or cardiac failure or other clinically significant cardiac disease |
7. Patients who have had major surgery or major trauma in the 4 weeks prior to randomisation. |
8. Patients who have been treated with a monoclonal antibody in the 4 weeks prior to randomisation. |
9. Patients who have been treated with radiotherapy in the 3 months prior to randomisation |
10. Patients who need continued treatment with a contraindicated concomitant medication or therapy |
11. Patients with known dihydropyrimidine dehydrogenase (DPD) deficiency |
12. Patients with hearing impairment or sensory-motor neuropathy of WHO grade > 2 |
13. Women who are pregnant |