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RecruitingNCT03051464MORPHEUSUpdated Jun 30, 2026

Randomizing Two Radiotherapy Boost Options to Avoid Rectal Cancer Surgery

A Phase 2/3 interventional study of Complete responders and Non-complete responders and Chemoradiation + EBRT Boost in Stage II Rectal Cancer, Organ Preservation and Non-operative Treatment, sponsored by Sir Mortimer B. Davis - Jewish General Hospital. Recruiting at 4 sites in 2 countries. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-06-30.

Sponsored by Sir Mortimer B. Davis - Jewish General Hospital · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
131
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

A randomized study of 131 patients. Patients with a clinical T2-3 N0-1 rectal cancer will be randomized to two arms (arm A: standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and an external beam boost of 9 Gy compared to arm B: standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and followed by a brachytherapy boost of 30 Gy in 3 fractions).

Read the detailed description

It is becoming clear that there is a now an international consensus that rectal cancer research efforts need to be more focused in optimizing a non-surgical approach. This concept is very relevant to an ageing patient population with multiple co-morbidities regularly seen at the Jewish General Hospital and across the province. After interim analysis on 40 patients of the pilot study a phase III study is proposed. We are therefore proposing a phase III multicentric study of 145 patients to compare the two best known radiation dose escalation strategies and to achieve a complete clinical response. Patients with a clinical T2-3 N0-1 rectal cancer will be randomized to two arms (arm A: standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and an external beam boost of 9 Gy compared to arm B: standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and followed by a brachytherapy boost of 30 Gy in 3 fractions). Patients that have a high risk of recurrence or with more advanced stages of the disease will be excluded from the study, as only the local disease is being treated. The primary outcome for this proposal is rectum preservation in treated patients.

02

Conditions studied

  • Stage II Rectal Cancer
  • Organ Preservation
  • Non-operative Treatment
  • Rectal Cancer (Stage III)
  • Rectal Cancer Patients

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Keywords

  • rectal cancer
  • non-operative management
  • rectal preservation
  • organ preservation
  • brachytherapy boost for rectal cancer
  • low rectal cancer curative treatment
  • mid rectal cancer curative treatment
  • rectal brachytherapy
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Rectal cancer patients, clinically staged as T2-T3a,b N0-1 by MRI or endoscopic/trans-rectal ultrasound
  • Rectal cancer staged as N0-1 by MRI or EUS/TRUS
  • No metastatic lesion
  • Rectal tumor occupying less than half of the circumference
  • Tumor less than 5 cm on its largest dimension
  • Tumor located at less than 10 cm from the anal verge
  • Tumor penetration less than 5 mm in the mesorectal fat
  • Tumor accessible for brachytherapy
  • Lumen accessible for colonoscopy
  • Patient should be a suitable candidate for brachytherapy and chemotherapy
  • Older than 18 years of age
  • Adequate birth control measures in women of childbearing potential
  • Written informed consent

Exclusion criteria

Exclusion Criteria:

  • Patients with previous pelvic radiation
  • Evidence of distant metastasis
  • Extension of malignant disease to the anal canal
  • Tumors staged as T4
  • Tumors larger than 5 cm in length
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
131 participants (estimated)

Study arms

  • Experimental
    Chemoradiation + EBRT Boost

    standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and an external beam boost of 9 Gy in 5; Complete responders and Non-complete responders

    Procedure: Complete responders and Non-complete responders · Radiation: Chemoradiation + EBRT Boost

  • Experimental
    Chemoradiation + HDRBT Boost

    standard chemoradiation (45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and followed by a brachytherapy boost of 30 Gy in 3 fractions; Complete responders and Non-complete responders

    Procedure: Complete responders and Non-complete responders · Radiation: Chemoradiation + HDRBT Boost

Interventions

  • ProcedureComplete responders and Non-complete responders

    Patients that are complete responders will not have surgery. Patients that are non-complete responders will have surgery.

  • RadiationChemoradiation + EBRT Boost

    45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and an external beam boost of 9 Gy in 5

  • RadiationChemoradiation + HDRBT Boost

    45 Gy in 25 with concomitant 5-FU or Xeloda chemotherapy) and followed by a brachytherapy boost of 30 Gy in 3 fractions

05

What researchers measure

Primary outcomes

  1. TME-free survival

    Time from date of randomization to either TME or death in the intention to treat population

    Time frame: 2 years post treatment

Secondary outcomes

  1. Local Recurrence

    Number of participants with Local recurrence as assessed by tests during follow-up visits.

    Time frame: 2 years post treatment

  2. Disease-free survival

    The time between the date of randomization and recurrence, either in the pelvis or metastases. Patients without an event will be censored at the last date the patient was known to be disease-free.

    Time frame: 5 years post treatment

  3. Overall survival

    The time between date of randomization and date of death due to any causes.

    Time frame: 5 years post treatment

  4. Overall Quality of life

    Quality of life Questionnaires over different time point

    Time frame: 5 years post treatment

06

Study locations

4 of 4 sites recruiting
  • UT Southwestern Medical Center
    Dallas, Texas 75390, United States
    Recruiting
  • Le Centre Hospitalier de l'Université de Montreal
    Montreal, Quebec H2X0A9, Canada
    Recruiting
  • Jewish General Hospital
    Montreal, Quebec H3T 1E2, Canada
    Recruiting
  • Centre hospitalier universitaire de Québec
    Québec, Quebec G2L2Z3, Canada
    • André-Guy Martin, MD · Contact
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03051464
Lead sponsor
Sir Mortimer B. Davis - Jewish General Hospital
Responsible party
Dr. Te Vuong (Director, Radiation Oncology Department, Sir Mortimer B. Davis - Jewish General Hospital) — Principal investigator
First posted
Feb 13, 2017
Start date
Apr 25, 2017
Primary completion
Jan 2028 (estimated)
Completion
Jan 2030 (estimated)
Last update
Jun 30, 2026

Study contacts

Susanne Knoepfel
Contact
sknoepfel@jgh.mcgill.ca
5143408288 ext. 21285
Te Vuong, MD
principal investigator · Sir Mortimer Jewish General Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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