ClinicalTrials.gg
RecruitingNCT06906887Updated Jul 28, 2026

PULSO Trial: Pulsed Low-Dose-Rate (PLDR) Radiation Chemoradiation (CRT) vs. Standard CRT for Esophageal Cancer

A Phase 2 interventional study of Induction Chemotherapy (modified FLOT or modified FOLFOX-6) and Chemotherapy in Esophageal Cancer, Oesophageal Cancer and GastroEsophageal Cancer, sponsored by Medical College of Wisconsin. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-28.

Sponsored by Medical College of Wisconsin · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2025; still recruiting 1 year 4 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 675 studies in Esophageal Neoplasms with a site in United States — 122 open to participants now, 172 under way, 2 of them phase 3. Esophageal Neoplasms · United States.

Planned enrollment
229th of 525
50 · median 42
Started
2025
with 27 others
Phase 2
210 of 675
19 open now
Primary completion
2030-11
later than 156 of 169 live
Registered
636th of 675
by date

Among the 675 studies in Esophageal Neoplasms with a site in United States, this one is the 229th largest by planned enrollment of the 525 interventional ones, is one of 28 that started in 2025, is one of 210 in phase 2, reaches primary completion later than 156 of the 169 other live ones, and was the 636th registered.

By phase

675 studies; the count open now beside each. This study's row is marked.

Phase 2this study210 · 19 open
Phase 1167 · 29 open
Observational111 · 33 open
No phase93 · 20 open
Phase 1/267 · 16 open
Phase 317 · 2 open
Phase 46 · 2 open
Other kind2 · 1 open
Phase 2/32 · 0 open

By the year they started

First in 1992; this study’s year is marked. 28 started in 2025.

Size and results

Median enrollment 42 across the 525 interventional studies, 159 across the 111 observational. Of the 461 that completed or were terminated, 172 (37%) have results posted.

Was this useful?
Watch this landscapeDownload CSVWith an account: a weekly mail of what changed among 675 studies in Esophageal Neoplasms with a site in United States, or all of them as a file.
02

Study summary

This is a prospective, randomized, open-label, two-arm phase 2 trial that will evaluate whether the use of Pulsed Low-Dose-Rate radiation technique, as compared to standard radiation, is associated with reduced rates of clinically significant esophagitis during and following chemoradiation.

Read the detailed description

PLDR radiation technique has been shown to kill cancer cells while limiting normal tissue toxicity. In PLDR, subjects receive the same total dose of radiation for each treatment, but the treatment is delivered in a series of low-dose pulses which are separated by timed pauses. Radiation given with this approach may be less toxic but appears to be equally effective. This trial will evaluate the PLDR technique in combination with standard chemotherapy as part of definitive or curative treatment for locally advanced esophageal cancer.

03

Conditions studied

  • Esophageal Cancer
  • Oesophageal Cancer
  • GastroEsophageal Cancer

Keywords

  • Pulsed Low-Dose-Rate Radiation
  • Chemoradiation
  • esophagitis
  • Esophagectomy
  • Esophageal Cancer
  • Oesophageal Cancer
  • GastroEsophageal Cancer
  • Pulsed reduced dose rate radiation
  • Pulsed radiation
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

A potential study subject who meets all of the following inclusion criteria is eligible to participate in the study.

  1. Age ≥ 18 years.
  2. Stage II-IVb adenocarcinoma of the esophagus (if IVb, oligometastatic only, felt to be eligible for definitive dose CRT treatment by treating physician).
  3. Currently receiving or have received induction chemotherapy and planned for definitive dose chemoradiation (+/- esophagectomy).
  4. (ECOG) performance status 0-2.
  5. Adequate hematologic function within 30 days prior to registration defined as follows:

    1. ≥ 1,500/mcg
    2. ≥ 8 gm/dL
    3. ≥ 100,000/mcL.
  6. Adequate renal function within 30 days prior to registration, defined as a of ≥ 50 ml/min as calculated by the Cockcroft-Gault equation.
  7. Adequate hepatic function within 30 days prior to registration, defined as total ≤ 1.5 x

    a. Note: patients with known Gilbert Syndrome can have a total bilirubin \< 2.5 x upper limit of normal (ULN).

  8. Female patients \<65 years of age and of must have a negative serum/urine pregnancy test within 14 days prior to study entry. A female not of childbearing potential is one who has undergone a hysterectomy, bilateral oophorectomy, tubal ligation, or who has had no menses for 12 consecutive months.
  9. Patients of must agree to use effective for the duration of study treatment. Effective contraception includes oral contraceptives, implantable hormonal contraception, double-barrier method, or intrauterine device.
  10. Patients with a prior or concurrent whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the regimen are eligible for this trial.
  11. Ability to understand a written document, and the willingness to sign it.

Exclusion criteria

Exclusion Criteria:

A potential study subject who meets any of the following exclusion criteria is ineligible to participate in the study.

  1. Age \< 18 years.
  2. Extensive distant cancer, defined as >5 metastases.
  3. Recurrent esophageal cancer.

    a. Note: prior or concurrent are allowed if they do not impact the study's primary endpoint (i.e., treatment-associated toxicity).

  4. Prior non-approved chemotherapy for the treatment of cancer.
  5. Prior radiotherapy to the region of the study cancer that would result in an overlap of radiation therapy fields.
  6. Women must not be pregnant or breast-feeding.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

05

Study design

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

Study arms

  • Experimental
    Pulsed Low-Dose-Rate Radiation (PLDR)

    Neoadjuvant radiation delivered in short pulses; same dose as standard chemoradiation arm.

    Drug: Induction Chemotherapy (modified FLOT or modified FOLFOX-6) · Drug: Chemotherapy · Radiation: Pulsed Low-Dose-Rate (PLDR) Radiation · Procedure: Surgery

  • Experimental
    Standard Chemoradiation

    Standard (non-pulsed) neoadjuvant radiation; same dose as PLDR arm.

    Drug: Induction Chemotherapy (modified FLOT or modified FOLFOX-6) · Drug: Chemotherapy · Radiation: Conventional Radiation · Procedure: Surgery

Interventions

  • DrugInduction Chemotherapy (modified FLOT or modified FOLFOX-6)

    Subjects are expected to receive 2-4 months of induction chemotherapy; the interval and dosages will be determined and can be modified at the discretion of their medical oncologist. The preferred induction chemotherapies are modified FLOT or FOLFOX-6. Subjects can enroll if they receive less than 2 months of induction chemotherapy as long as they are deemed to be a candidate for concurrent chemoradiation therapy.

  • DrugChemotherapy

    The preferred concurrent chemoradiation is carboplatin/paclitaxel weekly.

  • RadiationConventional Radiation

    For both standard conventional radiation therapy and PLDR radiation therapy, the standard dose (5000cGy/25fx default, 4140-5040 in 23-28 fractions) should be given. Fractions should consist of 180-200 cGy per treatment.

  • RadiationPulsed Low-Dose-Rate (PLDR) Radiation

    For both standard conventional radiation therapy and PLDR radiation therapy, the standard dose (5000cGy/25fx default, 4140-5040 in 23-28 fractions) should be given. Fractions should consist of 180-200 cGy per treatment. For PLDR radiation therapy, each fraction will be delivered as a series of 20 cGy (or 0.2 Gy) pulses that are separated by 3-minute time intervals.

  • ProcedureSurgery

    Esophagectomy is not required for trial and will be administered per medical judgement of the treating physicians. Surgery will take place at the time directed by the surgeon. This typically will take place approximately 6-13 weeks after chemoradiation therapy.

06

What researchers measure

Primary outcomes

  1. New prescription for narcotics

    The number of subjects requiring a new prescription for narcotics.

    Time frame: Up to 6 weeks after radiation treatment

  2. Increasing existing narcotics

    The number of subjects increasing existing narcotics by 25%.

    Time frame: Up to 6 weeks after radiation treatment

  3. Oral intake

    The number of subjects transitioning from solid to liquid or liquid to no oral intake.

    Time frame: Up to 6 weeks after radiation therapy

07

Study locations

1 of 1 sites recruiting
  • Froedtert & the Medical College of Wisconsin
    Milwaukee, Wisconsin 53226, United States
    Recruiting
    • Lindsay Puckett, MD · Contactlpuckett@mcw.edu · 414-805-4400
    • Lindsay Puckett, MD · Principal investigator
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2025 (actual). Primary completion is estimated for Nov 2030, 64 months after the start.

Of 174 non-industry phase 2 interventional studies under Esophageal Neoplasms, half reached primary completion within 55 months of starting (the median), counting those still running; a quarter within 33 and three quarters within 85. This study's planned 64 months is above that.

Counting every sponsor, half of 198 studies reached it within 52 months; a quarter within 33 and three quarters within 78.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 26, 2025
First posted
Apr 2, 2025
StartActual
Jun 17, 2025
Primary completionEst.
Nov 1, 2030
CompletionEst.
Jun 1, 2032
Last update
Jul 28, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06906887
Responsible party
Lindsay Puckett, MD (Associate Professor, Medical College of Wisconsin) — Principal investigator
First posted
Apr 2, 2025
Start date
Jun 17, 2025
Primary completion
Nov 1, 2030 (estimated)
Completion
Jun 1, 2032 (estimated)
Last update
Jul 28, 2026

Study contacts

Medical College of Wisconsin Cancer Center Clinical Trials Office
Contact
cccto@mcw.edu
866-680-0505 ext. 8900
Lindsay Puckett, MD
principal investigator · Medical College of Wisconsin

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion