NCT07339488RecruitingPhase 2
Intestinal Low-Dose Radiotherapy Plus Immunochemotherapy for Conversion of Borderline Resectable/Unresectable Esophageal Squamous Cell Carcinoma
Efficacy and Safety of Combining Intestinal Low Dose Radiotherapy Plus Tislelizumab and Chemotherapy for Conversion of Borderline Resectable/Unresectable Esophageal Squamous Cell Carcinoma
Source: ClinicalTrials.gov · Last updated 5 Oct 2026
Brief summary (registry, in English)
Esophageal cancer (EC) ranks among the leading malignant gastrointestinal tumors globally in terms of both incidence and mortality. Cases of EC in China account for over 50% of the global total, with squamous cell carcinoma being the primary pathological type. Locally advanced EC (LAEC), particularly cases where radical surgical resection is not feasible, exhibits high recurrence rates and low 5-year survival rates. However, studies have shown that patients with LAEC who undergo comprehensive treatment followed by surgery experience significantly prolonged survival and improved quality of life compared to those who do not receive surgical intervention. Current conversion treatment regimens under investigation include: chemotherapy alone, chemoradiotherapy, immunotherapy combined with chemotherapy, and immunotherapy combined with chemoradiotherapy-each of these approaches has distinct advantages and limitations. Immunochemotherapy has emerged as a current research focus: it not only demonstrates significantly superior efficacy compared to chemotherapy alone but also exhibits lower cumulative toxicity than radiotherapy-combined conversion regimens, resulting in a more favorable overall benefit-risk ratio. As such, it represents the most promising conversion treatment strategy. Retrospective and prospective clinical studies have shown that low-dose radiotherapy targeting the small intestine can enhance the anti-tumor response of immune checkpoint inhibitors (ICIs) in patients with advanced solid tumor, prolong their overall survival, and increase the incidence of the abscopal effect. Further mechanistic investigations have revealed that intestinal low-dose radiotherapy (ILDR) may augment the immune cancerous lethality by modulating the gut microbiota and their metabolic profiles. Based on the findings from these preliminary studies, the current research plans to conduct a prospective phase II single-arm clinical trial to investigate the efficacy and safety of ILDR combined with immunochemotherapy as conversion therapy in patients with borderline resectable or unresectable esophageal squamous cell carcinoma (BR/UR ESCC). This research plans to enroll at least 39 evaluable cases or a total of 39 cases in two seperated stages, focusing on patients with thoracic BR/UR ESCC. Patients will receive a single fraction of ILDR with a mean dose of 1 Gy, concurrently with 3 cycles of albumin-bound paclitaxel (260 mg/m² on day 1), cisplatin (75 mg/m² on day 1), and tislelizumab (200 mg on day 1). The efficacy and safety of the treatment will be evaluated throughout the study.
- Status (registry)
- Recruiting
- Phase (registry)
- Phase 2
- Study type
- Interventional
- Enrollment
- 39 (estimated)
- First submitted
- 1 Dec 2025
- Start date
- 5 Dec 2025
- Primary completion date
- 30 Oct 2029
- Lead sponsor
- Chuangzhen Chen
- Diseases
- Gastric and esophageal cancer
- NCT number
- NCT07339488
What you commit to
- Study type: Interventional · Phase 2
- Planned participants: 39
- From 5 Dec 2025 to the primary completion date, 30 Oct 2029
- 1 site in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Patients with contraindications to radiotherapy or immune checkpoint inhibitor (ICI) therapy.
- Drug and/or alcohol abuse.
- Concurrent participation in another therapeutic clinical trial.
- Major surgical procedure within 30 days prior to enrollment.
- Use of antibiotics, antifungals, antivirals, or antiparasitics within 4 weeks prior to registration.
Other illness
- Presence or high risk of esophageal perforation.
- Subjects with active, uncontrolled systemic bacterial, viral, or fungal infections despite optimal treatment.
- Severe cardiac disease (i.e., NYHA functional class II or higher).
- Active hepatitis B, hepatitis C, HIV, or syphilis.
- Active brain disease or central nervous system/meningeal metastases with significant symptoms, or impaired decision-making capacity.
- Hypersensitivity to drugs included in the trial.
Other
- Patients with distant metastases other than supraclavicular lymph node metastases.
- Respiratory depression, airway obstruction, or tissue hypoxia.
- Markedly abnormal liver or kidney function (i.e., indicators \>3 times the upper limit of normal).
- Pregnant or lactating women.
Who the study is looking for
- Patients voluntarily enroll in this study, sign an informed consent form, and demonstrate good compliance.
- Age ≥18 years and ≤75 years; both sexes are eligible.
- ECOG performance status score of 0-1.
- Pathologically confirmed esophageal squamous cell carcinoma (ESCC) prior to surgery.
- Thoracic esophageal cancer.
- Unresectable lesions, defined as: T4 stage; Borderline resectable T3 disease, in which imaging cannot exclude invasion of adjacent organs or structures, such as the trachea, bronchi, or aorta; T3 disease with supraclavicular lymph node metastasis; or clinically confirmed unresectable disease by the surgeon.
- No prior history of anti-tumor treatment, including chemotherapy, hormonal therapy, radiotherapy, or immunotherapy.
- Baseline laboratory requirements (within 7 days prior to enrollment):
- Hematology:
- Hb≥90 g/L (no transfusion within 14 days)
- NEUT ≥1.5×10⁹/L
- PLT ≥100×10⁹/L
- WBC≥3×10⁹/L
- Biochemistry:
- ALT and AST≤2.5×ULN
- TBIL≤1.5×ULN
- SCr≤1.5×ULN; or CrCl≥60 mL/min Coagulation: APTT, INR, and PT≤1.5×ULN Thyroid function: TSH≤ULN (if abnormal, FT3/FT4 levels should also be considered; eligible if FT3/FT4 are normal) Echocardiography: LVEF≥50%
- Female subjects need to agree to use contraception during the study and for 6 months post-study; serum pregnancy test negative within 7 days prior to enrollment; non-lactating. Male subjects must agree to use contraception during the study and for 6 months post-study.
- No psychological, familial, social, or geographical factors that may impair protocol adherence.
- Other parameters meet general clinical trial enrollment criteria.
- The subject or authorized representative has read, fully understands the patient information sheet, and signed the informed consent form.
Age in the registry: 18 years to 75 years · Sex: All · Does not accept healthy volunteers
Sites (1)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Cancer Hospital, Shantou University Medical College Coordinator of this site? Confirm its status | Shantou | China | Recruiting |
This page is information, not medical advice. Discuss any trial with your doctor.