Locally Advanced Rectal CancerELECTRANCT05877352
Intraoperative Electron Radiotherapy in Rectal Cancer - A Feasibility Trial
A study testing Intraoperative Electron Radiotherapy (IOERT) and Extended Margin Surgery in people with Locally Advanced Rectal Cancer and Locally Recurrent Rectal Cancer, run by University Hospital Southampton NHS Foundation Trust at 1 site in United Kingdom.
Trial summary
Single centre double-blinded three-arm randomised controlled trial of extended margin surgery + IOERT at standard dose (10 Gy) versus extended margin surgery + IOERT at higher dose (15 Gy) versus extended margin surgery alone in a 1:1:1 ratio in patients with Locally Advanced Rectal Cancer (LARC) or Locally Recurrent… Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Locally Advanced Rectal Cancer, Locally Recurrent Rectal Cancer
- What is being tested?
- Intraoperative Electron Radiotherapy (IOERT) and Extended Margin Surgery
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 31 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 18 May 2022to 25 Apr 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age ≥ 16
- Non-metastatic/oligo-metastatic (up to 3 lesions from 2 sites predicted to be radically treatable) - locally advanced or locally recurrent disease involving the posterior or lateral components of the pelvis and predicted to be resectable but with close margins from imaging as determined by a specialist MDT (sMDT)
- Colorectal sMDT review with experience in pelvic exenteration, which has proposed IntrOperative Electron Radiotherapy (IOERT) as an option for treatment
- Patient suitable for IOERT as component of treatment in the view of the responsible Clinical Oncologist
- Performance status ≤1 as defined by the Eastern Cooperative Oncology Group (ECOG)
- Deemed medically fit for surgery
- Written informed consent
Who cannot join
- Unresectable disease/likelihood of R2 resection
- sMDT determined excess prior radiotherapy within IOERT target zone
- Women who are pregnant or breastfeeding
- Participation within an interventional clinical trial within 3 months of the point of registration within ELECTRA
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
University Hospital Southampton NHS Foundation Trust
Southampton, Hampshire, SO16 6YD
About this study
Single centre double-blinded three-arm randomised controlled trial of extended margin surgery + IOERT at standard dose (10 Gy) versus extended margin surgery + IOERT at higher dose (15 Gy) versus extended margin surgery alone in a 1:1:1 ratio in patients with Locally Advanced Rectal Cancer (LARC) or Locally Recurrent Rectal Cancer (LRRC).
Read the detailed description
Rectal cancer is a cancer that occurs in the pelvis from the rectum. Locally advanced rectal cancer outgrows the rectum and attaches to other body parts in the pelvis and locally recurrent rectal cancer is a rectal cancer that comes back after surgery, and usually attaches to many different pelvic structures. They are both difficult to manage. The standard of care treatment involves chemotherapy and radiotherapy, followed by what is known as an extended margin operation to remove all cancer affected organs and not leave any cancer cells behind. If cancer cells reach the edge of the removed tissue, there is a high chance of leaving cancer cells behind. This is a key predictor of negative outcome in patients. Intraoperative electron beam radiotherapy (IOERT) was developed to help improve patient outcomes. Once the cancer has been removed, the surgeon and a cancer radiotherapy specialist examine the patient's scans, the cancer specimen and the area the cancer was in, and if there is concern about small numbers of cancer cells being left behind they treat the area with radiotherapy to destroy these cells. Patients that are due to receive treatment for these subsets of rectal cancer will be approached to take part. If eligible on the day of surgery the patient will be randomised to one of three arms: Arm A - standard of care (No IOERT), Arm B - extended margin surgery plus IOERT (10 Gy), or Arm C - extended margin surgery plus higher dose IOERT (15 Gy). The surgeon, cancer specialist team and patient will be blinded to study treatment. Patients will be followed up at 30 days, 3 months and for a minimum of 12 months post surgery as part of the trial and they will be followed up for 5 years as part of standard care.
- Being tested
- Intraoperative Electron Radiotherapy (IOERT), Extended Margin Surgery
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Intraoperative Electron Radiotherapy (IOERT)Radiation
IOERT can be defined as the direct application of high-energy electron beam irradiation to a tumour bed during an operative procedure. This approach permits precise delivery of a single large fraction of radiation directly and specifically to high recurrence risk anatomical target areas, which the treating clinicians (surgeon and attending clinical oncologist) predict will be a close or involved margin, while simultaneously displacing and shielding dose-limiting radiosensitive structures such as the small bowel or ureter or any anastomoses, if not involved by tumour.
Extended Margin SurgeryProcedure or surgery
Surgery intended to remove both a tumour and any metastases
| Study group | Role | What they receive |
|---|---|---|
| No IOERT | Active comparator | Extended margin surgery Receives: Procedure: Extended Margin Surgery |
| Low Dose IOERT | Experimental | Extended margin surgery and IOERT at standard dose (10 Gy) Receives: Radiation: Intraoperative Electron Radiotherapy (IOERT); Procedure: Extended Margin Surgery |
| High Dose IOERT | Experimental | Extended margin surgery and IOERT at higher dose (15 Gy) Receives: Radiation: Intraoperative Electron Radiotherapy (IOERT); Procedure: Extended Margin Surgery |
What is being measured
The primary outcome is the main question the study is designed to answer.
Patients meeting eligibility criteria
Number and percentage of patients meeting eligibility criteria and number of patients referred to a sMDT over the trial period
Measured: 2 years
Patients accepting randomisation
Number and percentage of patients accepting randomisation
Measured: 2 years
Successful delivery of IOERT
Number and percentage of patients for which IOERT was successfully delivered as planned as part of the trial
Measured: 2 years
Blind maintained for patients and clinicians
Number and percentage of patients and clinicians for which blinding was maintained for IOERT delivery
Measured: 2 years
Questionnaire analysis
Percentage of patients whose questionnaires can be analysed
Measured: 2 years
Availability of potential primary outcome data
Percentage of patients for whom we can collect information on potential primary outcomes
Measured: 2 years
Secondary outcomes (13)
Morbidity
Clavien Dindo classification
Measured: Up to 30 days post randomisation
Mortality
Mortality
Measured: 30 days post randomisation
IOERT Field Recurrence
IOERT Field Recurrence is defined as the area directly within the IOERT field as marked by ligaclips or identified by the surgical oncologist for future radiological surveillance.
Measured: 12 months post randomisation
Overall local recurrence
Overall local recurrence (OLR) is defined as including both IOERT-field and non-IOERT field loco-regional recurrences.
Measured: 12 months post randomisation
Overall survival
Overall survival
Measured: 12 months post randomisation
Treatment related toxicity
Treatment related toxicity graded by CTCAE v5
Measured: 12 months post randomisation
Time to local or systemic recurrence
Time to local or systemic recurrence
Measured: Time from randomisation to local or systemic recurrence or 3 years post the start of recruitment, whichever comes first
R1 Rate
R1 Rate
Measured: At randomisation
EQ-5D-5L
Quality of life scored from EQ-5D-5L
Measured: At 3 and 12 months post randomisation
LRRC QoL
Quality of life scored from LRRC QoL
Measured: At 3 and 12 months post randomisation
QLQ-C30
Quality of life scored from QLQ-C30
Measured: At 3 and 12 months post randomisation
SF-36
Quality of life scored from SF-36
Measured: At 3 and 12 months post randomisation
Resource use and cost
Cost will be estimated for the NHS. An NHS and social care perspective will be used, including intervention costs, outpatient visits and investigations, A\&E attendances, hospital admissions, number and dose of each radiotherapy treatment. Itemised resource usage date will be priced using appropriate national sources: Personal Social Services Research Unit (PSSRU), NHS Reference costs and BNF (British National Formulary) for the UK.
Measured: At 3 and 12 months post randomisation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 May 2023
- Study start18 May 2022
- Primary completion25 Apr 2024
- Study completion25 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Locally Advanced Rectal CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A single centre double-blinded three-arm randomised controlled trial of extended margin surgery + IOERT at standard dose (10 Gy) versus extended margin surgery + IOERT at higher dose (15 Gy) versus extended margin surgery alone (no IOERT) in a 1:1:1 ratio in patients with LARC or LRRC.
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 31 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital Southampton NHS Foundation Trust
- Sponsor type
- University, hospital or other
- Collaborators
- IntraOp Medical Corporation, PLANETS Cancer Charity, Cancer Research UK
- Responsible party
- Sponsor
- Investigators
- Alex Mirnezami, Prof, Principal investigator, University Hospital Southampton NHS Foundation Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05877352
- Sponsor's protocol ID
- RHMCAN1600
- Other IDs
- ISRCTN48105173
- Acronym
- ELECTRA
- Status last verified
- May 2025
- First submitted
- 29 Mar 2023
- Last updated
- 14 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Intraoperative Electron Radiotherapy in Rectal Cancer - A Feasibility Trial
- ClinicalTrials.gov ID
- NCT05877352
- Acronym / sponsor ID
- ELECTRA / RHMCAN1600
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 31 participants (actual)
- Lead sponsor
- University Hospital Southampton NHS Foundation TrustUniversity, hospital or other
- Collaborators
- IntraOp Medical Corporation, PLANETS Cancer Charity, Cancer Research UK
- Study start
- 18 May 2022 (actual)
- Primary completion
- 25 Apr 2024 (actual)
- Study completion
- 25 Apr 2027 (estimated)
- First posted
- 26 May 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Single centre double-blinded three-arm randomised controlled trial of extended margin surgery + IOERT at standard dose (10 Gy) versus extended margin surgery + IOERT at higher dose (15 Gy) versus extended margin surgery alone in a 1:1:1 ratio in patients with Locally Advanced Rectal Cancer (LARC) or Locally Recurrent Rectal Cancer (LRRC).
Detailed description
Rectal cancer is a cancer that occurs in the pelvis from the rectum. Locally advanced rectal cancer outgrows the rectum and attaches to other body parts in the pelvis and locally recurrent rectal cancer is a rectal cancer that comes back after surgery, and usually attaches to many different pelvic structures. They are both difficult to manage. The standard of care treatment involves chemotherapy and radiotherapy, followed by what is known as an extended margin operation to remove all cancer affected organs and not leave any cancer cells behind. If cancer cells reach the edge of the removed tissue, there is a high chance of leaving cancer cells behind. This is a key predictor of negative outcome in patients. Intraoperative electron beam radiotherapy (IOERT) was developed to help improve patient outcomes. Once the cancer has been removed, the surgeon and a cancer radiotherapy specialist examine the patient's scans, the cancer specimen and the area the cancer was in, and if there is concern about small numbers of cancer cells being left behind they treat the area with radiotherapy to destroy these cells. Patients that are due to receive treatment for these subsets of rectal cancer will be approached to take part. If eligible on the day of surgery the patient will be randomised to one of three arms: Arm A - standard of care (No IOERT), Arm B - extended margin surgery plus IOERT (10 Gy), or Arm C - extended margin surgery plus higher dose IOERT (15 Gy). The surgeon, cancer specialist team and patient will be blinded to study treatment. Patients will be followed up at 30 days, 3 months and for a minimum of 12 months post surgery as part of the trial and they will be followed up for 5 years as part of standard care.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 3
- Model description
- A single centre double-blinded three-arm randomised controlled trial of extended margin surgery + IOERT at standard dose (10 Gy) versus extended margin surgery + IOERT at higher dose (15 Gy) versus extended margin surgery alone (no IOERT) in a 1:1:1 ratio in patients with LARC or LRRC.
| Arm | Type | Receives |
|---|---|---|
| No IOERT | Active comparator | Procedure: Extended Margin SurgeryExtended margin surgery |
| Low Dose IOERT | Experimental | Radiation: Intraoperative Electron Radiotherapy (IOERT), Procedure: Extended Margin SurgeryExtended margin surgery and IOERT at standard dose (10 Gy) |
| High Dose IOERT | Experimental | Radiation: Intraoperative Electron Radiotherapy (IOERT), Procedure: Extended Margin SurgeryExtended margin surgery and IOERT at higher dose (15 Gy) |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (7 listed)
- Age ≥ 16
- Non-metastatic/oligo-metastatic (up to 3 lesions from 2 sites predicted to be radically treatable) - locally advanced or locally recurrent disease involving the posterior or lateral components of the pelvis and predicted to be resectable but with close margins from imaging as determined by a specialist MDT (sMDT)
- Colorectal sMDT review with experience in pelvic exenteration, which has proposed IntrOperative Electron Radiotherapy (IOERT) as an option for treatment
- Patient suitable for IOERT as component of treatment in the view of the responsible Clinical Oncologist
- Performance status ≤1 as defined by the Eastern Cooperative Oncology Group (ECOG)
Key exclusion criteria (4 listed)
- Unresectable disease/likelihood of R2 resection
- sMDT determined excess prior radiotherapy within IOERT target zone
- Women who are pregnant or breastfeeding
- Participation within an interventional clinical trial within 3 months of the point of registration within ELECTRA
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Intraoperative Electron Radiotherapy (IOERT)IOERT can be defined as the direct application of high-energy electron beam irradiation to a tumour bed during an operative procedure. This approach permits precise delivery of a single large fraction of radiation directly and specifically to high recurrence risk anatomical target areas, which the treating clinicians (surgeon and attending clinical oncologist) predict will be a close or involved margin, while simultaneously displacing and shielding dose-limiting radiosensitive structures such as the small bowel or ureter or any anastomoses, if not involved by tumour. | Radiation | High Dose IOERT, Low Dose IOERT |
| Extended Margin SurgerySurgery intended to remove both a tumour and any metastases | Procedure or surgery | High Dose IOERT, Low Dose IOERT, No IOERT |
Primary outcome
Patients meeting eligibility criteria
Time frame: 2 years
Number and percentage of patients meeting eligibility criteria and number of patients referred to a sMDT over the trial period
Patients accepting randomisation
Time frame: 2 years
Number and percentage of patients accepting randomisation
Successful delivery of IOERT
Time frame: 2 years
Number and percentage of patients for which IOERT was successfully delivered as planned as part of the trial
Blind maintained for patients and clinicians
Time frame: 2 years
Number and percentage of patients and clinicians for which blinding was maintained for IOERT delivery
Questionnaire analysis
Time frame: 2 years
Percentage of patients whose questionnaires can be analysed
Availability of potential primary outcome data
Time frame: 2 years
Percentage of patients for whom we can collect information on potential primary outcomes
13 secondary outcomes
Morbidity
Time frame: Up to 30 days post randomisation
Mortality
Time frame: 30 days post randomisation
IOERT Field Recurrence
Time frame: 12 months post randomisation
Overall local recurrence
Time frame: 12 months post randomisation
Overall survival
Time frame: 12 months post randomisation
Treatment related toxicity
Time frame: 12 months post randomisation
Time to local or systemic recurrence
Time frame: Time from randomisation to local or systemic recurrence or 3 years post the start of recruitment, whichever comes first
R1 Rate
Time frame: At randomisation
EQ-5D-5L
Time frame: At 3 and 12 months post randomisation
LRRC QoL
Time frame: At 3 and 12 months post randomisation
QLQ-C30
Time frame: At 3 and 12 months post randomisation
SF-36
Time frame: At 3 and 12 months post randomisation
Resource use and cost
Time frame: At 3 and 12 months post randomisation
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 May 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alex Mirnezami, Prof principal investigator
University Hospital Southampton NHS Foundation Trust
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Intraoperative Electron Radiotherapy (IOERT) and Extended Margin Surgery in people with Locally Advanced Rectal Cancer and Locally Recurrent Rectal Cancer, run by University Hospital Southampton NHS Foundation Trust at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Patients meeting eligibility criteria (time frame: 2 years). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.