Effect of Oxygen Inhalation on Fatigue After Chemotherapy of Breast Cancer in High Altitude Area

October 24, 2021 updated by: Jiuda Zhao
At present, there are few studies on the side effects of chemotherapy in breast cancer patients at high altitude area, and there are no studies on the relationship between oxygen inhalation and fatigue after chemotherapy in breast cancer patients at high altitude. The investigators intend to explore whether oxygen inhalation can improve fatigue at high altitude through this prospective randomized study. In our study, a single center, open-label, randomized phase 2 clinical trial will conduct to investigate whether oxygen inhalation during chemotherapy can improve chemotherapy-related fatigue in patients with breast cancer. The effects of oxygen inhalation on side effects of chemotherapy such as Cancer related fatigue (CRF) were observed. The investigators intend to explore whether oxygen therapy can improve fatigue at high altitude through this prospective randomized study. The investigators enrolled breast cancer patients before chemotherapy. The investigators will use the checklist individual strength(CIS) and the brief fatigue inventory (BFI) to evaluate the fatigue status of patients, and extract the blood of patients for evaluate blood pro-inflammatory cytokines IL-1 β, IL-6, C-reactive protein (CRP), transforming growth factor (TGF-β), soluble tumor necrosis factor (TNF) receptor II (sTNF-RII), inducible factor-1(HIF-1), Hypoxia inducible factor-2(HIF-2)in the plasma.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Fatigue is the most common symptom experienced by patients from cancer diagnosis to the end of life. CRF is different from other types of fatigue. It is severe, persistent and can not be alleviated by rest or sleep. CRF affects nearly 65% of cancer patients, more than two-thirds believe that severe CRF lasts at least 6 months, and one-third report that fatigue persists for several years after chemotherapy.

The etiology of CRF has not been fully elucidated, although it may involve several physiological and biochemical systems, which may vary with tumor type, disease stage and treatment. Recently, several cytokines and other proinflammatory mediators produced in tryptophan degradation and cancer response are associated with fatigue; however, their direct role in the pathogenesis of fatigue remains controversial. Cytokines may play a role at a variety of levels, including mood, muscle mass, strength and metabolic status, and thus are associated with the pathophysiology of fatigue. Recent studies have shown that fatigue is positively correlated with circulating levels of inflammatory markers, especially IL-6, IL-1 and neopterin, which are significantly correlated with CRF. CRF is also common in breast cancer patients, and the incidence rate of CRF is increasing as the incidence of breast cancer increases. In the treatment of breast cancer patients， chemotherapy can cause some patients' non hematological side effects such as fatigue. During the chemotherapy of breast cancer at high altitude area, clinical observation showed that the incidence rate of side effects after chemotherapy was higher in plateau area. Retrospectively analyzed the efficacy and safety of epirubicin combined with taxanes chemotherapy in the treatment of 48 cases of breast cancer in high altitude areas of Tibet. It was found that 89.5% of the patients with neutropenia after chemotherapy were significantly higher than those in low altitude areas, which also confirmed this phenomenon. The increased side effects of chemotherapy and radiotherapy in cancer patients at high altitude are closely related to hypoxia. The oxygen content and oxygen partial pressure in the atmosphere of plateau area also decrease with the increase of altitude, and the oxygen partial pressure in human alveoli also decreases, so the arterial oxygen partial pressure and saturation also decrease. A number of studies have shown that the special hypoxia environment at high altitude will have a lot of effects on the human body. In terms of cardiovascular system, it will make pulmonary hypertension and heart rate increase, and make the heart bear a heavy pressure load, leading to the occurrence of high altitude heart disease. In terms of nervous system, chronic hypoxia environment is prone to sleep disordered breathing at night, which seriously affects the brain nerve function and leads to heart failure sleep structure disorder. On the other hand, in order to adapt to the outside world, the human body in the plateau environment, within a certain limit, through the regulation of the nervous system and body fluid mechanism, carries out a series of adjustments and stress reactions, It makes a series of physiological changes in body fluid, hemorheology, blood biochemistry, blood gas and organ function, and some pathological changes, resulting in changes in physiological indexes, drug plasma protein binding rate, drug metabolic enzyme activity and expression, and inflammatory factors in blood. The investigators speculate that the above factors lead to the increase of side effects after chemotherapy at high altitude, especially the influence of inflammatory cytokines in the blood, leading to the occurrence of CRF.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
102

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Qinghai
      • Xining, Qinghai, China, 810000
        • Recruiting
        • Qinghai University Affiliated Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  1. Female breast cancer patients aged ≥ 18 years old;
  2. Breast cancer was confirmed by histopathological investigation;
  3. Chemotherapy including neoadjuvant chemotherapy, postoperative adjuvant chemotherapy and palliative chemotherapy for advanced breast cancer;
  4. Eastern Cooperative Oncology Group（ECOG ）score of physical condition (0-1);
  5. Voluntarily participate in the clinical trial and sign the informed consent form after informed consent (patients voluntarily accept the test and give informed consent);
  6. The basic indexes were consistent, and the blood routine and ECG were normal;
  7. Before chemotherapy, fatigue scale was used to score, and no fatigue symptom was confirmed by CIS and BFI;

Exclusion Criteria:

  1. Due to nervous system disease, difficulty in understanding and / or lack of personnel unable to complete the report;
  2. The patients were treated with radiotherapy at the same time of chemotherapy; 3.There were no other tumors, and brain metastases and pleural effusion were excluded;

4.Women diagnosed with untreated anemia and thyroid dysfunction； 5.Heart and lung diseases were excluded; 6.The respiratory system diseases affecting blood oxygen saturation were excluded; 7.Fatigue symptoms were confirmed by cis and BFI.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Oxygen inhalation treatment group
  1. Patients receive chemotherapy for breast cancer.
  2. Patients are randomly divided into inhalation treatment group. Oxygen inhalation is started on the first day of chemotherapy, and the oxygen inhalation volume is 2 L / min, 8 hours / day for 3 consecutive days.（d1，d2，d3）.
  3. Blood samples are collected before and after chemotherapy（d0，d3）.
  4. CIS and BFI are measured before chemotherapy（d0, d3 chemotherapy regimen/ d0, d3， chemotherapy regimen）.
Other: Oxygen inhalation treatment group
Oxygen inhalation group: oxygen inhalation was started on the first day of chemotherapy, and the oxygen inhalation volume was 2 L / min, 8 hours / day for 3 consecutive days.
Placebo Comparator: Oxygen non-inhalation treatment group
  1. Patients receive chemotherapy for breast cancer.
  2. Patients are randomly divided into non-inhalation treatment group.
  3. Blood samples are collected before and after chemotherapy（d0，d3）.
  4. CIS and BFI are measured before chemotherapy（d0, d3，chemotherapy regimen/ d0, d3， chemotherapy regimen）.
Other: Control group
The control group was not given oxygen inhalation.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Fatigue was measured by Checklist for Individual Strength（CIS）.
Time Frame: The difference of fatigue degree between the two groups on baseline and third day after chemotherapy
We use the Checklist for Individual Strength（CIS）fatigue scale to compare the fatigue degree of the experimental group and the control group before and after chemotherapy. In our study, we selected 8 questions in the CIS scale, each patient should answer these 8 questions, and then record the score according to the patients' answers. Each question can be scored according to absolute right and absolute wrong, and the score is from 8 to 56.
The difference of fatigue degree between the two groups on baseline and third day after chemotherapy

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Fatigue was measured by Brief Fatigue Inventory (BFI) .
Time Frame: The difference of fatigue degree between the two groups on baseline and third day after chemotherapy
We used the Brief Fatigue Inventory (BFI) to compare the fatigue degree of the experimental group and the control group before and after chemotherapy. There are four questions in the BFI. The fourth question contains six small questions. The score of the questionnaire ranges from 0 to 90.
The difference of fatigue degree between the two groups on baseline and third day after chemotherapy
Blood pressure
Time Frame: The day before chemotherapy and the third day after chemotherapy.
Blood pressure refers to the lateral pressure of blood flow in blood vessels, including systolic pressure and diastolic pressure. We use mmHg to measure blood pressure.
The day before chemotherapy and the third day after chemotherapy.
Biomarker in blood
Time Frame: The difference Biomarker level between the two groups on baseline and third day after chemotherapy
pro-inflammatory cytokines IL-1 β, IL-6, C-reactive protein (CRP) , soluble tumor necrosis factor (TNF) receptor II (sTNF-RII),transforming growth factor (TGF-β) , Hypoxia inducible factor-1(HIF-1) , Hypoxia inducible factor-2(HIF-2)
The difference Biomarker level between the two groups on baseline and third day after chemotherapy
Oxygen saturation
Time Frame: The day before chemotherapy and the third day after chemotherapy.
It is the percentage of oxygenated hemoglobin volume in the blood, that is, the oxygen concentration in the blood, which is called arterial oxygen saturation. It is usually measured by the percentage sign (%).
The day before chemotherapy and the third day after chemotherapy.
Heart rate
Time Frame: The day before chemotherapy and the third day after chemotherapy.
Heart rate refers to the number of heart beats per minute in a normal person's quiet state, also known as the quiet heart rate, which is generally 60-100 beats per minute. We use beats per minute to measure it.
The day before chemotherapy and the third day after chemotherapy.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Jiuda Zhao

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 1, 2021

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 1, 2022

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2022

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 18, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 24, 2021

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 1, 2021

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 29, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 24, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • AHQU-2021001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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