- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04797390
A Study Evaluating an Advanced Pneumatic Compression Device Versus Usual Care for Treatment of Head and Neck Lymphedema
A Randomized Trial of an Advanced Pneumatic Compression Device vs. Usual Care for Head and Neck Lymphedema
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Aim 1:
To compare the short-term and long-term effectiveness of self-administered APCD therapy versus Usual Care in HNC survivors with treatment naive LEF on anatomical measures of internal and external LEF. Baseline measures will be obtained at the start of therapy. Short-term effectiveness will be evaluated at 2 months and long-term effectiveness will be evaluated at 4 and 6 months. Hypothesis: the APCD therapy will be associated with greater short-term and long-term reduction in anatomical measures of LEF.
Aim 2:
To compare the short-term and long-term effectiveness of self-administered APCD therapy versus Usual Care in HNC survivors with treatment naive LEF on patient reported biopsychosocial outcome measures impacted by LEF. Outcome measures will include: 1) symptom burden, 2) symptom burden and functional impairment, 3) quality of life (QOL), 4) work and activity, 5) perceived self-management capacity, 6) body image, and 7) diet modifications. Baseline measures will be obtained at the start of therapy. Short-term effectiveness will be evaluated at 2 months and long-term effectiveness will be evaluated at 4 and 6 months. Hypothesis: the APCD therapy will be associated with greater short-term and long-term improvement in patient reported biopsychosocial outcomes.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35924
- Recruiting
- University Of Alabama
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Illinois
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Chicago, Illinois, United States, 60612
- Recruiting
- Rush University Medical Center
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Kentucky
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Louisville, Kentucky, United States, 40202
- Recruiting
- University of Louisville
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Maryland
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Baltimore, Maryland, United States, 21205
- Recruiting
- Johns Hopkins University
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Michigan
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Ann Arbor, Michigan, United States, 48109
- Recruiting
- University of Michigan
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Detroit, Michigan, United States, 48201
- Recruiting
- Karmanos Cancer Institute
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New York
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Bronx, New York, United States, 10467
- Recruiting
- Montefiore Medical Center
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Contact:
- Thomas Ow, MD
- Email: THOW@montefiore.org
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Staten Island, New York, United States, 10310
- Recruiting
- Richmond University Medical Center
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Contact:
- Hoon Lee, MD
- Email: HoLee@RUMCSI.org
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Tennessee
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Nashville, Tennessee, United States, 37232
- Recruiting
- Vanderbilt University Medical Center
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Texas
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Fort Worth, Texas, United States, 76104
- Recruiting
- Advanced Head & Neck Rehabilitation Center of Texas
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18 years
- Pathologically confirmed cancer of the HNC (larynx, pharynx, oral cavity, paranasal sinuses, major salivary glands, and HNC of unknown primary)
- Completed curative intent cancer therapy with no evidence of active cancer at time of study enrollment
- A diagnosis of either internal or external head and neck lymphedema
- At least one core lymphedema associated symptom of ≥ 4 out of 10 at the time of study screening
- Must be able and willing to participate in all aspects of the study and provide informed consent prior to study participation
- Must be able to speak and understand English
Exclusion Criteria:
- Previous APCD or Usual Care treatment for HNC LEF
- Acute facial infection (e.g., facial or parotid gland abscess)
- Known carotid sinus hypersensitivity syndrome
- Symptomatic carotid artery disease, as manifested by a recent transient ischemic attack (within 30 days), ischemic stroke, or amaurosis fugax (monocular visual ischemic symptoms or blindness)
- Internal jugular venous thrombosis (within 3 months)
- Patient is pregnant or trying to become pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Advanced Pneumatic Compression Device (APCD)
Daily self-administered treatment with the Flexitouch® Plus system (FT)
|
Once daily treatment with Flexitouch Plus.
Other Names:
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Active Comparator: Usual Care
Complete Decongestive Therapy (CDT) directed by a lymphedema therapist and any additional adjunctive measures as prescribed by the lymphedema therapist
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Usual care consists of a two-phase CDT.
Phase 1 includes consultation with a lymphedema therapist, patient education, MLD, compression garments or bandages, skin care techniques, and a program of exercises and postural recommendations.
Phase 2 consists of ongoing self-care, where patients conduct a life-long program of disease management that mimics the program in phase 1.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Reduction in Swelling/Inflammation - Endoscopy
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
|
The change in percent of sites with visible swelling and inflammation as assessed via endoscopy (using Modified Patterson Scale).
The range for each anatomical structure includes 1-4: Normal, Mild, Moderate, and Severe.
A lower score means a better outcome.
A greater negative value indicates a greater reduction in swelling.
Total score range: 0-100%
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Changes between Baseline, 2 months, 4 months, 6 months
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Reduction in Swelling/Imaging - CT
Time Frame: Changes between Baseline, 2 months, 6 months
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The changes in fat stranding, epiglottic thickness, and prevertebral soft tissue (PVST) using the CT Lymphedema and Fibrosis Assessment Tool (CT-LEFAT).
The range for fat stranding includes 0-2: Normal, Mild Changes, Advanced Changes.
A lower score means a better outcome.
Epiglottis and PVST are measured in mm.
A lower measurement means a better outcome.
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Changes between Baseline, 2 months, 6 months
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Reduction in Swelling/Inflammation - Grading of External Lymphedema
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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The presence of swelling and inflammation as assessed through grading of external lymphedema via the Head and Neck Lymphedema and Fibrosis Assessment criteria (HNLEF).
A total of 9 sites are evaluated for the presence of lymphedema and graded from 1 (mild) to 3 (severe) at each site.
The number of sites ranged from 0-9 with a total severity score ranging from 0-27.
A lower score indicates a better outcome.
A greater negative value indicates a greater reduction in swelling.
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Changes between Baseline, 2 months, 4 months, 6 months
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Reduction in Swelling/Inflammation - Digital Photography
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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The presence of swelling and inflammation are assessed by digital photography.
A lower value means a better outcome.
A greater negative value indicates a greater reduction in swelling.
Three views are scored each with 30 grids.
The percentage of views with visible swelling was determined.
The score ranges from 0-100%.
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Changes between Baseline, 2 months, 4 months, 6 months
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Symptom Burden - Lymphedema Symptom Intensity and Distress Survey
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Lymphedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-HN) assesses the measurement characteristics of a symptom burden for participants with head and neck lymphedema.
Each symptom is rated on intensity and distress using a 5-point scale.
A maximum response for any symptom within a given cluster will be used for the analysis.
The total score ranged from 0-10.
The values represent a change from baseline.
A lower score means a better outcome.
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Changes between Baseline, 2 months, 4 months, 6 months
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Symptom Burden and Functional Impairment - Vanderbilt Head and Neck Symptom Survey
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Vanderbilt Head and Neck Symptom Survey plus General Symptom Survey (VHNSS plus GSS) assesses symptom burden and functional impairment.
Values represent a median score change from baseline.
Score range: 0-10.
A lower score indicates a better outcome.
A more negative value indicates a greater change from baseline.
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Changes between Baseline, 2 months, 4 months, 6 months
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Quality of Life - Linear Analog Self-Assessment
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Quality of life is assessed using the Linear Analog Self-Assessment.
The total score for the assessment ranges from 0-50.
Each category represents a change in score from the baseline visit which ranged from positive 4 to negative 4. A positive change indicates an improvement.
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Changes between Baseline, 2 months, 4 months, 6 months
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Work and Activity - Work Productivity and Activity Impairment Questionnaire
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Work Productivity and Activity Impairment Questionnaire (WPAIQ) PRO assessment asks questions about work and activity impairment due to lymphedema and other health problems.
WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes.
Total score range: 0-100%
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Changes between Baseline, 2 months, 4 months, 6 months
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Perceived self-management capacity - Perceived Medical Condition Self-Management Scale (PMCSMS)
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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The 8-item Perceived Medical Condition Self-Management Scale (PMCSMS) is intended to measure patients' belief that they are capable of carrying out the self-management behaviors required by their medical condition.
The scale is composed of four positively worded items and four negatively worded items, each rated on a five-point Likert scale (1=Strongly Disagree to 5=Strongly Agree).
Negatively worded items are reversed scored, yielding a total score ranging from 8 to 40, with a higher score indicating stronger belief of perceived self-management competence.
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Changes between Baseline, 2 months, 4 months, 6 months
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Body image - Body Image Quality of Life Inventory (BIQLI)
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Body Image Quality Life Inventory (BIQLI) assesses participants' body image using 7 point scale ranging from -3 (very negative) to +3 (very positive).
Score range: -57 to 57.
A higher score indicates a better outcome.
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Changes between Baseline, 2 months, 4 months, 6 months
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Diet modifications - Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24)
Time Frame: Changes between Baseline, 2 months, 4 months, 6 months
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Diet modifications will be assessed using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24).
The ASA24 is a tool from National Cancer Institute (NCI) that enables multiple automatically coded self-administered 24-hour recalls and food records.
Changes in total caloric intake, fat, carbohydrate, fiber, sugars, and protein will be evaluated.
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Changes between Baseline, 2 months, 4 months, 6 months
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Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 8030 (Other Identifier: CTEP)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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