- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05662553
ENB Guided MWA Combined With VATS Versus Sequential Surgery for Synchronous Bilateral Multiple Primary Lung Nodules
A Prospective, Multi-center, Randomized Controlled Clinical Study of ENB Guided MWA Combined With VATS Versus Sequential Surgery for Synchronous Bilateral Multiple Primary Lung Nodules
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Lung cancer is one of the most common cancers and the leading cause of cancer-related death worldwide. With the improvement of people's health awareness and the wide application of LDCT and HRCT, the incidence of multiple primary lung cancer is increasing, especially the synchronous bilateral multiple primary pulmonary nodules are the difficulties in the treatment of pulmonary nodules. Bilateral sequential surgery is associated with higher intraoperative risks, higher rates of postoperative complications, and lower postoperative quality of life. At present, a small number of recent retrospective studies have shown that microwave ablation(MWA) guided by electromagnetic navigation bronchoscopy(ENB) combined with video-assisted thoracic surgery(VATS) treatment can effectively treat bilateral multiple primary pulmonary nodules, which not only has a low complication rate, but also can avoid secondary surgery.
Based on previous studies, the research plans to conduct a prospective, multi-center, randomized controlled study to evaluate the safety and efficacy of ENB guided MWA combined with VATS versus sequential surgery for synchronous bilateral multiple primary lung nodules, as well as its potential value as a new treatment option for these participants.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hecheng Li, PhD, MD
- Phone Number: +8613917113402
- Email: lihecheng2000@hotmail.com
Study Contact Backup
- Name: Dingpei Han, PhD, MD
- Phone Number: _18017420216
- Email: dmhan1985@163.com
Study Locations
-
-
Shanghai
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Shanghai, Shanghai, China, 200000
- Recruiting
- Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
-
Contact:
- Hecheng Li, PhD, MD
- Phone Number: +8613917113402
- Email: lihecheng2000@hotmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aged ≥18 years and ≤80 years;
- The subjects are diagnosed synchronous bilateral multiple primary lung nodules by HRCT
- The primary nodule is diagnosed as lung cancer by preoperative puncture or multidisciplinary discussion, which can be treated with radical surgery.
- At least one secondary lesion (6mm≤diameter≤20mm, CTR<0.5) is contralateral to the primary nodule,which need treatment after multidisciplinary discussion
- The ipsilateral secondary lesions can be treated by sublobar resection at the same time
- ECOG PS score 0-1
- The subjects participate voluntarily and sign a written informed consent;
Exclusion Criteria:
- Patients have contraindications of surgery or anesthesia
- Patients are unable to undergo bronchoscopy
- A contralateral secondary lesion is unreachable during ENB planning
- There are large blood vessels 2 mm near the contralateral secondary lesion
- Patients have severe bleeding tendency and coagulation dysfunction which cannot be improved in a short time
- Patients have interstitial pneumonia, pulmonary fibrosis, or severe emphysema
- Patients have diseases,like severe anemia, dehydration, severe nutritional and metabolic disorders, which cannot be cured or improved in a short time
- Patients have severe systemic infection and fever (>38.5°C)
- Patients have other malignant tumors
- Patients have participated in other clinical trials
- Investigators consider the patient do not fit for the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Ablation
After randomization, the enrolled patients in this arm should be performed path simulation under ENB with preoperative CT.
On the operation day, single-cavity intubation will be carried out first, and the secondary lesion will be reached through the planned path.
After that,the biopsy tissue of the lesion will be sent to ROSE for detection.
If malignant,the ablation will be performed,and the location, energy and ablation time will be adjusted according to intraoperative CT.
After ablation, radical surgery will be performed on the primary lesion.
|
ENB guide MWA combine ENB, microwave ablation and 3D reconstruction technology, and guide the probe in the airway to the target lesion for ablation therapy, which is safe and effective.
For patients with synchronous bilateral multiple primary pulmonary nodules, ENB guide MWA combined with VATS treatment can not only avoid the risk of bilateral surgery, but also complete the "one-stop" treatment, which is a new treatment mode.
|
Active Comparator: Surgery
The control group will undergo VATS treatment on the primary lesion on the day of operation, and will be re-admitted to the hospital after discharge and recovery (3-4 months) for contralateral secondary lesion surgery.
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Bilateral surgery is a traditional treatment, but it will lead to increased intraoperative risk and postoperative complication rate, and more likely to lead to postoperative complications such as decreased quality of life and cardiopulmonary dysfunction.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total perioperative complication rates
Time Frame: From the time of treatment to one month after operation
|
Complications refer to operation-related adverse events during and after the operation according to the Clavien-Dindo Classification, including pulmonary infection, Broncho-pulmonary hemorrhage, respiratory failure, pleural effusion, pneumothorax, persistent lung leak, arrhythmia, wound infection, death.
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From the time of treatment to one month after operation
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective response rate(ORR)
Time Frame: One and three months after ablation
|
Objective response rate(ORR)is the proportion of patients with complete responses and partial responses.
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One and three months after ablation
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Treatment-related side effects
Time Frame: From the time of treatment to one month after operation
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Number of participants with treatment-related adverse events as assessed by CTCAE 5.0.
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From the time of treatment to one month after operation
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The operation time
Time Frame: During operation
|
the duration of the operation in minutes.
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During operation
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The intraoperative blood loss
Time Frame: During operation
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the volume of blood loss in ml.
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During operation
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Postoperative hospital stay (days)
Time Frame: One months after treatment
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The time of hospitalization in days.
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One months after treatment
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Postoperative extubation time (days)
Time Frame: One months after treatment
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The duration of chest drainage in days.
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One months after treatment
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Mortality within 30 days after surgery
Time Frame: One month after treatment
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number of death within 30 days after surgery.
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One month after treatment
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Complications (grade ≥3)
Time Frame: One and three months after treatment
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complications above grade 3 that need to be treated during and after the operation according to the Clavien-Dindo Classification.
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One and three months after treatment
|
Life expectancy(EORTC QLQ-LC29)
Time Frame: One and three months and every year after treatment
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patients' quality of life by questionnaires according to EORTC QLQ-LC29.
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One and three months and every year after treatment
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Lung function
Time Frame: One and three months and every year after treatment
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forced expiratory volume in one second(FEV1).
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One and three months and every year after treatment
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3-year disease-free survival(DFS)
Time Frame: A follow-up period of 3 years
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DFS : the time from surgical resection to clinically confirmed local recurrence, distant metastasis, second primary tumor diagnosis, or patient death (control group since the second operation).
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A follow-up period of 3 years
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The proportion of completed two operations
Time Frame: During operation, an average of 4 months
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the patients in control group complete two operations
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During operation, an average of 4 months
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The overall cost of treatment
Time Frame: During hospitalization, an average of 2 weeks
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The overall cost of treatment include direct and indirect costs.
Additional costs for hospitalization and surgery.
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During hospitalization, an average of 2 weeks
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Biopsy success rate
Time Frame: During operation
|
The percentage of people with successful biopsy.
|
During operation
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Biopsy positive rate
Time Frame: During operation
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The proportion of patients with malignant biopsies in the overall population
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During operation
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Hecheng Li, PhD, MD, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
Study record dates
Study Major Dates
Study Start (Anticipated)
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
Other Study ID Numbers
- RTS-016
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
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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