- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07466810
Resection and Defect Repair of Oral Cancer Aided by Mixed Reality Technology
Prospective Clinical Study in Resection and Defect Repair of Oral Cancer Aided by Mixed Reality Technology Based on UE5 Engine
The objective of this exploratory clinical trial is to apply Unreal Engine 5 (UE5)-based Mixed Reality (MR) technology to achieve real-time stereoscopic visualization of surgical planning, personalized free flap harvest and defect reconstruction, accurate oral cancer resection, and precise morphological and volumetric matching of the reconstructed free flap to the defect site.
Researchers adopted a parallel controlled design, with participants randomized into three groups: Experimental Group 1 (undergoing Mixed Reality [MR] technology-assisted surgery), Experimental Group 2 (undergoing virtual surgical guide-assisted surgery), and Control Group (undergoing conventional surgery). A total of 30 participants will be recruited, with 10 cases in each group.
The primary purpose is to confirm the effectiveness of MR technology in assisting oral cancer resection, free flap design, harvest, and defect reconstruction. Allocation concealment will be implemented via the sealed envelope method.
Study Overview
Status
Conditions
Detailed Description
Study population: Patients with oral cancer confirmed by preoperative pathology (tumor diameter > 3 cm), who had defects suitable for free flap reconstruction, signed written informed consent, agreed to complete postoperative follow-up, and were medically eligible for major surgery. This study was conducted at the Department of Oral and Maxillofacial-Head and Neck Oncology, the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
The study is conducted at the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
Primary research questions & outcome assessments:
- Whether UE5-based MR technology enables precise morphological and volumetric matching of free flaps in oral cancer reconstruction.
- Comparisons of operative duration, flap characteristics (utilization, volume, survival), and primary wound healing rate between mixed reality (MR), virtual surgical guide, and conventional surgery.
- Whether MR technology can overcome the limitations of virtual surgical guide systems and further enhance surgical efficiency and precision.
Researchers adopted a parallel controlled design, with participants randomized into three groups: Experimental Group 1 (undergoing Mixed Reality [MR] technology-assisted surgery), Experimental Group 2 (undergoing virtual surgical guide-assisted surgery), and Control Group (undergoing conventional surgery). A total of 30 participants will be recruited, with 10 cases in each group. The primary purpose is to confirm the effectiveness of MR technology in assisting oral cancer resection, free flap design, harvest, and defect reconstruction. Allocation concealment will be implemented via the sealed envelope method.
During the study period, participants will be required to complete the following main tasks and receive relevant interventions:
Preoperatively: Cooperate with computed tomography (CT) data acquisition and complete ultrasonic localization/computed tomography angiography (CTA) examinations (for flap region localization, identification of perforator positions and flap thickness, and corresponding body surface marking). Participants will also collaborate with researchers to design the tumor resection margin, as well as the shape and volume of the free flap to be harvested. After signing the informed consent form, participants will receive surgical treatment corresponding to their randomization assignment.
Intraoperatively: Following the onset of general anesthesia, participants will cooperate with routine surgical skin preparation and draping. For participants in Experimental Group 1, registration and fusion must be completed prior to the initiation of formal surgery to ensure the registration accuracy of MR technology during the operation. In accordance with the preoperative surgical plan, precise tumor resection, free flap harvest, and defect reconstruction will be performed with MR guidance.
Postoperatively: Complete follow-up visits as required, including outpatient follow-ups at 2 weeks ± 3 days, 1 month ± 7 days, 3 months ± 2 weeks, and 6 months ± 1 month postoperatively. Participants will cooperate with physical examinations, CT/magnetic resonance imaging (MRI) scans, and Likert scale assessments, and assist researchers in collecting surgery-related and postoperative recovery data. CT scans will be performed at 1 month and 6 months postoperatively; engineers will import the CT data into a computer, fuse it with the preoperative design scheme, and calculate the morphological similarity (expressed as a percentage).
During the study period, participants must promptly inform researchers if disease progression, complications, or other conditions precluding continued study participation occur. Participants may voluntarily withdraw from the study at any time without affecting their standard medical care.
Participants shall cooperate with researchers in data collection and refrain from participating in other clinical studies or related treatments that may interfere with the results of this study.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: mingming Lv
- Phone Number: 86+13818448654
- Email: lvmingming001@163.com
Study Locations
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Shanghai, China
- Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Definite pathological diagnosis of oral cancer before surgery;
- Defects suitable for free flap reconstruction;
- Patients have signed the informed consent form and are willing to cooperate with postoperative follow-up.
Exclusion Criteria:
- Poor general condition, evaluated as unable to tolerate surgical treatment.
-Exclusion Criteria (After Enrollment)
Subjects who have been enrolled in this trial will be excluded if they meet any of the following conditions:
- Violation of important inclusion criteria;
- Subjects did not receive surgical treatment;
- No observation data after randomization. Withdrawal Criteria Withdrawal of subjects from the trial refers to cases where enrolled subjects are determined by the investigator to withdraw from the trial due to conditions that make it inappropriate to continue the trial. In accordance with the informed consent form, subjects have the right to withdraw from the trial midway. Subjects who do not explicitly propose to withdraw but stop receiving treatment and tests and are lost to follow-up are also considered "withdrawn" (or "lost to follow-up"). The reason for withdrawal should be understood and recorded as much as possible, such as: poor subjective curative effect; inability to tolerate certain adverse reactions; inability to continue participating in the clinical study due to personal reasons; economic factors; or lost to follow-up without stating the reason.
(1) Aggravation or deterioration of the condition during the trial that requires emergency measures; (2) Occurrence of certain comorbidities, complications or special physiological changes in subjects during the trial, making it inappropriate to continue participating in the trial; (3) Voluntary withdrawal by the subject.
Data Handling of Withdrawn Subjects
Regardless of the reason, the complete clinical data of subjects who withdraw from the trial shall be retained. For all withdrawn subjects, the trial conclusion form and the reason for withdrawal shall be filled in the case report form (CRF). Generally, there are 6 types of reasons: occurrence of adverse events (including adverse drug reactions and allergic reactions), lack of efficacy (deterioration of condition or occurrence of complications), violation of the trial protocol (including poor compliance), lost to follow-up (including voluntary withdrawal by the patient), termination by the sponsor, or others.
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 |
|---|---|
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No Intervention: Control Group (Conventional Surgery)
Adoption of traditional surgical methods for oral cancer resection and defect repair; no auxiliary technologies such as mixed reality or virtual guides are used, and tumor resection and flap repair are completed relying on the clinician's clinical experience.
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Experimental: Experimental Group 1 (Mixed Reality Technology)
Application of Mixed Reality (MR) technology based on the UE5 engine to assist in oral cancer resection and defect repair; realize real-time three-dimensional visualization of surgical plans, precise resection of oral cancer, "tailor-made" flap harvesting, and match the shape and volume of the defect site.
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Intervention Description: Assisted oral cancer resection and defect reconstruction using MR technology based on UE5 engine, to achieve real-time stereoscopic visualization of surgical planning, accurate tumor resection and personalized free flap harvest, ensuring the reconstructed flap matches the defect site in morphology and volume.
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Experimental: Experimental Group 2 (Virtual Surgical Guide)
Application of virtual surgical guide technology to assist in oral cancer resection and defect repair; assist surgery relying on pre-designed and manufactured guides to improve surgical standardization; guide printing is required before surgery, and the plan cannot be adjusted in real time during surgery.
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Intervention Description: Assisted oral cancer resection and defect reconstruction using virtual surgical guide technology, with surgery performed under the guidance of preoperatively designed and fabricated guides to improve surgical standardization.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Morphological and Volumetric Matching Degree of Free Flap Reconstruction
Time Frame: Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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Description: Computed Tomography (CT) scans will be performed at 1 month and 6 months postoperatively.
CT data will be fused with the preoperative design scheme to calculate morphological similarity (expressed as a percentage), so as to evaluate the morphological and volumetric matching effect between the reconstructed flap and the defect site in the three groups.
The core purpose is to compare the precision of MR technology with the other two methods.
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Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Surgery-related Indicators
Time Frame: Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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The operative duration and utilization rate of harvested free flaps will be recorded in the three groups to evaluate the impact of different adjuvant technologies on surgical efficiency.
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Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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Postoperative Recovery Indicators
Time Frame: Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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The free flap survival rate and primary wound healing rate will be counted in the three groups; the incidence of postoperative complications will be observed to evaluate surgical safety and reconstruction efficacy.
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Preoperatively 2 weeks ± 3 days postoperatively 1 month ± 7 days postoperatively 3 months ± 2 weeks postoperatively 6 months ± 1 month postoperatively
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Collaborators and Investigators
Investigators
- Principal Investigator: mingming lv, Associate Professor, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Publications and helpful links
General Publications
- Levine JP, Patel A, Saadeh PB, Hirsch DL. Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art. J Craniofac Surg. 2012 Jan;23(1):288-93. doi: 10.1097/SCS.0b013e318241ba92.
- Joo YH, Hwang SH, Park JO, Cho KJ, Kim MS. Functional outcome after partial glossectomy with reconstruction using radial forearm free flap. Auris Nasus Larynx. 2013 Jun;40(3):303-7. doi: 10.1016/j.anl.2012.07.012. Epub 2012 Aug 10.
- Chien CY, Su CY, Hwang CF, Chuang HC, Jeng SF, Chen YC. Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes. Eur J Surg Oncol. 2006 Apr;32(3):353-7. doi: 10.1016/j.ejso.2005.12.010. Epub 2006 Feb 7.
- Sakuraba M, Asano T, Miyamoto S, Hayashi R, Yamazaki M, Miyazaki M, Ugumori T, Daiko H, Kimata Y. A new flap design for tongue reconstruction after total or subtotal glossectomy in thin patients. J Plast Reconstr Aesthet Surg. 2009 Jun;62(6):795-9. doi: 10.1016/j.bjps.2007.09.056. Epub 2008 Apr 29.
- Forner D, Phillips T, Rigby M, Hart R, Taylor M, Trites J. Submental island flap reconstruction reduces cost in oral cancer reconstruction compared to radial forearm free flap reconstruction: a case series and cost analysis. J Otolaryngol Head Neck Surg. 2016 Feb 5;45:11. doi: 10.1186/s40463-016-0124-8.
- Valentini V, Cassoni A, Marianetti TM, Battisti A, Terenzi V, Iannetti G. Anterolateral thigh flap for the reconstruction of head and neck defects: alternative or replacement of the radial forearm flap? J Craniofac Surg. 2008 Jul;19(4):1148-53. doi: 10.1097/SCS.0b013e3181764ad6.
- Wu JC, Huang JJ, Tsao CK, Abdelrahman M, Kolios G, Cheng MH. Comparison of Posteromedial Thigh Profunda Artery Perforator Flap and Anterolateral Thigh Perforator Flap for Head and Neck Reconstruction. Plast Reconstr Surg. 2016 Jan;137(1):257-266. doi: 10.1097/PRS.0000000000001880.
- Bai S, Shang H, Liu Y, Zhao J, Zhao Y. Computer-aided design and computer-aided manufacturing locating guides accompanied with prebent titanium plates in orthognathic surgery. J Oral Maxillofac Surg. 2012 Oct;70(10):2419-26. doi: 10.1016/j.joms.2011.12.017. Epub 2012 Apr 18. No abstract available.
- Kumar BP, Venkatesh V, Kumar KA, Yadav BY, Mohan SR. Mandibular Reconstruction: Overview. J Maxillofac Oral Surg. 2016 Dec;15(4):425-441. doi: 10.1007/s12663-015-0766-5. Epub 2015 Apr 19.
- Chang EI, Boukovalas S, Liu J, Largo RD, Hanasono MM, Garvey PB. Reconstruction of Posterior Mandibulectomy Defects in the Modern Era of Virtual Planning and Three-Dimensional Modeling. Plast Reconstr Surg. 2019 Sep;144(3):453e-462e. doi: 10.1097/PRS.0000000000005954.
- Foley BD, Thayer WP, Honeybrook A, McKenna S, Press S. Mandibular reconstruction using computer-aided design and computer-aided manufacturing: an analysis of surgical results. J Oral Maxillofac Surg. 2013 Feb;71(2):e111-9. doi: 10.1016/j.joms.2012.08.022. Epub 2012 Nov 17.
- Deek NFAL, Wei FC. Computer-Assisted Surgery for Segmental Mandibular Reconstruction with the Osteoseptocutaneous Fibula Flap: Can We Instigate Ideological and Technological Reforms? Plast Reconstr Surg. 2016 Mar;137(3):963-970. doi: 10.1097/01.prs.0000479998.49928.71.
- Koumoullis H, Burley O, Kyzas P. Patient-specific soft tissue reconstruction: an IDEAL stage I report of hemiglossectomy reconstruction and introduction of the PANSOFOS flap. Br J Oral Maxillofac Surg. 2020 Jul;58(6):681-686. doi: 10.1016/j.bjoms.2020.04.017. Epub 2020 Apr 27.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
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
- SH9H-2024-T403-1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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