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Immunomodulating Nutrients in Perioperative Patients With Gastric Cancer

20 de abril de 2017 actualizado por: Jaw-Yuan Wang, MD, PhD, Kaohsiung Medical University Chung-Ho Memorial Hospital

Combination of Arginine, Glutamine, and Omega-3 Fatty Acid Supplements for Perioperative Enteral Nutrition in Surgical Patients With Gastric Adenocarcinoma or Gastrointestinal Stromal Tumor (GIST)

The survey is a phase IV, prospective randomized clinical trial to determine whether an immunomodulating nutrient-enriched diet compared to a standard diet can improve nutritional status and reduce postoperative infection and surgery-induced immune suppression in patients with gastric cancer or GIST undergoing major surgery in a single medical center.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

Primary Objective:

  1. The primary end points:

    To evaluate the effect of immunomodulating diets on the postoperative inflammatory response: including interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α).

  2. Secondary Objectives:

(1). Biochemistry parameters: glucose,blood urine nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein, sodium, and leukocyte count.

(2). Nutritional status: albumin, prealbumin, BMI (3). Adverse events (4). Clinical outcomes: postoperative complications, time to first bowel action and length of hospital stay after surgery.

Number of Subjects: Eligible patients will be randomized in 2 arms in the ratio of 1:1, to reach 15 patients at least in each.

Plan of the Study:

  1. This is a randomized, comparative, double blinded study in 2 arms.
  2. Study Schedule Study date: the time getting approval letter issued by both regulatory authority and institutional review board (IRB). Duration of the study: 5 years.
  3. Duration of Treatment: Treatment was administered before curative surgery for gastric adenocarcinoma or gastric GIST, and postoperative day 5-14 or to discharge whichever occurred first, or consent withdrawal during any time of the study, when the patient would be withdrawn.

Tipo de estudio

Intervencionista

Inscripción (Actual)

34

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Taiwán
      • Kaohsiung, Taiwán, 807
        • Chung-Ho Memorial Hospital, Kaohsiung Medical University:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

20 años a 85 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Age between 20-85 years old
  • Histologically proven primary gastric cancer or GIST.
  • Patients was planning to receive elective curative gastric surgery, such as partial gastrectomy, subtotal gastrectomy, proximal gastrectomy, total gastrectomy, etc.
  • Patient is able to understand the requirements of the study and written informed consent was obtained from each subject.

Exclusion Criteria:

  • They were less than 20 years or over 85 years old
  • Hepatic dysfunction or bile stasis (serum total bilirubin >2.5 mg/dL)
  • Renal dysfunction (serum creatinine >1.5 mg/dL), or required hemodialysis
  • Cardiac dysfunction (NYHA functional class >III, or stroke history)
  • Severe hypoalbuminemia (albumin <2.5 g/dL)
  • Karnofsky performance status less than 60
  • Overweight (body mass index [BMI] >30 kg/m2)
  • Exhibited drug abuse or chronic alcoholism
  • Had life-threatening disease, or underwent emergent surgery
  • With infection or bowel obstruction
  • Pregnant or lactating
  • Had received chemotherapy within 14 days of the initiation of the trial
  • Had received immunosuppressive therapy or had immunological diseases recently
  • Had already participated in another clinical study with an investigational drug or an investigational medical device within a month of the initiation or during the study
  • Hypersensitive to casein, fish oil, soybean, or corn oil

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Doble

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: immunomodulating nutrients enriched diet
Patients received oral feeding with an ordinary diet plus 400 mL/day (400 kcal/day) of the immunomodulating nutrients enriched diet for 3-5 days before curative surgery for gastric adenocarcinoma or gastric GIST. On postoperative day 3, enteral nutrition (EN) was initiated with 5% glucose in water at a rate of 20 mL/h. On postoperative day 4, patients received a semi-liquid diet plus 400 mL/day (400 kcal/day) of the immunomodulating nutrients enriched diet. From postoperative day 5-14 or to discharge whichever occurred first, 1200 mL/day (1200 kcal/day) of the interventional diet was administered, and an oral soft diet was also administered if no postoperative complications developed and if oral feeding was not prohibited.
Suplemento dietético: immunomodulating nutrients enriched diet
Otros nombres:
  • neo-mune
Comparador activo: standard diet
Patients received oral feeding with an ordinary diet plus 400 mL/day (400 kcal/day) of the standard diet for 3-5 days before curative surgery for gastric adenocarcinoma or gastric GIST. On postoperative day 3, EN was initiated with 5% glucose in water at a rate of 20 mL/h. On postoperative day 4, patients received a semi-liquid diet plus 400 mL/day (400 kcal/day) of the interventional diet. From postoperative day 5-14 or to discharge whichever occurred first, 1200 mL/day (1200 kcal/day) of the standard diet was administered, and an oral soft diet was also administered if no postoperative complications developed and if oral feeding was not prohibited.
Suplemento dietético: standard diet

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
immunomodulating effects
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
Inflammatory markers including interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) were employed to assess inflammatory processes.
at discharge from the hospital or 14 days after surgery, whichever occurred first

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
blood glucose
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood urine nitrogen
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood aspartate aminotransferase (AST) in U/L
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood alanine aminotransferase (ALT) in U/L
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood triglycerides (TG) in mg/dL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood cholesterol in mg/mL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood low-density lipoprotein (LDL) in mg/mL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood high-density lipoprotein (HDL) in mg/mL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood sodium (Na) mEq/L
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood leukocyte count cells/μL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood albumin in g/dL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
blood prealbumin in mg/dL
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
body mass index (BMI) in kg/m^2
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
at discharge from the hospital or 14 days after surgery, whichever occurred first
postoperative complications
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
postoperative complications that related to surgery
at discharge from the hospital or 14 days after surgery, whichever occurred first
time to first bowel action
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
interval of surgery to first bowel action (hours)
at discharge from the hospital or 14 days after surgery, whichever occurred first
length of hospital stay after surgery
Periodo de tiempo: at discharge from the hospital or 14 days after surgery, whichever occurred first
length of hospital stay after surgery (days)
at discharge from the hospital or 14 days after surgery, whichever occurred first

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Kaohsiung Medical University Chung-Ho Memorial Hospital

Investigadores

  • Silla de estudio: Jaw-Yuan Wang, PhD, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

1 de junio de 2011

Finalización primaria (Actual)

1 de junio de 2016

Finalización del estudio (Actual)

1 de septiembre de 2016

Fechas de registro del estudio

Enviado por primera vez

5 de abril de 2017

Primero enviado que cumplió con los criterios de control de calidad

20 de abril de 2017

Publicado por primera vez (Actual)

21 de abril de 2017

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

21 de abril de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

20 de abril de 2017

Última verificación

1 de abril de 2017

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • KMUHIRB-2011-05-01(II)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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