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Haalbaarheid van auriculaire acupressuur voor eetlust en gewicht bij patiënten met stadium II-IV maag-, slokdarm- en pancreaskanker
Een gerandomiseerde, gecontroleerde studie waarin de effecten van een acupressuurinterventie op de eetlust en het gewicht worden getest bij patiënten met maag-, slokdarm- en pancreaskanker: een pilot- en haalbaarheidsstudie
This clinical trial evaluates the feasibility and acceptability of acupressure to the ear (auricular) to address appetite and weight in patients with stage II-IV gastric, esophageal, or pancreatic cancer. Cancer anorexia, the abnormal loss of appetite, directly leads to cancer-associated weight loss (cachexia) through malnourishment, reduced caloric intake, treatment side-effects, and other modifiable risk factors. Cachexia prolongs length of hospital stay for patients, negatively impacts treatment tolerance and adherence, and reduces overall patient quality of life. Auricular acupressure is a form of micro-acupuncture that exerts its effect by stimulating the central nervous system using adhesive taped pellets applied to specific locations on the external ear. The use of these pellets to deliver auricular acupressure has been shown to improve pain, fatigue, insomnia, nausea and vomiting, depression, and quality of life in both cancer and non-cancer settings. Auricular acupressure is a safe, inexpensive, and non-invasive approach to addressing cancer-related symptoms and treatment side-effects and may be effective at improving appetite and weight loss in stage II-IV gastric, esophageal, and pancreatic cancer patients.
Studie Overzicht
Toestand
Conditie
- Stadium II alvleesklierkanker AJCC v8
- Stadium III Alvleesklierkanker AJCC v8
- Stadium IV alvleesklierkanker AJCC v8
- Klinische fase III maagkanker AJCC v8
- Klinische stadium IV maagkanker AJCC v8
- Klinisch stadium II oesofageaal adenocarcinoom AJCC v8
- Klinisch stadium II slokdarmplaveiselcelcarcinoom AJCC v8
- Klinische fase II maagkanker AJCC v8
- Klinisch stadium III oesofageaal adenocarcinoom AJCC v8
- Klinisch stadium III slokdarmplaveiselcelcarcinoom AJCC v8
- Klinisch stadium IV oesofageaal adenocarcinoom AJCC v8
- Klinisch stadium IV slokdarmplaveiselcelcarcinoom AJCC v8
Gedetailleerde beschrijving
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo auricular acupressure in addition to their usual care on study. Patients also undergo collection of blood samples on study.
ARM II: Patients receive usual care on study. Patients also undergo collection of blood samples on study.
After completion of study treatment, patients in Arm II are followed up at 8 weeks after active treatment ends.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
-
-
Washington
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Seattle, Washington, Verenigde Staten, 98109
- Fred Hutch/University of Washington Cancer Consortium
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- 18-65 years of age
- Stage II-IV gastric, esophageal, or pancreatic cancer
- Appetite score on visual analog scale ≤ 70/100
- At least 60 days of planned systemic treatment, whether already initiated or scheduled to be initiated
- Access to phone and electronic device for study contacts and questionnaires
- Willing and able to attend 4 in-person auricular acupressure treatments at the Fred Hutch South Lake Union Clinic
- Willing and able to perform 4 at-home self-applied treatments of auricular acupressure
- Participants must not have received acupressure or acupuncture for low appetite within last 30 days
- Participants must not be actively using corticosteroids, mirtazapine (Remeron), olanzapine (Zyprexa), or Marinol for appetite stimulation at baseline
- Participants must be able to intake food orally and not require sole or supplemental intravenous nutrition at baseline
- Participants must not have a history of physiological eating disorders (e.g., anorexia nervosa) in the last 3 years
- Participants must not have a current known or diagnosed immunodeficiency
- Participants must have an intact auricular pinna
- Able to understand and willing to sign written informed consent in English
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Arm I (acupressure therapy)
Patients undergo auricular acupressure in addition to their usual care on study. Patients also undergo collection of blood samples on study. |
Ancillary studies
Andere namen:
Undergo collection of blood samples
Andere namen:
Receive usual care
Andere namen:
Undergo auricular acupressure
Andere namen:
|
|
Actieve vergelijker: Arm II (usual care)
Patients receive usual care on study. Patients also undergo collection of blood samples on study. |
Ancillary studies
Andere namen:
Undergo collection of blood samples
Andere namen:
Receive usual care
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Accrual (Feasibility)
Tijdsspanne: Up to 2 years, during study accrual
|
Accrual will be measured by the average rate of participants-per-month enrolled into both groups with the goal of 5 patients/month over a 15-month period. |
Up to 2 years, during study accrual
|
|
Retention (Feasibility)
Tijdsspanne: Up to 8 weeks
|
Retention will be measured by the number of participants who remain in the trial and provide data at the closeout visit. |
Up to 8 weeks
|
|
Intervention Adherence (Feasibility)
Tijdsspanne: Up to 8 weeks
|
Adherence will be measured in the intervention group by the number of applied auricular acupressure treatments, with the total possible being 8. |
Up to 8 weeks
|
|
Intervention Fidelity (Feasibility)
Tijdsspanne: Up to 8 weeks
|
Fidelity will be assessed by study team adherence to symptom query and appropriate ear seed point modifications to the standard protocol and accuracy of seed placement according to photographic analysis. |
Up to 8 weeks
|
|
Acceptability (Feasibility)
Tijdsspanne: Up to 16 weeks
|
Acceptability will be assessed using a random convenience sample of participants and providers through semi-structured interviews. |
Up to 16 weeks
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in Appetite
Tijdsspanne: Baseline to week 4
|
As measured by the Functional Assessment for Anorexia/Cachexia Treatment Subscale. Analyses will assess change in each outcome as a change from baseline to week 4. The Functional Assessment for Anorexia/Cachexia Treatment Subscale is a 12-item subscale that measures the symptoms and concerns of patients with anorexia/cachexia. The subscale can be used as a standalone instrument. Patients rate each item from 0 to 4 (0 = Not at all; 1 = A little bit; 2 = Somewhat; 3 = Quite a bit; and 4 = Very Much). The recall period for each question is "during the past 7 days". As each of the 12 items ranges from 0-4, the range of possible scores is 0-48, with 0 being the worst possible score and 48 the best. To obtain the 0-48 score each negatively-worded item response is recoded so that 0 is a bad response and 4 is good response. |
Baseline to week 4
|
|
Change in Appetite
Tijdsspanne: Baseline to week 8
|
As measured by the Functional Assessment for Anorexia/Cachexia Treatment Subscale. Analyses will assess change in each outcome as a change from baseline to week 8. The Functional Assessment for Anorexia/Cachexia Treatment Subscale is a 12-item subscale that measures the symptoms and concerns of patients with anorexia/cachexia. The subscale can be used as a standalone instrument. Patients rate each item from 0 to 4 (0 = Not at all; 1 = A little bit; 2 = Somewhat; 3 = Quite a bit; and 4 = Very Much). The recall period for each question is "during the past 7 days". As each of the 12 items ranges from 0-4, the range of possible scores is 0-48, with 0 being the worst possible score and 48 the best. To obtain the 0-48 score each negatively-worded item response is recoded so that 0 is a bad response and 4 is good response. |
Baseline to week 8
|
|
Change in Body Weight (kg)
Tijdsspanne: Baseline to week 4
|
Analyses will assess change in each outcome as a change from baseline to week 4. |
Baseline to week 4
|
|
Change in Body Weight (kg)
Tijdsspanne: Baseline to week 8
|
Analyses will assess change in each outcome as a change from baseline to week 8. |
Baseline to week 8
|
Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Blake Langley, Fred Hutch/University of Washington Cancer Consortium
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Endocriene systeemziekten
- Neoplasmata per site
- Neoplasmata
- Neoplasmata van het spijsverteringsstelsel
- Ziekten van het spijsverteringsstelsel
- Endocriene klierneoplasmata
- Alvleesklier Ziekten
- Pancreasneoplasmata
- Health Services Administration
- Kwaliteit, toegang en evaluatie van de gezondheidszorg
- Onderzoekstechnieken
- Therapeutica
- Klinische laboratoriumtechnieken
- Diagnostische technieken en procedures
- Diagnose
- Kwaliteit van de gezondheidszorg
- Complementaire therapieën
- Modaliteiten fysiotherapie
- Kwaliteitsindicatoren, gezondheidszorg
- Revalidatie
- Richtlijnen als onderwerp
- Kwaliteitsborging, gezondheidszorg
- Therapie, zacht weefsel
- Musculoskeletale manipulaties
- Zorgstandaard
- Exemplaarbehandeling
- Oefen richtlijnen als onderwerp
- Acupressuur
Andere studie-ID-nummers
- RG1123492
- RG1123492 (Andere identificatie: Fred Hutch/University of Washington Cancer Consortium)
- NCI-2023-03942 (Register-ID: CTRP (Clinical Trial Reporting Program))
- 3KL2TR002317 (Subsidie/contract van de Amerikaanse NIH)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Individual participant data that underlie the results reported in published articles after de-identification may be made available upon request (text, tables, figures, and appendices).
IPD-tijdsbestek voor delen
Beginning 6 months and ending 36 months after publication of results or study protocol, as requested.
IPD-toegangscriteria voor delen
Researchers and investigators who: 1) provide a methodologically sound proposal to expand on aims in the original, approved proposal; and/or 2) aim to conduct individual, participant-level meta-analyses. Proposals should be directed to blangley@fredhutch.org. To gain access, data requestors will need to sign a data access agreement.
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ICF
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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