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Het effect van elektrostimulatie- en compressietoepassingen op neuropathiesymptomen en levenskwaliteit bij de behandeling van door chemotherapie geïnduceerde perifere neuropathie bij patiënten met kanker van het gastro-intestinale systeem die een op oxaliplatine gebaseerde behandeling krijgen
Het effect van elektrostimulatie- en compressietoepassingen op neuropathiesymptomen en kwaliteit van leven bij de behandeling van chemotherapie-geïnduceerde perifere neuropathie bij gastro-intestinale kankerpatiënten die op oxaliplatine gebaseerde behandeling ontvangen
Dit onderzoek werd uitgevoerd om het effect van elektrostimulatie- en compressietoepassingen te evalueren op de ernst, het aantal en de pijnniveaus van neuropathiesymptomen en de levenskwaliteit van patiënten met uitgezaaide gastro-intestinale kanker die een op oxaliplatine gebaseerde behandeling ondergaan bij het beheer van chemotherapie-geïnduceerde perifere neuropathie.
De studiepopulatie bestond uit patiënten met gastro-intestinale kanker tussen 2025-2026. Gegevensverzamelingsinstrumenten werden toegepast op patiënten die aan de inclusiecriteria voldeden en chemotherapie-geïnduceerde perifere neuropathie ontwikkelden. Patiënten werden vervolgens gestratificeerd op leeftijd en geslacht en toegewezen aan "controlegroep, elektrostimulatiegroep, compressiegroep en elektrostimulatie+compressiegroep" met behulp van blokrandomisatie. Statistische poweranalyse bepaalde het totale aantal deelnemers in de studie op 140 patiënten, met 35 patiënten in elke groep. Patiënten in de controlegroep profiteerden van de standaardprocedures van de kliniek en kregen geen interventie.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Sivas
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Sivas, Sivas, Turkije (Türkiye), 58010
- Sivas Cumhuriyet University Health Services Application and Research Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria:
- 18 jaar of ouder zijn,
- Een diagnose van gemetastaseerd gastro-intestinaal carcinoom (maag, pancreas, colon, rectum) hebben,
- Gepland staan om 6 cycli chemotherapie te ontvangen,
- 1 cyclus op oxaliplatine gebaseerde chemotherapie (FOLFOX en FOLFİRİNOX) hebben ontvangen,
- Geen gediagnosticeerde psychische stoornis hebben,
- Geen huidproblemen hebben in de gebieden waar TENS- en compressietoepassingen zullen worden uitgevoerd,
- Na informatie en uitleg over de studie het geïnformeerde toestemmingsformulier mondeling en schriftelijk hebben goedgekeurd.
Exclusiecriteria:
- Eerder op oxaliplatine gebaseerde behandeling (monotherapie of combinatie) hebben ontvangen,
- Een pacemaker hebben,
- Een voorgeschiedenis van huidgevoeligheid in handen en voeten hebben,
- Een andere neurotoxische chemotherapie-agent hebben ontvangen of momenteel ontvangen, anders dan op oxaliplatine gebaseerde behandeling,
- Perifere neuropathie hebben ontwikkeld door andere oorzaken dan chemotherapie [tumorcompressie, voedingsdeficiënties, infecties of ernstige systemische ziekte (diabetes mellitus, etc.)].
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: TENS Group
Participants received the TENS intervention at each scheduled session from Cycle 2 through Cycle 6 during oxaliplatin-based chemotherapy, in addition to usual care.
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TENS was delivered using the F. Bosch FB2405 TENS+EMS dual-channel device with four 5 × 5-cm surface electrodes placed bilaterally over PC6 and KI1.
Program 4 provided a modulated pulse rate of 2-60 Hz and a pulse width of 156-260 microseconds.
The device output was adjustable from 0-80 mA per channel into a 500-Ω load, but no fixed mA value was used.
Intensity was individually titrated to a strong, comfortable, non-painful sensory level without visible muscle contraction.
Each session lasted 180 minutes: 30 minutes before, throughout the 120-minute oxaliplatin infusion, and 30 minutes after the infusion.
Sessions were administered every 14 days from Cycle 2 through Cycle 6, for five sessions.
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Experimenteel: Compression group
Participants received the compression intervention at each scheduled session from Cycle 2 through Cycle 6 during oxaliplatin-based chemotherapy, in addition to usual care.
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Bilateral compression of the hands and feet was applied using Beybi Sensitive surgical gloves one size smaller than the participant's measured glove size and knee-high Varimed CCL II graduated compression stockings providing 23-32 mmHg.
Each session lasted 180 minutes: 30 minutes before, throughout the 120-minute oxaliplatin infusion, and 30 minutes after the infusion.
Sessions were administered every 14 days from Cycle 2 through Cycle 6, for five sessions.
All applications were individually fitted and directly supervised by the same research nurse.
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Experimenteel: Sequential TENS Plus Compression Group
Participants received TENS followed by compression at each scheduled intervention session from Cycle 2 through Cycle 6 during oxaliplatin-based chemotherapy, in addition to usual care.
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Participants received 90 minutes of TENS followed immediately by 90 minutes of bilateral hand-and-foot compression, using the same devices, parameters, electrode placement, gloves, and stockings as in the monotherapy groups.
TENS began 30 minutes before the oxaliplatin infusion and continued during the first 60 minutes of the 120-minute infusion.
After TENS was stopped and the electrodes were removed, compression was applied during the remaining 60 minutes of the infusion and for 30 minutes afterward.
The total sequential intervention lasted 180 minutes.
Sessions were administered every 14 days from Cycle 2 through Cycle 6, for five sessions.
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Geen tussenkomst: Usual Care Control Group
Participants received usual care from Cycle 2 through Cycle 6 and received no study-specific TENS or compression intervention.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Baseline-Adjusted EORTC QLQ-CIPN20 Total Score Trajectory Across T1-T4
Tijdsspanne: Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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The EORTC QLQ-CIPN20 is a 20-item patient-reported questionnaire assessing sensory, motor, and autonomic symptoms associated with chemotherapy-induced peripheral neuropathy. Scores are linearly transformed to a 0-100 scale, with higher scores indicating greater CIPN-related symptom burden. The primary outcome was the baseline-adjusted post-baseline trajectory of the EORTC QLQ-CIPN20 total score across T1-T4. The assessments before Cycles 3-6 (T1-T4) were modelled jointly, with the score obtained before Cycle 2 (T0) included as the baseline covariate. The overall Group-by-Time interaction constituted the primary treatment-effect test. Baseline-adjusted between-group contrasts at T4 constituted the primary endpoint pairwise comparisons. |
Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Baseline-Adjusted EORTC QLQ-C30 Scale Score Trajectories Across T1-T4
Tijdsspanne: Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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The EORTC QLQ-C30 is a 30-item patient-reported questionnaire assessing health-related quality of life in patients with cancer. It includes five functional scales, three symptom scales, a global health status/quality-of-life scale, and six single-item symptom measures. Scores are linearly transformed to a 0-100 scale. Higher functional and global health status scores indicate better functioning and quality of life, whereas higher symptom scores indicate greater symptom burden. For each EORTC QLQ-C30 scale, the assessments before Cycles 3-6 (T1-T4) were modelled jointly, with the corresponding score obtained before Cycle 2 (T0) included as the baseline covariate. The Group-by-Time interaction was evaluated as a secondary treatment-period effect. |
Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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NCI-CTCAE v5.0 Peripheral Sensory Neuropathy Grade Across T1-T4
Tijdsspanne: Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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Chemotherapy-induced peripheral sensory neuropathy severity was assessed by a medical oncologist using the clinician-rated National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0 (NCI-CTCAE v5.0). Peripheral sensory neuropathy was graded from 0 to 4, with higher grades indicating greater severity and functional impairment. Because all participants were classified as Grade 2 at T0 and sparse or zero cells prevented stable repeated-measures categorical modelling, grade distributions were compared among the randomized groups separately at each post-baseline treatment-period assessment from T1 to T4. |
Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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DN4 Total Score Trajectory and DN4-Defined Neuropathic Pain Positivity Across T1-T4
Tijdsspanne: Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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Neuropathic pain was assessed using the Douleur Neuropathique en 4 Questions (DN4), a 10-item clinician-administered instrument comprising seven symptom-interview items and three clinical-examination items. The total score ranges from 0 to 10, with higher scores indicating a greater number of neuropathic pain features. A score of 4 or higher was classified as DN4-defined neuropathic pain positivity. The DN4 total scores obtained before Cycles 3-6 (T1-T4) were modelled jointly, with the DN4 total score obtained before Cycle 2 (T0) included as the baseline covariate. The Group-by-Time interaction was evaluated as a continuous secondary treatment-period effect. DN4-defined neuropathic pain positivity was compared among the randomized groups separately at each T1-T4 assessment. |
Before Cycles 3, 4, 5, and 6 (T1-T4), corresponding to 2, 4, 6, and 8 weeks after the T0 assessment before Cycle 2; each chemotherapy cycle lasted 14 days.
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Exploratory QLQ-CIPN20 Total Scores at 6-Month Follow-up
Tijdsspanne: At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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The EORTC QLQ-CIPN20 total score was assessed at the prespecified 6-month follow-up.
Scores range from 0 to 100, with higher scores indicating greater CIPN-related symptom burden.
This assessment was analyzed separately as an exploratory follow-up outcome and was not included in the primary T0-T4 treatment-period analysis.
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At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Exploratory EORTC QLQ-C30 Scale Scores at 6-Month Follow-up
Tijdsspanne: At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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EORTC QLQ-C30 scale scores were assessed exploratorily at the prespecified long-term follow-up.
Scores range from 0 to 100.
Higher functional and global health status scores indicate better functioning and quality of life, whereas higher symptom scores indicate greater symptom burden.
This assessment was conducted to examine participants' health-related quality-of-life status after the extended follow-up interval.
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At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Exploratory NCI-CTCAE v5.0 Peripheral Sensory Neuropathy Grade at 6-Month Follow-up
Tijdsspanne: At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Peripheral sensory neuropathy severity was assessed exploratorily at the prespecified long-term follow-up using NCI-CTCAE v5.0.
Neuropathy is graded from 0 to 5, with higher grades indicating greater severity and functional impairment.
This assessment was conducted to examine participants' neuropathy status after the extended follow-up interval.
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At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Exploratory DN4 Total Score and Neuropathic Pain Positivity at 6-Month Follow-up
Tijdsspanne: At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Neuropathic pain was assessed exploratorily at the prespecified long-term follow-up using the DN4.
Total scores range from 0 to 10, with higher scores indicating more neuropathic pain features.
A score of 4 or higher was classified as positive for neuropathic pain.
This assessment was conducted to examine participants' neuropathic pain status after the extended follow-up interval.
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At 6 months after completion of Cycle 6 (T5 exploratory follow-up assessment); each chemotherapy cycle lasted 14 days.
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie directeur: Şerife KARAGÖZOĞLU, Proff., Cumhuriyet University
Publicaties en nuttige links
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Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
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Studieregistratiedata
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per site
- Neoplasmata
- Neoplasmata van het spijsverteringsstelsel
- Ziekten van het spijsverteringsstelsel
- Gastro-intestinale aandoeningen
- Gastro-intestinale neoplasmata
- Therapeutica
- Modaliteiten fysiotherapie
- Revalidatie
- Anesthesie en analgesie
- Elektrische stimulatietherapie
- Analgetie
- Transcutane elektrische zenuwstimulatie
Andere studie-ID-nummers
- CumhuriyetU-SBE-SÖ-1
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ANALYTIC_CODE
- MVO
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