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Immunomodulating Nutrients in Perioperative Patients With Gastric Cancer

20 de abril de 2017 atualizado 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.

Visão geral do estudo

Descrição detalhada

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or to discharge whichever occurred first, or consent withdrawal during any time of the study, when the patient would be withdrawn.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 estudo

Intervencional

Inscrição (Real)

34

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

20 anos a 85 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
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.
Outros nomes:
  • neo-mune
Comparador Ativo: 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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
immunomodulating effects
Prazo: 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 resultados secundários

Medida de resultado
Descrição da medida
Prazo
blood glucose
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

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

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

1 de junho de 2011

Conclusão Primária (Real)

1 de junho de 2016

Conclusão do estudo (Real)

1 de setembro de 2016

Datas de inscrição no estudo

Enviado pela primeira vez

5 de abril de 2017

Enviado pela primeira vez que atendeu aos critérios de CQ

20 de abril de 2017

Primeira postagem (Real)

21 de abril de 2017

Atualizações de registro de estudo

Última Atualização Postada (Real)

21 de abril de 2017

Última atualização enviada que atendeu aos critérios de controle de qualidade

20 de abril de 2017

Última verificação

1 de abril de 2017

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

produto fabricado e exportado dos EUA

Não

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