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- Ensaio Clínico NCT05731076
Suporte de autogestão para pacientes com câncer de pulmão com caquexia
Eficácia do suporte de autogerenciamento no estado nutricional em pacientes com câncer de pulmão com síndrome de caquexia do câncer: uma trilha clínica randomizada
O objetivo deste ensaio clínico randomizado é testar a eficácia da intervenção nutricional baseada em exercícios de suporte de autogerenciamento em pacientes com câncer de pulmão com síndrome de caquexia e anorexia por câncer. A principal questão que pretende responder é:
• A intervenção nutricional combinada com exercícios melhoraria o estado nutricional de pacientes com câncer de pulmão? Os participantes farão um plano de exercícios personalizado e comerão alimentos ricos em proteínas após a educação baseada no suporte ao autogerenciamento.
E há um grupo de comparação: os pesquisadores irão comparar o grupo de comparação para ver o estado nutricional que recebe educação de saúde de rotina.
Visão geral do estudo
Status
Intervenção / Tratamento
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Changhua
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Changhua, Changhua, Taiwan, 51052
- Changhua Christian Hospital
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Taipei
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Taipei, Taipei, Taiwan, 11219
- Taipei Veterans General Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Descrição
Critério de inclusão:
- Câncer de pulmão diagnosticado (código CID-10: C33-C34)
- Perda de peso corporal: perda de peso corporal 2% antes do recrutamento 2 meses ou perda de peso corporal 5% antes do recrutamento 6 meses.
- Médico julgado pode fazer exercício em casa sem supervisor.
- Possui smartphone e concorda em usar o aplicativo associado ao exercício.
- Concorde em usar a banda inteligente Xioami enquanto for aceitável.
- Clareza consciente e comunicação.
- Grupo de Oncologia Cooperativa Oriental (ECOG) 0-1.
Critério de exclusão:
- Participantes com doenças cardiovasculares não podem se exercitar sem supervisão.
- Diabetes Mellitus com baixo controle do açúcar no sangue.
- Doença pulmonar obstrutiva crônica com dispnéia aos esforços.
- Plaquetas < 50000mm3 devido a doença ou tratamento.
- Hemoglobina <10mg/dl.
- Tropeço recente, dor intensa, alteração cognitiva e comportamental.
- Metástase cerebral suspeita ou diagnosticada.
- Metástase óssea suspeita ou diagnosticada.
- Receber alimentação por sonda nasogástrica ou nutrição parenteral.
- Médico julgado não pode fazer exercício em casa.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Combined Exercise and Nutrition Self-management Support Program
Participants receive a 12-week multimodal intervention.
This includes personalized exercise prescriptions (aerobic, resistance, and flexibility training) guided by wearable technology and structured nutritional counseling focused on adequate protein intake (e.g., 1.2 g/kg/day).
All activities are supported by a self-management behavioral framework to enhance adherence.
In addition, both arms receive baseline cancer care from hospital case managers to ensure ethical standards of care are met.
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A structured 12-week multimodal support program.
(1) Exercise: Personalized home-based aerobic, resistance, and flexibility training (at least 3 times/week, 30 min/session) monitored via Xiaomi smart bands.
(2) Nutrition: Goal-oriented counseling focused on achieving a high-protein intake (e.g., 1.2-1.5 g/kg/day).
(3) Self-management: Continuous support using a self-monitoring manual, wearable device feedback, and a dedicated Line@ social media platform for real-time interaction with researchers, providing counseling and symptom management support to enhance patient adherence.
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Sem intervenção: Routine health education group
Participants will receive standard of care provided by cancer case managers, including education on medication adherence, symptom/side-effect management, and nutritional supplement trials as needed.
To maintain study blinding, participants in this group will also wear Xiaomi smart bands and undergo the same assessment schedule (Baseline, Week 8, Week 12) without the additional self-management support program.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline Mini Nutrition Assessment(MNA)
Prazo: baseline, Week 8, Week 12.
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The MNA consists of 18 self-reported questions covering ingestion, weight loss, mobility, acute illness/stress, neuropsychological problems, BMI, living arrangements, polypharmacy, skin ulcers, meal frequency, food/fluid intake, and mode of feeding.
The maximal score is 30.
A score >23.5 means well-nourished, 17-23.5 means risk of malnutrition, and <17 means malnutrition.
Higher scores indicate better nutritional status.
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baseline, Week 8, Week 12.
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Feasibility of the self-management support program
Prazo: Week 12
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Assessed by recruitment rate (percentage of eligible patients enrolled), retention rate (percentage of participants completing the 12-week study), and adherence to the wearable device and Line@ interaction.
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Week 12
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Change from balseline in Body Mass Index(BMI)
Prazo: Baseline, Week 8, Week 12
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BMI is calculated as weight in kilograms divided by the square of height in meters (kg/m^2), measured using Bioelectrical Impedance Analysis (BIA) with the InBodyDial H20 device.
Data are recorded and rounded to one decimal place.
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Baseline, Week 8, Week 12
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Change from baseline in skeletal muscle mass
Prazo: Baseline, Week 8, Week 12
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Measured using Bioelectrical Impedance Analysis (BIA) with the InBodyDial H20 device.
Data are recorded in percentage (%) and rounded to one decimal place.
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Baseline, Week 8, Week 12
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Change from basleline body fat mass at 12weeks
Prazo: Baseline, Week 8, Week 12
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The body fat mass will be detected by InBodyDial H20.
Data record with percentage and after the first decimal place.
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Baseline, Week 8, Week 12
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Change from Baseline in Upper Body Muscle Endurance (30-Second Arm Curl Test)
Prazo: Baseline, Week 8, Week 12
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Used to evaluate upper body muscle endurance.
The participant sits on a chair with back supported and performs as many bicep curls as possible in 30 seconds using a dumbbell (5 lbs for females; 8 lbs for males).
The total number of completed curls is recorded.
Higher scores (more repetitions) indicate better upper body muscle endurance.
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Baseline, Week 8, Week 12
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Change from Baseline in Lower Body Muscle Strength (30-Second Chair-Stand Test)
Prazo: Baseline, Week 8, Week 12
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Used to evaluate lower body muscle strength.
The participant sits in the middle of a chair with back straight and feet flat on the floor, then stands up completely and sits down repeatedly for 30 seconds.
The total number of completed stands is recorded.
Higher scores (more repetitions) indicate better lower body muscle strength.
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Baseline, Week 8, Week 12
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Change from Baseline in cardiopulmonary function (6-Minute Walk Test)
Prazo: Baseline, Week 8, Week 12
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Examine cardiopulmonary function in this study.
Let the participant sit and rest 10 minutes before test.
Check vital signs and oxygen situation for patient safety.
Position the participant at the starting line, and walking back and forth along the mark on the floor.
When the participant starts to walk, starts the times.
Don't walk nor talk with him/ her, and count the laps attentively.
Participant can walk longer distance means better cardiopulmonary function.
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Baseline, Week 8, Week 12
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Change from basline in quality of life (FACT-L)
Prazo: Baseline, Week 12
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The Functional Assessment of Cancer Therapy-Lung (FACT-L) is used to determine quality of life in lung cancer patients.
It contains 5 dimensions: physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), functional well-being (7 items), and lung cancer subscale (9 items).
Items are rated on a 5-point Likert scale with total scores ranging from 0 to 144.
Higher scores indicate better quality of life."
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Baseline, Week 12
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Change from Baseline in Cancer anorexia-cachexia syndrome nutrition knowledge (CACSNKQ)
Prazo: Baseline, Week 12
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The CACSNKQ is designed to assess patients' knowledge regarding cancer anorexia-cachexia syndrome.
All items are multiple-choice with one correct answer.
The total score ranges from 0 to 21, with higher scores indicating better nutritional knowledge and self-management ability against the syndrome.
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Baseline, Week 12
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Change from baseline in dietary intake (24 hours dietary recall)
Prazo: Baseline, Week 8, Week12
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To assess participants' nutritional intake.
A 24-hour dietary recall interview is conducted to record all food and beverage consumption (including dish names, portion sizes, and preparation methods).
Data are converted into total calories (kcal) and macronutrients (protein, fat, and carbohydrates in grams) by a registered dietitian using nutritional analysis software.
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Baseline, Week 8, Week12
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Change from Baseline in amount of exercise
Prazo: Baseline to Week 8, and Week 8 to Week 12
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Measured using the Xiaomi Smart Band and a self-management support manual.
The Xiaomi Smart Band is worn daily by participants to record continuous physical activity data, including daily step count, exercise duration, walking distance, and heart rate.
Additionally, participants use the self-management support manual to log the specific duration and frequency of resistance training and stretching exercises.
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Baseline to Week 8, and Week 8 to Week 12
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Li Chun Chang, Master, Changhua Christian Hospital
- Diretor de estudo: Tsae Jyy Wang, PhD, National Taipei University of Nursing and Health Sciences
Publicações e links úteis
Publicações Gerais
- Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 May;12(5):489-95. doi: 10.1016/S1470-2045(10)70218-7. Epub 2011 Feb 4.
- Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116.
- Ozaki H, Nakagata T, Yoshihara T, Kitada T, Natsume T, Ishihara Y, Deng P, Kobayashi H, Machida S, Naito H. Effects of Progressive Walking and Stair-Climbing Training Program on Muscle Size and Strength of the Lower Body in Untrained Older Adults. J Sports Sci Med. 2019 Nov 19;18(4):722-728. eCollection 2019 Dec.
- Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Oldervoll L, Ravasco P, Solheim TS, Strasser F, de van der Schueren M, Preiser JC, Bischoff SC. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021 May;40(5):2898-2913. doi: 10.1016/j.clnu.2021.02.005. Epub 2021 Mar 15.
- Peddle-McIntyre CJ, Singh F, Thomas R, Newton RU, Galvao DA, Cavalheri V. Exercise training for advanced lung cancer. Cochrane Database Syst Rev. 2019 Feb 11;2(2):CD012685. doi: 10.1002/14651858.CD012685.pub2.
- Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017 Feb;36(1):11-48. doi: 10.1016/j.clnu.2016.07.015. Epub 2016 Aug 6.
- Schreiber M, Bucher T, Collins CE, Dohle S. The Multiple Food Test: Development and validation of a new tool to measure food choice and applied nutrition knowledge. Appetite. 2020 Jul 1;150:104647. doi: 10.1016/j.appet.2020.104647. Epub 2020 Feb 29.
- Anderson LJ, Albrecht ED, Garcia JM. Update on Management of Cancer-Related Cachexia. Curr Oncol Rep. 2017 Jan;19(1):3. doi: 10.1007/s11912-017-0562-0.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 220582
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