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Immunomodulating Nutrients in Perioperative Patients With Gastric Cancer

20 april 2017 uppdaterad av: 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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to discharge whichever occurred first, or consent withdrawal during any time of the study, when the patient would be withdrawn.

Studietyp

Interventionell

Inskrivning (Faktisk)

34

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

20 år till 85 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Kosttillskott: immunomodulating nutrients enriched diet
Andra namn:
  • neo-mune
Aktiv komparator: 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.
Kosttillskott: standard diet

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
immunomodulating effects
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
blood glucose
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Kaohsiung Medical University Chung-Ho Memorial Hospital

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 juni 2011

Primärt slutförande (Faktisk)

1 juni 2016

Avslutad studie (Faktisk)

1 september 2016

Studieregistreringsdatum

Först inskickad

5 april 2017

Först inskickad som uppfyllde QC-kriterierna

20 april 2017

Första postat (Faktisk)

21 april 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

21 april 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

20 april 2017

Senast verifierad

1 april 2017

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • KMUHIRB-2011-05-01(II)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

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