Chemotherapy Alone Versus Surgery Plus Chemotherapy for Distal Gastric Cancer With One Non-curable Factor
A Prospective,Multicentral,Open-label,Randomized,Controlled,Phase III Clinical Trial of Chemotherapy Alone Versus D2 Gastrectomy and Metastasectomy Plus Chemotherapy for Distal Gastric Cancer With One Non-curable Factor
研究概览
地位
地位
干预/治疗
干预/治疗
详细说明
Gastric cancer is the fourth most common malignancy worldwide and the second leading cause of cancer-related deaths, with the highest mortality rates reported in East Asia, including China. Many patients are diagnosed at an advanced stage of gastric cancer because of late onset and nonspecific symptoms. The prognosis of patients with advanced gastric cancer with non-curable factors, such as hepatic, peritoneal, or distant lymph node metastases, is poor. Chemotherapy is the standard of care for these patients. Palliative resection or bypass surgery is generally indicated in the presence of major symptoms such as bleeding or obstruction for incurable advanced gastric cancer. The usefulness of gastrectomy and metastasectomy is still unclear.
The REGATTA trial is the first clinical trial to explore the significance of surgery for incurable advanced gastric cancer. However, it concluded an opposite conclusion that gastrectomy followed by chemotherapy did not show any survival benefit compared with chemotherapy alone in advanced gastric cancer with a single non-curable factor. Interestingly, there was a significant interaction between treatment effect and tumor location in subgroup analyses of overall survival. Gastrectomy plus chemotherapy was associated with significantly worse overall survival in patients with upper-third tumors for less chemotherapy cycles. This finding raises the question whether inclusion criteria were restricted to the patients with lower-third tumor, findings of study might have been positive. So we raise this new trail to assess the significance of Gastrectomy and Metastasectomy for Distal Gastric Cancer With One Non-curable Factor.
研究类型
研究类型
注册 (预期的)
注册
阶段
阶段
- 阶段2
- 第三阶段
联系人和位置
学习联系方式
学习联系方式
- 姓名:Dazhi Xu, PHD
- 电话号码:(+86) 020-87343737
- 邮箱:xudzh@sysucc.org.cn
学习地点
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Tianjin、中国
- 招聘中
- Tianjin Medical University Cancer Institute and Hospital
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接触:
- Rupeng Zhang
- 电话号码:13920561244
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Anhui
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Anqing、Anhui、中国
- 招聘中
- Anqing Municipal Hospital
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接触:
- Yaming Zhang
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接触:
- Daibin Tang
- 电话号码:13865176528
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Hefei、Anhui、中国
- 招聘中
- The First Affiliated Hospital of Anhui Medical University
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接触:
- Aman Xu
- 电话号码:13705695470
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接触:
- Fei Zhong
- 电话号码:18226616729
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Hefei、Anhui、中国
- 招聘中
- Anhui Provincial Hospital
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接触:
- Xuhui Zhao
- 电话号码:18963789289
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接触:
- Yifu He
- 电话号码:13485691976
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Wuhu、Anhui、中国
- 招聘中
- First Affiliated Hospital of Wannan Medical College
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接触:
- Lianghui Shi
- 电话号码:13956159006
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Guangdong
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Guangzhou、Guangdong、中国
- 招聘中
- Yuebei People's Hospital
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接触:
- Tao Tao Zhang
- 电话号码:13500206389
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Guangzhou、Guangdong、中国
- 招聘中
- Cancer center of Sun Yat-sen University
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接触:
- Dazhi Xu
- 电话号码:86(020)87343737
- 邮箱:xudzh@sysucc.org.cn
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接触:
- Youqing Zhan
- 电话号码:86(020)87343910
- 邮箱:Zhanyq@sysucc.org.cn
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Jiangxi
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Nanchang、Jiangxi、中国
- 招聘中
- Jiangxi Provincial Cancer Hospital
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接触:
- Huamin Rao
- 电话号码:13879100685
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Zhejiang
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Hangzhou、Zhejiang、中国
- 招聘中
- Second Affiliated Hospital, School of Medicine, Zhejiang University
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接触:
- Li Chen
- 电话号码:13958092350
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参与标准
资格标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Lower age limit of research subjects 18 years old and upper age limit of 75 years old.
- PS (ECOG) of 0 or 1.
- Without any other malignancies.
- Written informed consent from the patient.
- Standard gastrectomy with D2 lymphadenectomy for primary cancer
A single non-curable factor was defined by preoperative CT :
hepatic metastasis (H1 or H2; maximum diameter ≤4 cm, number ≤4); peritoneal metastasis (R0 or R1 resection) para-aortic lymph node metastasis (number ≤4) ovarian metastasis adrenal metastasis renal metastasis
- No contraindications to chemotherapy, including normal peripheral blood routine, liver and kidney function and electrocardiogram (WBC≥4.0 x 109 /L, NEU≥1.5 x 109 /L,PLT≥100 x 109 /L and HGB≥90g/L)
Exclusion Criteria:
- Female in pregnancy or lactation.
- Supraclavicular lymph nodes metastases,lung and bone metastases.
- Massive ascites or cachexia.
- Extensive cancer metastases of liver, peritoneal metastasis,para-aortic lymph node
- Patients participating in any other clinical trails currently,or participated in other trails within 1 months.
- Suffering from other serious diseases, including cardiovascular, respiratory, kidney, or liver disease, complicated by poorly controlled hypertension, diabetes, mental disorders or diseases.
- Poor treatment compliance of patients
- The group of chemotherapy alone accepts gastrectomy for bleeding or obstruction
- Failure of R0 or R1 metastasectomy and gastrectomy with D2 lymphadenectomy
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
手臂数量
武器和干预
参与者组/臂参与者组/臂 |
干预/治疗干预/治疗 |
|---|---|
|
有源比较器:Chemotherapy
chemotherapy with capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
|
capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
其他名称:
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实验性的:Surgery+Chemotherapy
D2 Gastrectomy and Metastasectomy + chemotherapy with capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
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capecitabine and oxaliplatin (eight 3-week cycles of oral capecitabine 1000 mg/m² twice daily on days 1-14 plus intravenous oxaliplatin 130 mg/m² on day 1) for 6 months or progress of disease
其他名称:
D2 gastrectomy + metastasectomy
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研究衡量的是什么?
主要结果指标
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Overall survival
大体时间:5-year
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OS
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5-year
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次要结果测量
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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progression free survival
大体时间:3-year
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PFS
|
3-year
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合作者和调查者
调查人员
调查人员
- 首席研究员:Dazhi Xu, PHD、Sun Yat-sen University
研究记录日期
研究主要日期
学习开始 (实际的)
学习开始
初级完成 (预期的)
初级完成
研究完成 (预期的)
研究完成
研究注册日期
首次提交
首次提交
首先提交符合 QC 标准的
首先提交符合 QC 标准的
首次发布 (实际的)
首次发布
研究记录更新
最后更新发布 (实际的)
最后更新发布
上次提交的符合 QC 标准的更新
上次提交的符合 QC 标准的更新
最后验证
最后验证
更多信息
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