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Radiation Therapy or Observation After Chemotherapy in Treating Patients With Stage IV Non-Small Cell Lung Cancer

2017年1月13日 更新者:Alliance for Clinical Trials in Oncology

A Randomized Phase II Study of Oligometastatic Stage IV Non-Small Cell Lung Cancer (NSCLC) Treated With Systemic Therapy Plus Either Radiotherapy to All Sites of Gross Residual Disease or No Radiotherapy

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Sometimes, after chemotherapy, the tumor may not need more treatment until it progresses. In this case, observation may be sufficient. It is not yet known whether radiation therapy is more effective than observation after chemotherapy in treating non-small cell lung cancer.

PURPOSE: This randomized phase II trial is studying how well radiation therapy works compared with observation after chemotherapy in treating patients with stage IV non-small cell lung cancer.

研究概览

详细说明

OBJECTIVES:

Primary

  • To assess whether the addition of radiotherapy to radiographically apparent residual disease after an initial course of standard chemotherapy results in an improvement in overall survival of patients with oligometastatic stage IV non-small cell lung cancer.

Secondary

  • To compare the progression-free survival of patients treated with radiotherapy vs observation after standard chemotherapy.
  • To compare the time to disease progression and time to treatment failure in these patients.
  • To compare the confirmed response rate in these patients.
  • To compare the duration of response in these patients.
  • To compare the adverse events in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to prior treatment with bevacizumab during first-line chemotherapy (yes vs no), number of standard chemotherapy courses (2-3 vs 4-6), Linear Analog Self Assessment value (≤ 7 vs > 7), and histology (predominantly squamous cell vs not predominantly squamous cell). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients undergo observation for 6 weeks.
  • Arm II: Patients undergo radiotherapy 5 days a week for 6 weeks to all sites of gross disease.

After completion of study therapy, patients are followed every 3-6 months for up to 5 years.

研究类型

介入性

注册 (实际的)

3

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Arizona
      • Scottsdale、Arizona、美国、85259-5499
        • Mayo Clinic Scottsdale
    • Connecticut
      • Hartford、Connecticut、美国、06105
        • Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
    • Florida
      • Jacksonville、Florida、美国、32224
        • Mayo Clinic - Jacksonville
    • Illinois
      • Bloomington%、Illinois、美国、61701
        • Illinois CancerCare - Bloomington
      • Canton、Illinois、美国、61520
        • Illinois CancerCare - Canton
      • Canton、Illinois、美国、61520
        • Graham Hospital
      • Carthage、Illinois、美国、62321
        • Illinois CancerCare - Carthage
      • Eureka、Illinois、美国、61530
        • Illinois CancerCare - Eureka
      • Eureka、Illinois、美国、61530
        • Eureka Community Hospital
      • Galesburg、Illinois、美国、61401
        • Illinois CancerCare - Galesburg
      • Galesburg、Illinois、美国、61401
        • Galesburg Cottage Hospital
      • Galesburg、Illinois、美国、61401
        • Galesburg Clinic, PC
      • Galesburg、Illinois、美国、61401
        • InterCommunity Cancer Center of Western Illinois
      • Havana、Illinois、美国、62644
        • Mason District Hospital
      • Havana、Illinois、美国、62644
        • Illinois CancerCare - Havana
      • Kewanee、Illinois、美国、61443
        • Illinois CancerCare - Kewanee Clinic
      • Macomb、Illinois、美国、61455
        • Illinois CancerCare - Macomb
      • Macomb、Illinois、美国、61455
        • Mcdonough District Hospital
      • Maywood、Illinois、美国、60153
        • Cardinal Bernardin Cancer Center at Loyola University Medical Center
      • Moline、Illinois、美国、61265
      • Moline、Illinois、美国、61265
        • Trinity Cancer Center at Trinity Medical Center - 7th Street Campus
      • Monmouth、Illinois、美国、61462
        • Illinois CancerCare - Monmouth
      • Monmouth、Illinois、美国、61462
        • OSF Holy Family Medical Center
      • Normal、Illinois、美国、61761
        • Bromenn Regional Medical Center
      • Normal、Illinois、美国、61761
        • Community Cancer Center
      • Normal、Illinois、美国、61761
        • Illinois CancerCare - Community Cancer Center
      • Ottawa、Illinois、美国、61350
        • Community Hospital of Ottawa
      • Ottawa、Illinois、美国、61350
        • Oncology Hematology Associates of Central Illinois, PC - Ottawa
      • Peoria、Illinois、美国、61636
        • Methodist Medical Center of Illinois
      • Peoria、Illinois、美国、61614
        • Proctor Hospital
      • Peoria、Illinois、美国、61615
        • CCOP - Illinois Oncology Research Association
      • Peoria、Illinois、美国、61615
        • Oncology Hematology Associates of Central Illinois, PC - Peoria
      • Peru、Illinois、美国、61354
        • Illinois CancerCare - Peru
      • Peru、Illinois、美国、61354
        • Illinois Valley Community Hospital
      • Princeton、Illinois、美国、61356
        • Perry Memorial Hospital
      • Princeton、Illinois、美国、61356
        • Illinois CancerCare - Princeton
      • Spring Valley、Illinois、美国、61362
        • Valley Cancer Center
    • Indiana
      • Beech Grove、Indiana、美国、46107
        • St. Francis Hospital and Health Centers - Beech Grove Campus
      • Richmond、Indiana、美国、47374
        • Reid Hospital & Health Care Services
    • Iowa
      • Ames、Iowa、美国、50010
        • McFarland Clinic, PC
      • Bettendorf、Iowa、美国、52722
      • Clive、Iowa、美国、50325
        • Medical Oncology and Hematology Associates - West Des Moines
      • Des Moines、Iowa、美国、50309
        • CCOP - Iowa Oncology Research Association
      • Des Moines、Iowa、美国、50309
        • John Stoddard Cancer Center at Iowa Methodist Medical Center
      • Des Moines、Iowa、美国、50309
        • Medical Oncology and Hematology Associates at John Stoddard Cancer Center
      • Des Moines、Iowa、美国、50314
        • Medical Oncology and Hematology Associates at Mercy Cancer Center
      • Des Moines、Iowa、美国、50314
        • Mercy Cancer Center at Mercy Medical Center - Des Moines
      • Des Moines、Iowa、美国、50316
        • John Stoddard Cancer Center at Iowa Lutheran Hospital
      • Mason City、Iowa、美国、50401
        • Mercy Cancer Center at Mercy Medical Center - North Iowa
      • Sioux City、Iowa、美国、51101
        • Siouxland Hematology-Oncology Associates, LLP
      • Sioux City、Iowa、美国、51104
        • St. Luke's Regional Medical Center
      • Sioux City、Iowa、美国、51104
        • Mercy Medical Center - Sioux City
    • Kansas
      • Chanute、Kansas、美国、66720
        • Cancer Center of Kansas, PA - Chanute
      • Dodge City、Kansas、美国、67801
        • Cancer Center of Kansas, PA - Dodge City
      • El Dorado、Kansas、美国、67042
        • Cancer Center of Kansas, PA - El Dorado
      • Fort Scott、Kansas、美国、66701
        • Cancer Center of Kansas - Fort Scott
      • Independence、Kansas、美国、67301
        • Cancer Center of Kansas-Independence
      • Kingman、Kansas、美国、67068
        • Cancer Center of Kansas, PA - Kingman
      • Lawrence、Kansas、美国、66044
        • Lawrence Memorial Hospital
      • Liberal、Kansas、美国、67901
        • Southwest Medical Center
      • Newton、Kansas、美国、67114
        • Cancer Center of Kansas, PA - Newton
      • Parsons、Kansas、美国、67357
        • Cancer Center of Kansas, PA - Parsons
      • Pratt、Kansas、美国、67124
        • Cancer Center of Kansas, PA - Pratt
      • Salina、Kansas、美国、67401
        • Cancer Center of Kansas, PA - Salina
      • Topeka、Kansas、美国、66606
        • Cotton-O'Neil Cancer Center
      • Wellington、Kansas、美国、67152
        • Cancer Center of Kansas, PA - Wellington
      • Wichita、Kansas、美国、67214
        • Wesley Medical Center
      • Wichita、Kansas、美国、67208
        • Cancer Center of Kansas, PA - Medical Arts Tower
      • Wichita、Kansas、美国、67214
        • Cancer Center of Kansas, PA - Wichita
      • Wichita、Kansas、美国、67214
        • CCOP - Wichita
      • Wichita、Kansas、美国、67214
        • Via Christi Cancer Center at Via Christi Regional Medical Center
      • Wichita、Kansas、美国、67208
        • Associates in Womens Health, PA - North Review
      • Winfield、Kansas、美国、67156
        • Cancer Center of Kansas, PA - Winfield
    • Massachusetts
      • Burlington、Massachusetts、美国、01805
        • Lahey Clinic Medical Center - Burlington
    • Michigan
      • Ann Arbor、Michigan、美国、48106-0995
        • Saint Joseph Mercy Cancer Center
      • Ann Arbor、Michigan、美国、48106
        • CCOP - Michigan Cancer Research Consortium
      • Dearborn、Michigan、美国、48123-2500
        • Oakwood Cancer Center at Oakwood Hospital and Medical Center
      • Flint、Michigan、美国、48503
        • Hurley Medical Center
      • Flint、Michigan、美国、48503
        • Genesys Hurley Cancer Institute
      • Grosse Pointe Woods、Michigan、美国、48236
        • Van Elslander Cancer Center at St. John Hospital and Medical Center
      • Jackson、Michigan、美国、49201
        • Foote Memorial Hospital
      • Lansing、Michigan、美国、48912-1811
        • Sparrow Regional Cancer Center
      • Livonia、Michigan、美国、48154
        • St. Mary Mercy Hospital
      • Pontiac、Michigan、美国、48341-2985
        • St. Joseph Mercy Oakland
      • Port Huron、Michigan、美国、48060
        • Mercy Regional Cancer Center at Mercy Hospital
      • Saginaw、Michigan、美国、48601
        • Seton Cancer Institute at Saint Mary's - Saginaw
      • Warren、Michigan、美国、48093
        • St. John Macomb Hospital
    • Minnesota
      • Bemidji、Minnesota、美国、56601
        • MeritCare Bemidji
      • Burnsville、Minnesota、美国、55337
        • Fairview Ridges Hospital
      • Coon Rapids、Minnesota、美国、55433
        • Mercy and Unity Cancer Center at Mercy Hospital
      • Edina、Minnesota、美国、55435
        • Fairview Southdale Hospital
      • Fridley、Minnesota、美国、55432
        • Mercy and Unity Cancer Center at Unity Hospital
      • Hutchinson、Minnesota、美国、55350
        • Hutchinson Area Health Care
      • Maplewood、Minnesota、美国、55109
        • Minnesota Oncology Hematology, PA - Maplewood
      • Maplewood、Minnesota、美国、55109
        • HealthEast Cancer Care at St. John's Hospital
      • Minneapolis、Minnesota、美国、55407
        • Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
      • Minneapolis、Minnesota、美国、55415
        • Hennepin County Medical Center - Minneapolis
      • Robbinsdale、Minnesota、美国、55422-2900
        • Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
      • Rochester、Minnesota、美国、55905
        • Mayo Clinic Cancer Center
      • Saint Louis Park、Minnesota、美国、55416
        • CCOP - Metro-Minnesota
      • Saint Louis Park、Minnesota、美国、55416
        • Park Nicollet Cancer Center
      • Saint Paul、Minnesota、美国、55102
        • United Hospital
      • Shakopee、Minnesota、美国、55379
        • St. Francis Cancer Center at St. Francis Medical Center
      • St. Paul、Minnesota、美国、55101
        • Regions Hospital Cancer Care Center
      • Waconia、Minnesota、美国、55387
        • Ridgeview Medical Center
      • Woodbury、Minnesota、美国、55125
        • Minnesota Oncology Hematology, PA - Woodbury
    • Mississippi
      • Jackson、Mississippi、美国、39216
        • University of Mississippi Cancer Clinic
    • Missouri
      • Saint Louis、Missouri、美国、63131
        • Missouri Baptist Cancer Center
      • Saint Louis、Missouri、美国、63141
        • Arch Medical Services, Incorporated at Center for Cancer Care and Research
      • Springfield、Missouri、美国、65802
        • CCOP - Cancer Research for the Ozarks
      • Springfield、Missouri、美国、65804
        • St. John's Regional Health Center
      • Springfield、Missouri、美国、65807
        • Hulston Cancer Center at Cox Medical Center South
    • Montana
      • Billings、Montana、美国、59101
        • CCOP - Montana Cancer Consortium
      • Billings、Montana、美国、59101
        • Hematology-Oncology Centers of the Northern Rockies - Billings
      • Billings、Montana、美国、59101
        • Northern Rockies Radiation Oncology Center
      • Billings、Montana、美国、59101
        • St. Vincent Healthcare Cancer Care Services
      • Billings、Montana、美国、59107-7000
        • Billings Clinic - Downtown
      • Bozeman、Montana、美国、59715
        • Bozeman Deaconess Cancer Center
      • Butte、Montana、美国、59701
        • St. James Healthcare Cancer Care
      • Great Falls、Montana、美国、59405
        • Great Falls Clinic - Main Facility
      • Great Falls、Montana、美国、59405
      • Great Falls、Montana、美国、59405-5309
        • Big Sky Oncology
      • Great Falls、Montana、美国、59405
        • Sletten Cancer Institute at Benefis Healthcare
      • Havre、Montana、美国、59501
        • Northern Montana Hospital
      • Helena、Montana、美国、59601
        • St. Peter's Hospital
      • Kalispell、Montana、美国、59901
        • Kalispell Regional Medical Center
      • Kalispell、Montana、美国、59901
        • Glacier Oncology, PLLC
      • Kalispell、Montana、美国、59901
        • Kalispell Medical Oncology at KRMC
      • Missoula、Montana、美国、59801
        • Community Medical Center
      • Missoula、Montana、美国、59804
        • Guardian Oncology and Center for Wellness
      • Missoula、Montana、美国、59807-7877
        • Montana Cancer Specialists at Montana Cancer Center
      • Missoula、Montana、美国、59807
        • Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
    • North Carolina
      • Goldsboro、North Carolina、美国、27534
        • Wayne Memorial Hospital, Incorporated
      • Hendersonville、North Carolina、美国、28791
        • Pardee Memorial Hospital
    • North Dakota
      • Bismarck、North Dakota、美国、58501
        • Bismarck Cancer Center
      • Bismarck、North Dakota、美国、58501
        • Medcenter One Hospital Cancer Care Center
      • Bismarck、North Dakota、美国、58501
        • Mid Dakota Clinic, PC
      • Bismarck、North Dakota、美国、58502
        • St. Alexius Medical Center Cancer Center
      • Fargo、North Dakota、美国、58122
        • CCOP - MeritCare Hospital
      • Fargo、North Dakota、美国、58122
        • MeritCare Broadway
      • Grand Forks、North Dakota、美国、58201
        • Altru Cancer Center at Altru Hospital
    • Ohio
      • Dayton、Ohio、美国、45405
        • Grandview Hospital
      • Dayton、Ohio、美国、45406
        • Good Samaritan Hospital
      • Dayton、Ohio、美国、45409
        • David L. Rike Cancer Center at Miami Valley Hospital
      • Dayton、Ohio、美国、45415
        • Samaritan North Cancer Care Center
      • Dayton、Ohio、美国、45420
        • CCOP - Dayton
      • Findlay、Ohio、美国、45840
        • Blanchard Valley Medical Associates
      • Franklin、Ohio、美国、45005-1066
        • Middletown Regional Hospital
      • Greenville、Ohio、美国、45331
        • Wayne Hospital
      • Kettering、Ohio、美国、45429
        • Charles F. Kettering Memorial Hospital
      • Troy、Ohio、美国、45373-1300
        • UVMC Cancer Care Center at Upper Valley Medical Center
      • Wilmington、Ohio、美国、45177
        • Clinton Memorial Hospital
      • Wright-Patterson Afb、Ohio、美国、45433-5529
        • United States Air Force Medical Center - Wright-Patterson
      • Xenia、Ohio、美国、45385
        • Ruth G. McMillan Cancer Center at Greene Memorial Hospital
    • Oklahoma
      • Tulsa、Oklahoma、美国、74136
        • Natalie Warren Bryant Cancer Center at St. Francis Hospital
    • Oregon
      • Milwaukie、Oregon、美国、97222
        • Providence Milwaukie Hospital
      • Portland、Oregon、美国、97216
        • Adventist Medical Center
      • Portland、Oregon、美国、97213-2967
        • Providence Cancer Center at Providence Portland Medical Center
      • Portland、Oregon、美国、97225
        • CCOP - Columbia River Oncology Program
      • Portland、Oregon、美国、97225
        • Providence St. Vincent Medical Center
    • South Dakota
      • Sioux Falls、South Dakota、美国、57105
        • Medical X-Ray Center, PC
      • Sioux Falls、South Dakota、美国、57117-5039
        • Sanford Cancer Center at Sanford USD Medical Center
    • Tennessee
      • Kingsport、Tennessee、美国、37662
        • Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center
    • Virginia
      • Danville、Virginia、美国、24541
        • Danville Regional Medical Center
    • Washington
      • Vancouver、Washington、美国、98668
        • Southwest Washington Medical Center Cancer Center
    • Wisconsin
      • La Crosse、Wisconsin、美国、54601
        • Franciscan Skemp Healthcare - La Crosse Campus
    • Wyoming
      • Casper、Wyoming、美国、82609
        • Rocky Mountain Oncology
      • Sheridan、Wyoming、美国、82801
        • Welch Cancer Center at Sheridan Memorial Hospital

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 120年 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

    • Mixed histology allowed if all components are consistent with NSCLC
    • Squamous cell histology allowed
  • Stage IV disease

    • Oligometastatic disease (M1 with 1-3 metastases)

      • Patients with M1 disease that involves intrapulmonary metastases are eligible provided ≤ 40% of the total lung volume receives ≥ 20 Gy of radiotherapy
  • Previously untreated disease OR achieved stable disease or partial response within 8 weeks after completion of 2-6 courses of standard platinum-based chemotherapy (administered every 3-4 weeks)
  • Pleural effusion allowed provided it is minimal
  • No history of or current brain metastases

    • Patients who have had up to 3 brain metastases allowed provided they have been treated with not signs of progression

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-1
  • Life expectancy ≥ 12 weeks
  • Platelet count ≥ 100,00/mm^3
  • Hemoglobin ≥ 9 g/dL
  • WBC ≥ 2,000/mm^3
  • Creatinine ≤ 2 times upper limit of normal
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to undergo radiotherapy, based on radiation oncology consultation
  • Willing and able to comply with study treatment
  • FEV_1 ≥ 1 L
  • No requirement for daily supplemental oxygen
  • No second primary malignancy, except for any of the following:

    • Carcinoma in situ of the cervix
    • Nonmelanoma skin cancer
    • History of low-grade (Gleason score ≤ 6) localized prostate cancer, even if diagnosed within the past 5 years
    • Stage I breast cancer that was treated within the past 5 years
    • Other malignancy that was diagnosed and definitely treated ≥ 5 years ago with no subsequent evidence of recurrence
  • No concurrent severe and/or uncontrolled medical condition, including any of the following:

    • Angina pectoris
    • Congestive heart failure within the past 3 months, unless LVEF > 40%
    • Myocardial infarction within the past 6 months
    • Cardiac arrhythmia
  • No clinically significant infection
  • No psychiatric illness or social situation that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior therapy for this cancer other than 2-6 courses of standard platinum-based chemotherapy with or without bevacizumab
  • No prior radiotherapy to the treatment sites (e.g., primary lesion, clinically involved nodes, or metastatic lesions)
  • No bevacizumab during and for 4 weeks after completion of radiotherapy
  • No concurrent systemic chemotherapy
  • No other maintenance systemic therapy during radiotherapy
  • No other concurrent investigational agents for the primary neoplasm
  • No concurrent intensity modulated radiotherapy
  • No concurrent prophylactic nodal radiotherapy

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

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)

武器和干预

参与者组/臂
干预/治疗
其他:Arm I
Patients undergo observation for 6 weeks.
Patients undergo observation for 6 weeks.
实验性的:Arm II
Patients undergo radiotherapy 5 days a week for 6 weeks to all sites of gross disease.
Patients undergo radiotherapy 5 days a week for 6 weeks.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Overall Survival
大体时间:Time from registration to death or last follow-up (up to 5 years)
Overall survival was defined as the time from registration to the date of death or last follow-up
Time from registration to death or last follow-up (up to 5 years)

次要结果测量

结果测量
措施说明
大体时间
Response Rate
大体时间:Up to 5 years
A confirmed tumor response was defined as a complete response (CR) or partial response (PR) noted as the objective status on 2 consecutive evaluations around 3 months apart. All participants with measurable disease (non-CR at baseline, etc.), meeting the eligibility criteria who have signed a consent form and have started the study were evaluable for response.
Up to 5 years
Progression-free Survival
大体时间:Time from registration to disease progression or death (up to 5 years)
Progression-free survival was defined as the time from randomization to the first of either death due to any cause or progression.
Time from registration to disease progression or death (up to 5 years)
Time to Disease Progression
大体时间:Time from registration to disease progression (up to 5 years)
Time to disease progression was defined as the time from randomization to the earliest date documentation of disease progression occurs. If a patient dies without a documentation of disease progression, the patient will be considered to have had tumor progression at the time of their death unless there is sufficient documented evidence to conclude no progression occurred prior to death.
Time from registration to disease progression (up to 5 years)
Time to Treatment Failure
大体时间:Up to 5 years
Time to treatment failure was defined as the time from the date of randomization to the date at which the patient was removed from treatment (Arm II) or no treatment (Arm I) due to progression, adverse events, or refusal.
Up to 5 years
Duration of Response
大体时间:Up to 5 years
Duration of response was defined for all evaluable patients who have achieved an objective response as the date at which the patient's earliest best objective status was first noted to be either a complete response (CR) or partial response (PR) to the earliest date progression was documented.
Up to 5 years

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:Steven E. Schild, MD、Mayo Clinic

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2008年10月1日

初级完成 (实际的)

2010年9月1日

研究完成 (实际的)

2010年9月1日

研究注册日期

首次提交

2008年10月17日

首先提交符合 QC 标准的

2008年10月17日

首次发布 (估计)

2008年10月20日

研究记录更新

最后更新发布 (实际的)

2017年3月6日

上次提交的符合 QC 标准的更新

2017年1月13日

最后验证

2017年1月1日

更多信息

与本研究相关的术语

其他研究编号

  • NCCTG-N0724
  • NCI-2009-00664 (注册表标识符:CTRP (Clinical Trials Reporting System))
  • CDR0000616868 (注册表标识符:PDQ (Physician Data Query))

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

clinical observation的临床试验

3
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