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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05801666
Other study ID # CMU111-S-34
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date February 10, 2023
Est. completion date January 2024

Study information

Verified date May 2023
Source China Medical University, Taiwan
Contact Peiyu Kao
Phone 886-4-22052121
Email D20621@mail.cmuh.org.tw
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Esophagus cancer patients are at risk for malnourishment. Feeding jejunostomy is used in advanced esophagus cancer patients in order to support and supplement the patient's nutrition needs. In dumping syndrome, the food is rapidly introduced into the intestine at a rate that is faster than normal, it is associated with both digestive system and vasoactive symptoms. Dumping syndrome has an association with both esophagus cancer patients and feeding jejunostomy. In the mid and long term, dumping syndrome is an important issue that contributes to the risk of malnourishment in advanced esophagus cancer patients. Acupuncture effect on digestive symptoms was widely investigated with effective abilities to regulate and reduce digestive symptoms. Acupuncture is also considered a safe intervention for cancer patients. A total of 60 advanced esophageal cancer patients will be divided into two equal groups, the intervention group (n=30) and the control groups (n=30). Patients in the Intervention group will receive acupuncture using the following acupoints: ST36 (Zusanli), ST37 (Shangjuxu), ST39 (Xiajuxu), PC6 (Neiguan), and LI4 (Hegu) liv 3 (Taichung). Patients and assessors will be blind to trial allocation. The patients in the Control group will receive shallow acupuncture on 12 non-acupoints (sham points). Both groups will receive acupuncture twice a week for 6 weeks. The main outcome measurements are body weight, BMI, the Sigstad's score and the Arts' dumping questionnaire, 3 and 6 months mortality.


Description:

The direct effect of acupuncture on dumping syndrome was not previously well investigated. The goal of this randomized control clinical trial is to investigate the effect of acupuncture on dumping syndrome in esophagus cancer patients with jejunostomy tube feeding. We hypothesize that acupuncture will have a regulatory effect on dumping syndrome. This research will investigate a possible cooperation and integration approach of both western and Chinese medicine in esophagus cancer treatment. In this integration, each treatment method focus on its strength (western medicine in tumor treatment and Chinese medicine in digestion symptoms) in order to improve the patient's condition and quality of life. This research will shed more light on the effectiveness of acupuncture as an intervention on both esophagus cancer patients and dumping syndrome. In case that the study findings will be in favor of acupuncture, it will provide a valuable, low cost supportive therapeutic option for advanced esophagus cancer patients with dumping syndrome. This study will be conducted in the china medical university hospital in Taichung City, Taiwan, department of chest surgery. The study will be initiated after IRB approval and will be concluded until January 2024. Informed consent will be obtained prior to patient's enrollment. The 2 groups are an intervention group and a control group. A total of 60 esophagus cancer patients with feeding jejunostomy from china medical hospital from the department of chest surgery. will be divided equally to 30 patients in each group after meeting the study inclusion criteria and informed consent. 60 patients from the china medical university will be divided into 2 groups. In both the ACU group and CON group, A qualified acupuncture doctor with at least 2 years of clinical experience will provide the intervention sessions on both groups. The acupuncture frequency will be 2 times a week for 6 weeks in both groups. Both groups will also receive routine western medicine treatments. In addition to routine western medicine treatments, patients in the intervention group will also receive daily bilateral traditional Chinese medicine style acupuncture on the following acupuncture points: ST36 (Zusanli), ST37 (Shangjuxu), ST39 (Xiajuxu), PC6 (Neiguan), and LI4 (Hegu) liv 3(Taichung). The acupoints indications in this group are specific to treat indigestion-related conditions. The effectiveness of those points in treating digestion (with exception of liv 3(Taichung)) was shown in our previous research. The treatment will take place once a day, for 2 times a week for 6 weeks. A total of 12 needles will be used in each session. Acupuncture treatment will be performed with sterile needles manufactured by "Yu Kuang" acupuncture needles 40mm with 30G. The patients in the control group will receive a bilateral shallow acupuncture (12 needles) on the sham points that are located 1 cm lateral/medial and 1 cm distal/proximal to the following acupoints: ST36 (Zusanli), ST37 (Shangjuxu), ST39 (Xiajuxu), PC6 (Neiguan), and LI4 (Hegu) liv 3 (Taichung) (figure 3). Those points are not indicated to treat digestion in Chinese medicine and in a location of 1 cm lateral/medial and 1 cm distal/proximal to those points there is no acupuncture point. The needle insertion will be a perpendicular shallow insertion into the skin tissue level. The acupuncture doctor will use the needle with tube insertion for needle insertion and will leave the needle in the depth of the tube insertion (approximately 4 mm depth into the skin) without needle manipulation. Needle retention time will be 30 minutes. In addition to the sham points, the patients in this group will also receive routine western medicine treatment as per each patient's needs. The treatment frequency and skin disinfection will be identical to the treatment group. Main outcome measurements are: body weight, Body Mass Index (BMI) (will be measured weekly) dumping syndrome questioners: the Sigstad's score and the Arts' dumping questionnaire (will be measured on the baseline, week3, week 6). The secondary outcomes are: muscle grip strength test (measured weekly) blood test: Complete Blood Count (CBC), kidney and electrolytes (measured as Adjuvant Concurrent Chemoradiation Therapy (CCRT) schedule), pre-albumin, albumin level, glucose blood levels, inflammation data including Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) (measured at baseline and on week 6). Total Intensive care unit (ICU) stay, total hospital stay, total mechanical ventilation in days, will be measured 6 months after inclusion. Mortality will be measured at 3 months, 6 months. Medical charts and drug use will also be measured.


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date January 2024
Est. primary completion date January 2024
Accepts healthy volunteers No
Gender All
Age group 20 Years to 80 Years
Eligibility Inclusion Criteria: - Advanced esophageal cancer - Post feeding jejunostomy - Plan of CCRT for esophageal cancer Exclusion Criteria: - Acute infection - Unstable vital signs - Other medical conditions which would affect nutrition status

Study Design


Intervention

Other:
Acupuncture
Acupuncture 5 points

Locations

Country Name City State
Taiwan China Medical University Hospital Taichung

Sponsors (1)

Lead Sponsor Collaborator
China Medical University, Taiwan

Country where clinical trial is conducted

Taiwan, 

Outcome

Type Measure Description Time frame Safety issue
Primary Body Weight Unit: kg baseline
Primary Body Weight Unit: kg week1
Primary Body Weight Unit: kg week2
Primary Body Weight Unit: kg week3
Primary Body Weight Unit: kg week4
Primary Body Weight Unit: kg week5
Primary Body Weight Unit: kg week6
Primary Body Height Unit: cm baseline
Primary Body Height Unit: cm week1
Primary Body Height Unit: cm week2
Primary Body Height Unit: cm week3
Primary Body Height Unit: cm week4
Primary Body Height Unit: cm week5
Primary Body Height Unit: cm week6
Primary Body Mass Index BMI:kg/m*2 baseline
Primary Body Mass Index BMI:kg/m*2 week1
Primary Body Mass Index BMI:kg/m*2 week2
Primary Body Mass Index BMI:kg/m*2 week3
Primary Body Mass Index BMI:kg/m*2 week4
Primary Body Mass Index BMI:kg/m*2 week5
Primary Body Mass Index BMI:kg/m*2 week6
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) baseline
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week1
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week2
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week3
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week4
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week5
Primary Sigstad's score Sigstad's score: diagnostic index >7 is suggestive of dumping syndrome. whereas a score <4 suggests that other diagnoses should be considered.(Shock +5, syncope/unconsciousness +4, Desire to lie or sit down +4, dyspnoea +3, Weakness/exhaustion +3, Sleepiness/drowsiness +3, Palpitation +3, Restlessness +2, Dizziness +2, Headaches +1, Feeling of warmth /sweating +1, Nausea +1, Abdominal fullness +1, Borborygmus +1, Eructation -1, Vomiting -4) week6
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. baseline
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 1
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 2
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 3
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 4
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 5
Primary Arts' Dumping Questionnaire Each symptom is scored for severity on a 0-3 Likert scale (0=absent, 1=mild, 2=relevant and 3=severe), the total severity score for dumping syndrome is the sum of severities of all symptoms. week 6
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg baseline
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week1
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week2
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week3
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week4
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week5
Secondary Muscle grip strength test Electronic Hand Dyanmometer(EH101)), Unit: kg, Max Capacity: 90kg week6
Secondary Complete Blood Count (CBC)-WBC Unit:1000/µL baseline
Secondary Complete Blood Count (CBC)-WBC Unit:1000/µL week 6
Secondary Complete Blood Count (CBC)-RBC Unit:million/µL, baseline
Secondary Complete Blood Count (CBC)-RBC Unit:million/µL, week 6
Secondary Complete Blood Count (CBC)-Hemoglobin Unit:g/dL baseline
Secondary Complete Blood Count (CBC)-Hemoglobin Unit:g/dL week 6
Secondary Complete Blood Count (CBC)-Hematocrit Unit: % baseline
Secondary Complete Blood Count (CBC)-Hematocrit Unit: % week 6
Secondary Complete Blood Count (CBC)-MCV Unit: fL baseline
Secondary Complete Blood Count (CBC)-MCV Unit: fL week 6
Secondary Complete Blood Count (CBC)-MCH Unit: pg/cell baseline
Secondary Complete Blood Count (CBC)-MCH Unit: pg/cell week 6
Secondary Complete Blood Count (CBC)-MCHC Unit: g/dL baseline
Secondary Complete Blood Count (CBC)-MCHC Unit: g/dL week 6
Secondary Complete Blood Count (CBC)-RDW Unit: % baseline
Secondary Complete Blood Count (CBC)-RDW Unit: % week 6
Secondary Complete Blood Count (CBC)-Platelet Unit: 1000/µL baseline
Secondary Complete Blood Count (CBC)-Platelet Unit: 1000/µL week 6
Secondary Complete Blood Count (CBC)-PDW Unit: fL baseline
Secondary Complete Blood Count (CBC)-PDW Unit: fL week 6
Secondary Complete Blood Count (CBC)-MPV Unit: fL baseline
Secondary Complete Blood Count (CBC)-MPV Unit: fL week 6
Secondary Kidney and Electrolytes-eGFR Unit: mL/min/1.73m*2 baseline
Secondary Kidney and Electrolytes-eGFR Unit: mL/min/1.73m*2 week 6
Secondary Kidney and Electrolytes-Creatinine Unit: mg/dL baseline
Secondary Kidney and Electrolytes-Creatinine Unit: mg/dL week 6
Secondary Kidney and Electrolytes-ACR Unit: mg/g baseline
Secondary Kidney and Electrolytes-ACR Unit: mg/g week 6
Secondary Kidney and Electrolytes-Urea Unit: g/day baseline
Secondary Kidney and Electrolytes-Urea Unit: g/day week 6
Secondary Kidney and Electrolytes-Uric Acid Unit: mg/dL baseline
Secondary Kidney and Electrolytes-Uric Acid Unit: mg/dL week 6
Secondary Kidney and Electrolytes-Potassium Unit: mEq/L baseline
Secondary Kidney and Electrolytes-Potassium Unit: mEq/L week 6
Secondary Kidney and Electrolytes-Sodium Unit: mEq/L baseline
Secondary Kidney and Electrolytes-Sodium Unit: mEq/L week 6
Secondary Kidney and Electrolytes-Calcium Unit: mg/dL baseline
Secondary Kidney and Electrolytes-Calcium Unit: mg/dL week 6
Secondary Kidney and Electrolytes-Phosphate Unit: mg/dL baseline
Secondary Kidney and Electrolytes-Phosphate Unit: mg/dL week 6
Secondary Pre-Albumin Unit: mg/dL baseline
Secondary Pre-Albumin Unit: mg/dL week 6
Secondary Albumin level Unit: g/dL baseline
Secondary Albumin level Unit: g/dL week 6
Secondary Glucose blood levels Unit: mg/dL baseline
Secondary Glucose blood levels Unit: mg/dL week 6
Secondary Erythrocyte Sedimentation Rate (ESR) Unit: mm/h baseline
Secondary Erythrocyte Sedimentation Rate (ESR) Unit: mm/h week 6
Secondary C-reactive Protein (CRP) Unit: mg/L baseline
Secondary C-reactive Protein (CRP) Unit: mg/L week 6
Secondary Total Intensive care unit (ICU) stay, total hospital stay, total mechanical ventilation in days Hospital satistics measured at 6 months
Secondary Mortality Hospital statistics measured at 3 months, 6 months
Secondary Medical charts and drug use. Hospital statistics measured at 3 months, 6 months
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