Head and Neck Cancer Clinical Trial
Official title:
Endoscopy Screening for Esophageal Neoplasm With Narrow Band Imaging in Patients With Head and Neck Cancer: A Controlled Tandem Endoscopy Trial
Patients with head and neck cancer frequently develop synchronous or metachronous esophageal
malignancies. Previous studies have demonstrated the efficacy of endoscopic screening for
esophageal cancer in head and neck cancer patients. The Narrow Band Imaging (NBI) system, an
optical technology that enhances the visualization of superficial vascular network, may be
superior to the conventional white light endoscopy for the detection of neoplastic lesions.
However, whether the application of NBI improves the detection results have not been
critically evaluated.
This study aims to investigate the diagnostic value of the NBI system in the endoscopic
screening for esophageal neoplastic lesions in patients with head and neck cancer.
This is a prospective blinded controlled tandem endoscopy trial conducted in a regional
medical center (Lotung Poh-Ai Hospital, Taiwan). Patients with tissue diagnosis of head and
neck cancer are enrolled. Endoscopy screening for esophageal lesions is first performed by
using the conventional white light system. Suspicious lesions are recorded. Then the entire
esophagus is examined under the NBI system by another endoscopist, who is blinded to the
result of the conventional endoscopy. After the endoscopic inspection completed, all
suspicious lesions are biopsied. Before each procedure, which one of the two participating
endoscopists applies the conventional or NBI system is randomized. The diagnostic rate of
esophageal neoplasm by the conventional white light system and that of the NBI system are
compared.
The endpoint is the neoplastic lesion detected on endoscopic biopsy. We considered invasive
cancer, carcinoma in-situ, and high-grade dysplasia (which usually cannot be distinguished
from carcinoma in situ) as the primary points. Any dysplastic lesions were considered as
secondary points.
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Observational Model: Cohort, Time Perspective: Cross-Sectional
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