Pediatric Cancer Clinical Trial
Official title:
Mucositis and Infection Reduction With Liquid Probiotics in Children With Cancer: a Randomised-controlled Feasibility Study
The aim of this study is to evaluate the feasibility of an randomised-controlled trial to investigate the efficacy of liquid probiotics to prevent or reduce mucositis and infection in children diagnosed with cancer who are undergoing treatment with regimes likely to cause mucositis.
TRIAL DESIGN
This will be a single-centre double-blind randomised-controlled feasibility study.
TRIAL SETTING
This study will take place at Leeds Teaching Hospital Trust (LTHT), Leeds UK. Participants
will be approached whilst admitted as inpatients (typically the paediatric haematology
oncology wards) and during outpatient clinics.
METHOD
Allocation sequence from a randomisation schedule will be generated A screening or trial ID
number will be assigned to each participant.
The allocation sequence will be concealed from health care professionals, participants and
families. Only the pharmacy team involved in randomisation, allocation will not be blinded to
allocation sequence and generation.
Following identification, confirmation of eligibility, consent and allocation of trial ID of
the participant, a prescription will be produced and the probiotic or placebo will be
allocated accordingly.
Appearance of the intervention and placebo will be similar in appearance, smell and taste.
The placebo will include maltdextrin (a polysaccharide). Both the probiotic and placebo will
be produced by the company Symprove.
Participants will start the course of probiotic or placebo on the first day of their course
of chemotherapy orally, or using an nasogastric or gastrostomy tube and will continue this
for 14 days. Doses will be adjusted according to the age of the participant as follows:
1-4 years:20ml once a day 4-11 years: 0.5ml/kg once a day 12-18 years: 1ml/kg once a day
Placebo will be delivered in similar, packaging, appearance and taste.
Participants or their parents will be asked to fill in a diary (paper or electronic using a
web-app) daily for 21 days in total. The diary will include questions to assess nausea,
vomiting, diarrhoea, pain and oral mucositis. An example of the patient diaries offered is
supplied. Either the participant or parent will fill in the diary on a daily basis for a
minimum of 21 days.
The web-app is an electronic version of the paper diary. Participants will to chose their
preferred method. Participants will be given the URL which they can download onto their phone
as a web-app. Data provided by participants in the web-app will only be identified by their
unique identification number and information will be transferred to an excel spread sheet.
Clinical records including electronic and written records will be reviewed to investigate any
febrile episodes and infections for incidence and duration of fever/infection and duration of
hospital stay until afebrile for 48 hrs. Any data collected from clinical records will be
stored on an excel web sheet which will be kept on an NHS computer. Data on the excel
spreadsheet will be identified using their unique identification number. Data will be
collected and analysed on an NHS computer. The person collecting the data (the principal
investigator) is also a member of the health care team and has access to clinical records as
part of routine care.
Participants will be invited to participate in an optional interview exploring their
experiences in taking part in the study. This will take up to 45 minutes and can be done over
the phone or in person whilst in the hospital. The interviews will be recorded using an
encrypted digital audio recorder.
Participants who chose to decline will also be invited to a short optional interview
exploring why they chose to decline. This will approximately be a 10 minute discussion which
will take place when the participant/their parent disclose they have decided to decline and
will only take place if both the participant/parent and interviewer (the chief investigator)
is present in the hospital.
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