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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03643614
Other study ID # RU SUSMU 310855.210617.1
Secondary ID
Status Completed
Phase Phase 1
First received
Last updated
Start date August 1, 2017
Est. completion date January 22, 2020

Study information

Verified date January 2020
Source South Ural State Medical University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A new strategy for treatment of late radiation damage is to develop methods aimed at stimulating the regenerative capabilities of irradiated tissues. Since the main pathogenetic mechanism of the development of late radiation damage is the death or damage of the replicative mechanism of stromal cells (SC), a justified approach can be considered as transplantation of intact SC. Currently, there is convincing evidence in the scientific literature that the injection of intact autologous SCs into the zone of fibrosis surrounding the chronic radiation ulcer leads to the healing of a wound defect.

An Initiative Clinical Trial. Introduction of autologous regenerative cells of adipose tissue for the treatment of post-irradiation vaginal-rectal fistula. It is assumed that patients will be included in the project within 12 months; the monitoring of each patient will last for 6 months; the total duration of the clinical part of the study will be 18 months; The total duration of the clinical trial including the preparatory phase and the writing of the report is about 24 months. It is assumed that at least 16 patients aged 20 to 75 years who have verified diagnosis of post-irradiation vaginal-rectal fistula will participate in this pilot project. The aims of the clinical trial are to preliminarily assess the safety, effectiveness and quality of life of patients after introducing autologous regenerative cells of adipose tissue for the treatment of post-irradiation vaginal-rectal fistula.


Recruitment information / eligibility

Status Completed
Enrollment 16
Est. completion date January 22, 2020
Est. primary completion date November 15, 2019
Accepts healthy volunteers No
Gender Female
Age group 20 Years to 75 Years
Eligibility Inclusion Criteria:

- Diagnosis of radiation-induced rectovaginal fistula established at least six months after radiation therapy

- Absence of oncological disease relapse during whole observation period

- Absence of rectal and anal cancer

- Patient have read and signed informed consent

Exclusion Criteria:

- Contraindications for local/general anesthesia or a history of anesthetic medicines allergy

- Acute hemorrhoid or anal fissure

- Acute purulent paraproctitis

- Inflammatory colon diseases

- History of extensive posttraumatic or postoperative alterations which causes obstacles to follow protocol examination

- Chronic sub- or decompensated internal organs diseases

- Clinically significant laboratory tests abnormalities

- Conditions that limits patient compliance (dementia, psycho-neurological diseases, drug abuse, alcohol abuse etc.)

- Patients involved in other clinical trials or taking medications under research during last three months

- Cancer patients including postoperative chemo- or/and radiotherapy at least three months after surgery

- Patients with increased activated partial thromboplastin time level 1,8 times above normal

- Patients who take anticoagulants or took anticoagulants at least one month before including into trial

- Patients who take or took before investigation glycoprotein inhibitors IIB/IIIA

- Patients with history of taking medications that influence fatty tissue structure

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Injection of autologous regenerative cells of adipose tissue
Autologous regenerative cells of adipose tissue obtained by enzymatic digestion of lipoaspirate are injected diffusively in the submucosal plane of the rectum and vagina with a sharp 27G needle. Adipose tissue that has not been subjected to enzymatic processing is injected through the punctures on the skin into the deep layers of the rectovaginal septum by means of cannula of 1.0-1.2 mm in diameter, 70 mm in length, 0.1-0.2 ml in one retrograde pass of the cannula.

Locations

Country Name City State
Russian Federation South Ural State Medical University Chelyabinsk Chelyabinsk Oblast

Sponsors (1)

Lead Sponsor Collaborator
South Ural State Medical University

Country where clinical trial is conducted

Russian Federation, 

Outcome

Type Measure Description Time frame Safety issue
Primary Serious adverse events Frequency, type and severity of serious adverse events (SAE) 4 weeks after injection of adipose-derived regenerative cells
Primary Serious adverse reactions Frequency, type and severity of serious adverse reactions (SAR) 4 weeks after injection of adipose-derived regenerative cells
Secondary Changes of fistula size Intervention impact on dimensions of rectovaginal fistula 48 weeks after intervention
Secondary Changes in rectovaginal soft tissue density and flexibility Intervention impact on soft tissue density and flexibility assessed by ultrasound elastography 48 weeks after intervention
Secondary Quality of life monitoring - 1 Quality of life estimated by validated questionnaire: The Short Form (36) Health Survey (SF-36). SF-36 is a 36-item, patient-reported survey of patient health.
The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
The eight sections are:
vitality
physical functioning
bodily pain
general health perceptions
physical role functioning
emotional role functioning
social role functioning
mental health
48 weeks after intervention
Secondary Quality of life monitoring - 2 Quality of life estimated by validated questionnaire. European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30 with module for proctitis-23 is a questionnaire developed to assess the proctitis-specific quality of life of cancer patients. Each subscale values varies from 1 to 4. Lower values represents better life quality. Total score is computed by summarizing of subscales. 48 weeks after intervention
See also
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Not yet recruiting NCT05709717 - Regenerative Therapy With Autologous Stromal Vascular Fraction Derived Mesenchymal Stem Cells and Platelet-rich Plasma to Treat Complex Perianal Diseases
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Active, not recruiting NCT04940611 - A Study of Surgical Interventions in Fistulizing Conditions