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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2300073458 |
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最近更新日期: Date of Last Refreshed on: |
2023-07-11 17:03:20 |
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注册时间: Date of Registration: |
2023-07-11 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
目标导向性肠内营养治疗在营养不良的食管癌患者围术期管理中的应用 |
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Public title: |
Goal-directed Enteral Nutritional Therapy for maLnourished Esophageal cancer patients during perioperative MANagement |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
目标导向性肠内营养治疗在营养不良的食管癌患者围术期管理中的应用 |
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Scientific title: |
Goal-directed Enteral Nutritional Therapy for maLnourished Esophageal cancer patients during perioperative MANagement |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
陈照丽 |
研究负责人: |
李印 |
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Applicant: |
Chen Zhaoli |
Study leader: |
Li Yin |
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申请注册联系人电话: Applicant telephone: |
+86 132 5051 0307 |
研究负责人电话:
Study leader's |
+86 132 5051 0307 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
13250510307@163.com |
研究负责人电子邮件: Study leader's E-mail: |
13250510307@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
北京朝阳区潘家园南里17号 |
研究负责人通讯地址: |
北京朝阳区潘家园南里17号 |
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Applicant address: |
17 Panjiayuan Nanli, Chaoyang District, Beijing |
Study leader's address: |
17 Panjiayuan Nanli, Chaoyang District, Beijing |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
中国医学科学院肿瘤医院 |
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Applicant's institution: |
Cancer Hospital, Chinese Academy of Medical Sciences |
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研究负责人所在单位: |
中国医学科学院肿瘤医院 |
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Affiliation of the Leader: |
Cancer Hospital, Chinese Academy of Medical Sciences |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
23/128-3870 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
国家癌症中心/中国医学科学院北京协和医学院肿瘤医院伦理委员会 |
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Name of the ethic committee: |
Ethics Committee of National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College |
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伦理委员会批准日期: Date of approved by ethic committee: |
2023-06-07 00:00:00 | ||
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伦理委员会联系人: |
徐震纲 |
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Contact Name of the ethic committee: |
Xu Zhengang |
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伦理委员会联系地址: |
北京朝阳区潘家园南里17号 |
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Contact Address of the ethic committee: |
17 Panjiayuan Lane South, Chaoyang District, Beijing |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 8778 8495 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
Cancergcp@163.com |
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研究实施负责(组长)单位: |
中国医学科学院肿瘤医院 |
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Primary sponsor: |
Cancer Hospital, Chinese Academy of Medical Sciences |
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研究实施负责(组长)单位地址: |
北京朝阳区潘家园南里17号 |
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Primary sponsor's address: |
17 Panjiayuan Lane South, Chaoyang District, Beijing |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
研究者发起的临床试验 |
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Source(s) of funding: |
Investigator-initiated clinical trials |
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研究疾病: |
食管癌患者 |
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Target disease: |
Esophageal cancer patients |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
IV期临床试验 | ||||||||||||||||||||||
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Study phase: |
4 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
本研究拟明确以每日热量目标为导向性个体化营养支持策略对存在营养风险的食管癌患者围术期治疗期间的安全性及有效性;通过补充速熠素能否有效降低围术期并发症发生率 |
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Objectives of Study: |
This study aims to determine the safety and effectiveness of individualized nutrition support strategy guided by daily calorie target in perioperative treatment of patients with nutritional risk of esophageal cancer. Whether the incidence of perioperative complications can be effectively reduced by supplementing immune nutrition preparation (Impact oral) |
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药物成份或治疗方案详述: |
Oral Impact 自上世纪90年代首次上市,已在全球30多个国家和地区上市,进行了60多项临床研究,其中16项为在亚洲展开的研究。受试人员主要为头颈部、胸腹部实体肿瘤围手术期及放化疗患者。这些研究对Impact的安全性、营养充足性、有效性都进行评估,另外有15项meta分析及1篇综述对Impact进行了综合评价。它是目前全球唯一同时含有精氨酸、n-3脂肪酸和核苷酸这三大免疫营养素的专利配方,被国内国外指南广泛推荐。 速熠素是在保留了Oral Impact核心经典配方的基础上,降低糖分提高蛋白质含量,经过三年的随机对照研究正式获批在中国上市的第一款,也是目前唯一一款肿瘤患者专用的营养品(特殊医学用途配方食品).良好的免疫应答对肿瘤术后康复尤其是伤口愈合至关重要,在肿瘤大手术术后的早期机体会处于一个免疫抑制期 。研究证实患者的免疫功能可在大约术后2周的时间恢复,而这种免疫抑制的状态可增加了肿瘤手术患者发生感染性并发症的几率 ,若再合并营养不良导致细胞复制所需的必需营养素如核苷酸、氨基酸、脂肪酸等营养素缺乏,可进一步削弱免疫系统。围手术期给予免疫营养的概念就是提供必要的营养素,以促进术后充分的免疫反应。研究证实单一免疫营养素的临床获益往往有限,而速熠素特有的三大免疫营养素(精氨酸、n-3不饱和脂肪酸和核苷酸)的临床获益已被超过60项的临床研究证实,被国内国外指南广泛推荐。 入组病例:共入组400例食管鳞癌患者(其中200例为目标导向性营养支持试验组,另外200例为对照组) 观察时间:术前新辅助治疗期间(术前42-63天)+手术期+术后辅助治疗及随访期(90天) 方法:符合入组标准的受试者将按照1:1比例进行随机分组,其中包括:(A)试验组,术前新辅助治疗期及围术期治疗期间,受试者遵循目标导向性营养支持策略进行营养管理,并且仅选择速熠素(IMPACT Oral?)作为营养制剂;(B)对照组,术前新辅助治疗期及围术期治疗期间,受试者遵循常规营养支持策略管理,但是选择非速熠素(IMPACT Oral?)作为营养制剂。试验组目标导向性营养支持策略简述为:根据受试者理想体重计算每日热量、蛋白质及微量元素补充目标,按照每72小时评估是否达标,每7~10日改变干预措施级别的原则,进行个性化营养管理。 |
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Description for medicine or protocol of treatment in detail: |
Oral Impact has been available in more than 30 countries and regions since it was first marketed in the 1990s and has conducted more than 60 clinical studies, including 16 in Asia. The subjects were mainly patients with head, neck, chest and abdomen solid tumors in perioperative period and radiotherapy and chemotherapy. These studies evaluated the safety, nutritional adequacy, and effectiveness of Impact. In addition, 15 meta-analyses and 1 review comprehensively evaluated Impact. At present, it is the world's only patented formula containing arginine, n-3 fatty acids and nucleotides at the same time, which is widely recommended by domestic and foreign guidelines.Impact oral is the first nutritional product (formula food for special medical use) for cancer patients that has been officially approved to be marketed in China after three years of randomized controlled study on the basis of retaining the Oral Impact core formula, reducing sugar and improving protein content. Good immune response is very important for postoperative rehabilitation of tumor, especially wound healing. In the early stage after major tumor surgery, the body will be in a period of immunosuppression. Studies have confirmed that the immune function of patients can be recovered in about 2 weeks after surgery, and this immunosuppressed state can increase the risk of infectious complications in patients undergoing tumor surgery. If combined malnutrition leads to the deficiency of essential nutrients for cell replication, such as nucleotides, amino acids, fatty acids and other nutrients, it can further weaken the immune system. The concept of perioperative immunonutrition is to provide the necessary nutrients to promote an adequate postoperative immune response. Studies have proved that the clinical benefits of a single immunonutrient are often limited, while the clinical benefits of the three unique immunonutrients of Almanit (arginine, n-3 unsaturated fatty acids and nucleotides) have been confirmed by more than 60 clinical studies and widely recommended by domestic and foreign guidelines. Enrolled cases: A total of 400 patients with esophageal squamous cell carcinoma were enrolled (including 200 patients in the target-oriented nutrition support test group and 200 patients in the control group). Observation time: preoperative neoadjuvant therapy period (preoperative 42-63 days) + operative period + postoperative adjuvant therapy and follow-up period (90 days) Methods: Subjects who met the enrollment criteria were randomly divided into 1:1 groups, including: (A) experimental group, during preoperative neoadjuvant treatment and perioperative treatment, subjects followed the target-oriented nutrition support strategy for nutrition management, and only IMPACT Oral? was selected as nutritional preparation; (B) Control group, during preoperative neoadjuvant treatment and perioperative treatment, subjects followed the conventional nutritional support strategy management, but chose IMPACT Oral? as the nutritional preparation. The goal-oriented nutrition support strategy of the experimental group was summarized as follows: daily calorie, protein and trace element supplementation targets were calculated according to the ideal body weight of the subjects, and personalized nutrition management was carried out according to the principle of assessing whether the targets were met every 72 hours and changing the level of intervention measures every 7 to 10 days. |
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纳入标准: |
1) 年龄18~80岁,男女不限; 2) 体力状况ECOG PS 0~1; 3) NRS 2002评分≥3; 4) 符合GLIM标准规定营养不良; 5) 术前组织病理学确诊为胸段食管鳞癌; 6) 临床分期为II~IVA期(第8版UICC/AJCC),经多学科评估可切除的局部晚期食管癌; 7) 计划行术前新辅助治疗,包括术前放化疗、化疗或联合免疫治疗(抗PD-1/PD-L1); 8) 受试者理解并签署知情同意书。 |
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Inclusion criteria |
1) Age 18-80 years old, male or female; 2) Physical status ECOG PS 0~1; 3) NRS 2002 score ≥3; 4) Malnutrition in line with GLIM standards; 5) Preoperative histopathological diagnosis of thoracic esophageal squamous cell carcinoma; 6) Resectable locally advanced esophageal cancer with clinical stage II to IVA (8th edition UICC/AJCC) evaluated by multiple disciplines; 7) Preoperative neoadjuvant therapy is planned, including preoperative chemoradiotherapy, chemotherapy or combined immunotherapy (anti-PD-1 /PD-L1); 8) The subject understands and signs the informed consent. |
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排除标准: |
1) 未接受术前新辅助治疗,直接行食管癌根治术; 2) 术前营养风险较低,NRS 2002评分< 3; 3) 合并严重影响试验用品消化吸收的内科疾病; 4) 正在使用其它可能影响试验效果的营养制剂; 5) 妊娠期、哺乳期女性受试者或有生育能力女性的基线妊娠试验检测阳性受试者; 6) 手术前期无法口服或无法通过管饲摄入营养; 7) 过去5年中(除成功治疗的原位基底细胞皮肤肿瘤以及原位宫颈肿瘤)患其他恶性肿瘤; 8) 已知存在肝、肾功能异常(丙氨酸氨基转移酶ALT≥2倍正常值上限;总胆红素Tbil≥2倍正常值上限;肌酐Cr≥2倍正常值上限); 9) 已知患有未受控制的糖尿病或空腹血糖≥10mmol/L; 10) 已知患有甲状腺功能减退或甲状腺功能亢进病史; 11) 受试者正在使用含Omega-3脂肪酸的脂肪乳、谷氨酰胺、胸腺肽、糖皮质激素、甲状腺素、生长激素、抗肿瘤坏死因子生物制剂; 12) 已知对研究产品的任何成分有过敏史; 13) 受试者拒绝知情同意或无法遵照研究方案治疗; 14) 研究者认为不适于参加本研究。 |
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Exclusion criteria: |
1) Radical resection of esophageal cancer was performed without preoperative neoadjuvant therapy; 2) Preoperative nutritional risk was lower, NRS 2002 score < 3; 3) Combined with medical diseases that seriously affect the digestion and absorption of test products; 4) Other nutritional preparations that may affect the test effect are being used; 5) Pregnant, lactating female subjects or fertile female subjects with positive baseline pregnancy test; 6) Unable to take in nutrition orally or through tube feeding before surgery; 7) Other malignant tumors in the past 5 years (except for successfully treated basal cell skin tumors in situ and cervical tumors in situ); 8) Known abnormalities of liver and kidney function (alanine aminotransferase ALT≥2 times the upper limit of normal; Total bilirubin Tbil≥2 times the upper limit of normal value; Creatinine Cr≥2 times the upper limit of normal value); 9) Known to have uncontrolled diabetes or fasting blood glucose ≥10mmol/L; 10) Known history of hypothyroidism or hyperthyroidism; 11) Subjects are using fatty milk containing Omega-3 fatty acids, glutamine, thymosin, glucocorticoid, thyroxine, growth hormone, and anti-tumor necrosis factor biologic agents; 12) a known history of allergy to any component of the investigational product; 13) The subject refuses informed consent or is unable to follow the study protocol; 14) The researchers do not consider it appropriate to participate in this study. |
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研究实施时间: Study execute time: |
从 From 2023-07-11 00:00:00至 To 2025-07-11 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2023-07-11 00:00:00 至 To 2023-09-11 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
正在进行 Recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
分层随机:根据男女,疾病的分期,参与的中心,使用线上随机软件由各中心主要研究者进行入组患者随机 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Stratified randomization: Patients were randomized according to men and women, disease stage, and participating centers using online randomization software by the principal investigator of each center |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
NONE |
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Blinding: |
NONE |
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
no |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
no |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
电子采集和管理系统 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Electronic Data Capture, EDC |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |