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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: |
ChiCTR2500101075 |
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最近更新日期: Date of Last Refreshed on: |
2025-04-18 16:33:54 |
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注册时间: Date of Registration: |
2025-04-18 00:00:00 |
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注册号状态: |
补注册 |
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Registration Status: |
Retrospective registration |
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注册题目: |
手术切除序贯仑伐替尼联合替雷利珠单抗与TACE、仑伐替尼联合替雷利珠单抗治疗可手术切除肝癌伴门脉癌栓患者的多中心随机对照试验 |
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Public title: |
Multicenter Randomized Controlled Trial of Sequential Surgery Followed by Lenvatinib Combined with Tislelizumab Compared to Transarterial Chemoembolization (TACE) and Lenvatinib Combined with Tislelizumab for Treating Patients with Hepatocellular Carcinoma with Venous Tumor Thrombus Who Are Eligible for Surgical Resection |
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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: |
手术切除序贯仑伐替尼联合替雷利珠单抗与TACE、仑伐替尼联合替雷利珠单抗治疗可手术切除肝癌伴门脉癌栓患者的多中心随机对照试验 |
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Scientific title: |
Multicenter Randomized Controlled Trial of Sequential Surgery Followed by Lenvatinib Combined with Tislelizumab Compared to Transarterial Chemoembolization (TACE) and Lenvatinib Combined with Tislelizumab for Treating Patients with Hepatocellular Carcinoma with Venous Tumor Thrombus Who Are Eligible for Surgical Resection |
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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: |
陶其飞 |
研究负责人: |
周伟平 |
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Applicant: |
Tao Qifei |
Study leader: |
Zhou Weiping |
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申请注册联系人电话: Applicant telephone: |
+86 183 2178 6380 |
研究负责人电话: Study leader's telephone: |
+86 136 0161 6763 |
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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: |
tqftxl@163.com |
研究负责人电子邮件: Study leader's E-mail: |
ehphwp@126.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: |
上海市杨浦区长海路225号 |
研究负责人通讯地址: |
上海市杨浦区长海路225号 |
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Applicant address: |
225 Changhai Road, Yangpu District, Shanghai, China |
Study leader's address: |
225 Changhai Road, Yangpu District, Shanghai, China |
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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: |
海军军医大学第三附属医院 |
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Applicant's institution: |
Third Affiliated Hospital of Naval Medical University |
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研究负责人所在单位: |
海军军医大学第三附属医院 |
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Affiliation of the Leader: |
Third Affiliated Hospital of Naval Medical University |
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是否获伦理委员会批准: |
是/Yes |
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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: |
EHBHKY2024-H011-P001 |
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: |
海军军医大学第三附属医院伦理学委员会 |
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Name of the ethic committee: |
Ethics Committee of Third Affiliated Hospital of Naval Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2024-04-25 00:00:00 |
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伦理委员会联系人: |
邰小云 |
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Contact Name of the ethic committee: |
Tai Xiaoyun |
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伦理委员会联系地址: |
上海市杨浦区长海路225号 |
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Contact Address of the ethic committee: |
225 Changhai Road, Yangpu District, Shanghai, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 152 2139 0719 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
海军军医大学第三附属医院 |
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Primary sponsor: |
Third Affiliated Hospital of Naval Medical University |
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研究实施负责(组长)单位地址: |
上海市杨浦区长海路225号 |
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Primary sponsor's address: |
225 Changhai Road, Yangpu District, Shanghai, China |
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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: |
自筹 |
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Source(s) of funding: |
Self-funded |
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Target disease: |
Hepatocellular carcinoma, combined portal vein tumor thrombosis |
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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: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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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: |
对比手术切除序贯仑伐替尼联合替雷利珠单抗与TACE、仑伐替尼联合替雷利珠单抗在肝癌伴门脉癌栓(Ⅰ型与Ⅱ型)的疗效 |
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Objectives of Study: |
Efficacy Comparison Between Surgical Resection Followed by Sequential Lenvatinib Combined with Tislelizumab and Transarterial Chemoembolization (TACE), Lenvatinib Combined with Tislelizumab for the Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (Types I and II) |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.年龄在18-70岁之间,性别不限(包含18岁和70岁); 2.临床诊断肝细胞癌(肝细胞的临床诊断标准:符合2023年原发性肝癌诊疗规范诊断标准); 3.影像学(增强MR或CT)见明确癌栓,癌栓未达到门静脉主干及对侧(程氏I、II型 或 Vp1-3型); 4.肿瘤及癌栓位于同一肝段、肝叶或半肝,且可安全切除(不伴肝硬化患者中剩余肝体积占标准肝体积>30%,伴肝硬化患者中剩余肝体积占标准肝体积>40%;经评估术后肝功能可代偿。) 5.无明确远处转移; 6.全身状态ECOG 0-1; 7.肝功能Child-Pugh评分 A; 8.具有充分的器官和骨髓功能,随机分组前7天内实验室检查值符合下列要求(获得实验室检查的前14天内不允许通过给予任何血液成分、细胞生长因子、白蛋白及其他纠正治疗的药物来满足条件),具体如下: 9.血常规:绝对中性粒细胞计数(absolute neutrophil count, ANC)≥1.5×109/L; 血小板计数(platelet, PLT)≥75×10 9/L; 血红蛋白含量(hemoglobin, HGB)≥9.0 g/dL; 10.肝功能:血清总胆红素(total bilirubin, TBIL)≤1.5×正常上限(upper limit of normal value, ULN);丙氨酸氨基转移酶(alanine aminotransferase, ALT)、天门冬氨酸氨基转移酶(aspartate transferase, AST)和碱性磷酸酶(alkaline phosphatase, ALP)≤2×ULN; 血清白蛋白≥28 g/L; 11.肾功能:血清肌酐(creatinine, Cr)≤ 1.5×ULN 或肌酐清除率(clearance of creatinine, CCr)≥ 50mL/min(Cockcroft-Gault 公式);尿常规结果显示尿蛋白<2+;对基线时尿常规检测显示尿蛋白≥2+的患者,应进行24小时尿液采集且24小时尿蛋白定量<1g; 1)凝血功能:凝血酶原时间(Prothrombin Time,PT)国际标准化比率(international normalized ratio,INR)和活化部分凝血活酶时间(activated partial thromboplastin time ,APTT)≤ 1.5倍ULN 12.既往未接受其他抗肿瘤治疗; 13.对于育龄期女性受试者,应在接受首次研究药物给药(第1周期第1天)之前的3天内接受尿液或血清妊娠试验且结果为阴性。如果尿液妊娠试验结果无法确认为阴性,则要求进行血液妊娠试验。非育龄期女性定义为绝经后至少1年,或进行过手术绝育或子宫切除术;如存在受孕风险,所有受试者(不论男性或女性)均需在整个治疗期间直至治疗末次研究药物给药后120天(或末次化疗药物给药后180天)内采用年失败率低于1%的避孕措施。预期生存时间≥12 周。 14.知晓本研究流程并同意参加,签署相关知情同意等文件 注:肝癌合并门脉癌栓可切除的判断:满足肝功能Child-Pugh评分 A,并且全身状态良好ECOG 0-1,肿瘤位于一侧肝脏,并且经手术医生判断术后肝功能可恢复(可通过剩余肝脏体积判断:不伴肝硬化患者中剩余肝体积占标准肝体积>30%,伴肝硬化患者中剩余肝体积占标准肝体积>40%;经评估术后肝功能可代偿)。 |
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Inclusion criteria |
1. Age between 18 to 70 years inclusive (including both 18 and 70 years old); 2. Clinical diagnosis of Hepatocellular Carcinoma (HCC), conforming to the diagnostic criteria of primary liver cancer treatment guidelines from 2023; 3. Clear tumor thrombus observed through imaging (enhanced MRI or CT), with the thrombus not reaching the main trunk of the portal vein or the contralateral side (Cheng's Type I, II, or Vp1-3); 4. The tumor and tumor thrombus are located within the same liver segment, lobe, or hemiliver and are deemed safely resectable (in patients without cirrhosis, the remaining liver volume must be >30% of the standard liver volume, and in patients with cirrhosis, the remaining liver volume must be >40% of the standard liver volume; postoperative liver function is expected to be compensatory after assessment); 5. No clear distant metastasis; 6. ECOG (Eastern Cooperative Oncology Group) performance status of 0-1; 7. Child-Pugh liver function score of A; 8. Adequate organ and bone marrow function, with laboratory test values within 7 days prior to randomization meeting the following requirements (no administration of any blood components, growth factors, albumin, or other corrective treatments is allowed within 14 days prior to obtaining laboratory tests to meet the conditions): specifically, - Complete blood count: Absolute neutrophil count (ANC) >=1.5×10^9/L; Platelet count (PLT) >=75×10^9/L; Hemoglobin (HGB) >=9.0 g/dL; - Liver function: Total serum bilirubin (TBIL) <=1.5 times the upper limit of normal value (ULN); Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), and Alkaline phosphatase (ALP) <=2×ULN; Serum albumin ≥28 g/L; - Renal function: Serum creatinine (Cr) <=1.5×ULN or Creatinine clearance (Ccr) >=50 mL/min (Cockcroft-Gault formula); Urine routine results show urine protein <2+; For patients with urine protein >=2+ at baseline urine routine, a 24-hour urine collection should be performed, and the 24-hour urine protein quantification should be <1g; - Coagulation function: Prothrombin Time (PT) International Normalized Ratio (INR) and Activated Partial Thromboplastin Time (APTT) <=1.5 times ULN. 9. No prior anti-cancer treatment received; 10. For female participants of childbearing age, a negative urine or serum pregnancy test should be conducted within 3 days prior to the first administration of the study drug (Day 1 of Cycle 1). If the urine pregnancy test result cannot be confirmed as negative, a blood pregnancy test is required. Non-childbearing age females are defined as postmenopausal for at least 1 year, or have undergone surgical sterilization or hysterectomy; if there is a risk of conception, all participants (regardless of gender) must use contraception with a failure rate of less than 1% per year throughout the treatment period until 120 days after the last administration of the study drug (or 180 days after the last chemotherapy drug administration). Expected survival time >=12 weeks; 11. Aware of the study process and willing to participate, signing related informed consent documents. **Note:** The determination of resectability for liver cancer combined with portal vein tumor thrombus: meeting the Child-Pugh liver function score of A, and having a good general condition with an ECOG performance status of 0-1, with the tumor located in one side of the liver, and judged by the surgeon that postoperative liver function can be restored (which can be judged by the remaining liver volume: in patients without cirrhosis, the remaining liver volume must be >30% of the standard liver volume, and in patients with cirrhosis, the remaining liver volume must be >40% of the standard liver volume; postoperative liver function is expected to be compensatory after assessment). |
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排除标准: |
1.已知的含纤维板层HCC、肉瘤样HCC、或混合胆管细胞癌和HCC 2.有其他肿瘤病史; 3.癌栓超过门静脉主干或至对侧门静脉,或合并肝静脉癌栓; 4.合并肝内多发转移或远处转移; 5.往6个月内出现过门静脉高压导致的食管或胃底静脉曲张出血事件;随机前3个月内已知的内镜检查存在重度(G3)静脉曲张;有门静脉高压证据(包括影像学检查发现脾大),经研究者评估出血风险高者 6.严重出血倾向或凝血功能障碍,或正在接受溶栓治疗 7.需要长期使用可以抑制血小板功能的药物如阿司匹林( >325 mg/day)、双嘧达莫或氯吡格雷等 8.不可控制的高血压,经最佳医学治疗后收缩压>140mmHg或舒张压>90 mmHg,高血压危象或高血压脑病病史 9.症状性充血性心力衰竭(纽约心脏病协会分级II-IV级),症状性或控制不佳的心律失常,先天性长QT综合征病史或筛查时校正的QTc>500ms(使用Fridericia法计算) 10.既往6个月内有胃肠道穿孔和/或瘘管病史,肠梗阻病史(包括需要肠外营养的不完全肠梗阻),广泛肠切除(部分结肠切除或广泛小肠切除,并发慢性腹泻)、克罗恩氏病、溃疡性结肠炎或长期慢性腹泻 11.既往和目前有肺纤维化史、间质性肺炎、尘肺、药物相关肺炎、肺功能严重受损等肺部疾病 12.急性或者慢性活动性乙型肝炎或丙型肝炎感染者,乙型肝炎病毒(HBV)DNA>2000IU/ml或104拷贝/ml;丙型肝炎病毒(HCV)RNA>103拷贝/ml;乙肝表面抗原(HbsAg)与抗HCV抗体同时阳性 13.人免疫缺陷病毒(HIV)感染者(HIV 1/2抗体阳性),已知的梅毒感染者 14.处于活动期或临床控制不佳的严重感染。 15.随机分组前4周之内使用过免疫抑制药物,不包括喷鼻、吸入性或其他途径的局部糖皮质激素或生理剂量的系统性糖皮质激素(即不超过10mg/天泼尼松或等效剂量的其他糖皮质激素),允许因治疗哮喘、慢性阻塞性肺疾病等疾病的呼吸困难症状临时使用糖皮质激素 16.既往接受过任何抗血管抑制剂、抗PD-1抗体、抗PD-L1/L2抗体、抗CTLA-4抗体,或其他免疫治疗 17.妊娠或哺乳的女性患者 18.可能会导致以下结果的其它急性或慢性疾病、精神疾病或实验室检测值异常:增加研究参与或研究药物给药的相关风险,或者干扰研究结果的解读,而且根据研究者的判断将患者列为不符合参加本研究的资格。 |
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Exclusion criteria: |
1. Known fibrolamellar hepatocellular carcinoma (HCC), sarcomatoid HCC, or mixed cholangiocarcinoma and HCC; 2. History of other malignancies; 3. Tumor thrombus extending beyond the main trunk of the portal vein or to the contralateral portal vein, or combined with hepatic vein tumor thrombus; 4. Combined with multiple intrahepatic metastases or distant metastases; 5. History of esophageal or gastric varices bleeding due to portal hypertension within the past 6 months; known severe (Grade 3) varices from endoscopic examination within the past 3 months; evidence of portal hypertension (including imaging findings such as splenomegaly), with a high risk of bleeding assessed by the investigator; 6. Severe bleeding tendency or coagulation dysfunction, or currently undergoing thrombolytic therapy; 7. Long-term use of medications that can inhibit platelet function, such as aspirin (>325 mg/day), dipyridamole, or clopidogrel, etc.; 8. Uncontrollable hypertension, with systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg after optimal medical treatment, history of hypertensive crisis or hypertensive encephalopathy; 9. Symptomatic congestive heart failure (New York Heart Association Class II-IV), symptomatic or poorly controlled arrhythmias, history of congenital long QT syndrome, or corrected QTc >500ms (calculated using the Fridericia formula) upon screening; 10. History of gastrointestinal perforation and/or fistula within the past 6 months, history of intestinal obstruction (including incomplete intestinal obstruction requiring parenteral nutrition), extensive bowel resection (partial colectomy or extensive small bowel resection with chronic diarrhea), Crohn's disease, ulcerative colitis, or long-term chronic diarrhea; 11. History of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, drug-related pneumonia, or severe impaired pulmonary function and other pulmonary diseases; 12. Acute or chronic active hepatitis B or C infection, hepatitis B virus (HBV) DNA >2000 IU/mL or 104 copies/mL; hepatitis C virus (HCV) RNA >103 copies/mL; positive for both hepatitis B surface antigen (HBsAg) and anti-HCV antibody; 13. Human immunodeficiency virus (HIV) infection (positive for HIV 1/2 antibodies), known syphilis infection; 14. Active or poorly controlled severe infection; 15. Use of immunosuppressive drugs within 4 weeks prior to randomization, excluding intranasal, inhaled, or other topical glucocorticoids or physiologic doses of systemic glucocorticoids (i.e., no more than 10 mg/day of prednisone or equivalent dose of other glucocorticoids), with allowance for temporary use of glucocorticoids for the treatment of dyspnea symptoms due to asthma, chronic obstructive pulmonary disease, and other diseases; 16. History of any anti-angiogenic agents, anti-PD-1 antibodies, anti-PD-L1/L2 antibodies, anti-CTLA-4 antibodies, or other immunotherapies; 17. Pregnant or lactating female patients; 18. Other acute or chronic diseases, mental disorders, or laboratory test abnormalities that may lead to the following outcomes: increased risk associated with study participation or study drug administration, or interference with the interpretation of study results, and as judged by the investigator, disqualify the patient from being eligible to participate in this study. |
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研究实施时间: Study execute time: |
从 From 2024-04-25 00:00:00至 To 2027-05-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2024-04-25 00:00:00 至 To 2026-05-01 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): |
各中心间采用区组化随机,竞争入组。利用EXCEL软件按1:1的比例生成受试者随机数字,中央随机系统采用分层区组的方式分配随机数。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Inter-center randomization was performed using blocked randomization, with competitive enrollment. The EXCEL software was utilized to generate random numbers for subjects in a 1:1 ratio. The central randomization system allocated the random numbers using stratified blocked randomization. |
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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: |
公开/Public |
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盲法: |
无 |
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Blinding: |
None |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
Yes |
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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): |
研究结束后通过论文或联系研究者获取 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
After the research is completed, review the publishing academic papers or by contact the investigator by email |
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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: |
病例记录表 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Case Record Form, CRF |
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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 |