Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
BMJ Support Palliat Care. 2022 Nov;12(e5):e646-e649. doi: 10.1136/bmjspcare-2019-002022. Epub 2019 Nov 29.
To evaluate the feasibility of a large prospective trial aimed at improving chemotherapy-induced nausea and vomiting (CINV) control in paediatric patients undergoing oral chemotherapy during acute lymphoblastic leukaemia (ALL) maintenance therapy.
English-speaking children, 4.0-17.99 years old and undergoing ALL maintenance treatment with an English-speaking guardian, were eligible to participate in this observational, serial, cross-sectional feasibility study. Data were collected from participants over one to three 7-day periods during months 2-3, 5-6 and 11-12 of ALL maintenance treatment. A future trial was considered feasible if the mean time to enrol 10 patients in each of three data collection periods was ≤1 year with ≥80% of patients returning evaluable data. CINV control was described as a secondary endpoint.
Twenty-nine of 31 consenting patients (median age: 6.5 years, IQR: 5.1-9.2) completed the study: 10 in months 2-3, 10 in months 5-6 and 9 in months 11-12. The total time to recruit 29 patients was 1.2 years. In each of the three data collections periods, 72% of the patients provided evaluable data. Complete CINV control was reported in 6/21 (29%) evaluable study periods.
A future trial to evaluate interventions to improve CINV control in patients with ALL undergoing oral maintenance chemotherapy as designed in this study is not feasible. An electronic data capture method and deferring patient recruitment until the mid-maintenance to late-maintenance phase should be considered in the design of a future trial.
评估一项旨在改善接受口服化疗的小儿患者化疗所致恶心和呕吐(CINV)控制的大型前瞻性试验的可行性,这些患者处于急性淋巴细胞白血病(ALL)维持治疗中。
符合条件的参与者为讲英语的 4.0-17.99 岁儿童,正在接受 ALL 维持治疗,有一位讲英语的监护人,他们可能参与这项观察性、连续、横断面可行性研究。在 ALL 维持治疗的第 2-3、5-6 和 11-12 个月期间,通过 1-3 个 7 天期收集参与者的数据。如果在每个数据收集期招募 10 名患者的平均时间≤1 年,且≥80%的患者返回可评估的数据,则认为未来的试验是可行的。CINV 控制被描述为次要终点。
31 名同意参与的患者中有 29 名(中位数年龄:6.5 岁,IQR:5.1-9.2)完成了研究:10 名在第 2-3 个月,10 名在第 5-6 个月,9 名在第 11-12 个月。招募 29 名患者的总时间为 1.2 年。在每个数据收集期,有 72%的患者提供了可评估的数据。在 21 个可评估研究期中有 6 个(29%)报告了完全 CINV 控制。
按照本研究设计,评估干预措施以改善接受口服维持化疗的 ALL 患者的 CINV 控制的未来试验是不可行的。在未来试验的设计中,应考虑采用电子数据捕获方法和将患者招募推迟到维持治疗的中期至晚期。