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黄芪桂枝五物汤治疗奥沙利铂所致周围神经毒性的有效性和安全性研究:一项随机、对照、双盲、多中心试验方案

Study on efficacy and safety of Huangqi Guizhi Wuwu decoction treatment for oxaliplatin induced peripheral neurotoxicity: A protocol for a randomized, controlled, double-blind, multicenter trial.

作者信息

Wei Xiao-Man, Chen Xiao-Feng, Shu Peng, Jiang Zhi-Wei, Wu Xiao-Yu, Zou Xi, Chen Kai, Shen Bo, Hu Wen-Wei, Lu Wei, Shen Wei-Xing, Li Liu, Wang Jun-Yi, Zhao Feng-Jiao, Yin Qing-Feng, Cheng Hai-Bo, Gu Yan-Hong

机构信息

The First Clinical College of Nanjing University of Chinese Medicine.

Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor.

出版信息

Medicine (Baltimore). 2020 May 29;99(22):e19923. doi: 10.1097/MD.0000000000019923.

Abstract

BACKGROUND

Oxaliplatin can cause severe peripheral neurotoxicity, which is an important reason for clinical oxaliplatin reduction and cessation of treatment. Oxaliplatin induced peripheral neurotoxicity (OIPN) can cause paresthesia and dysesthesia, even affect the quality life of patients. So far, there are no recognized and effective measures to prevent OIPN. Huangqi Guizhi Wuwu decoction is a classical prescription of ancient Chinese medicine recorded in "the synopsis of the Golden Chamber," which can be used in the treatment of various neurotoxicity. However, there is a lack of large-scale and high-quality clinical studies on the prevention of OIPN by Huangqi Guizhi Wuwu decoction. The purpose of this study is to evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction on preventing OIPN.

METHODS/DESIGN: This study is a randomized, controlled, double-blind, and multicenter clinical trial. Three hundred sixty patients will be randomly assigned into Huangqi Guizhi Wuwu decoction group and Huangqi Guizhi Wuwu decoction mimetic agent group. Patients will receive chemotherapy with FOLFOX of 8 cycles of 3 weeks with Traditional Chinese Medicine (TCM) for 6 months and 1-year follow-up. The primary outcome measure is the differences in the incidence of chronic neurotoxicity of grade 2 and above during and after treatment. The secondary outcome measure is the improvement in other symptoms associated with chemotherapy. Four methods will be used to evaluate the efficacy of neurotoxicity, including oxaliplatin specific toxicity grading standard (Levi classification); CTCAE4.02 version; EORTC QLQ-CIPN20 scale, EORTC QLQ C30 scale, and EORTC QLQ-CR29 scale are used at the same time; Electromyography.

DISCUSSION

This study will provide objective evidences to evaluate the efficacy and safety of Huangqi Guizhi Wuwu Decoction on preventing OIPN.

TRIAL REGISTRATION

Clinical Trials.gov (Identifier: NCT04261920).

摘要

背景

奥沙利铂可导致严重的外周神经毒性,这是临床上减少奥沙利铂用量及停止治疗的重要原因。奥沙利铂诱导的外周神经毒性(OIPN)可引起感觉异常和感觉障碍,甚至影响患者的生活质量。迄今为止,尚无公认有效的预防OIPN的措施。黄芪桂枝五物汤是《金匮要略》记载的一首中医经典方剂,可用于治疗各种神经毒性。然而,目前缺乏关于黄芪桂枝五物汤预防OIPN的大规模、高质量临床研究。本研究旨在评价黄芪桂枝五物汤预防OIPN的疗效和安全性。

方法/设计:本研究为一项随机、对照、双盲、多中心临床试验。360例患者将被随机分为黄芪桂枝五物汤组和黄芪桂枝五物汤模拟剂组。患者将接受3周8周期的FOLFOX化疗,同时服用中药6个月,并进行1年随访。主要观察指标为治疗期间及治疗后2级及以上慢性神经毒性的发生率差异。次要观察指标为化疗相关其他症状的改善情况。将采用4种方法评估神经毒性疗效,包括奥沙利铂特异性毒性分级标准(Levi分级);CTCAE4.02版;同时使用EORTC QLQ-CIPN20量表、EORTC QLQ C30量表和EORTC QLQ-CR29量表;肌电图。

讨论

本研究将为评价黄芪桂枝五物汤预防OIPN的疗效和安全性提供客观依据。

试验注册

ClinicalTrials.gov(标识符:NCT04261920)。

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