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水胶体敷料预防多靶点激酶抑制剂所致手足皮肤不良反应的 3 期随机自身对照研究方案

Hydrocolloid dressing as a prophylactic use for hand-foot skin reaction induced by multitargeted kinase inhibitors: protocol of a phase 3 randomised self-controlled study.

机构信息

Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan

Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan.

出版信息

BMJ Open. 2020 Oct 6;10(10):e038276. doi: 10.1136/bmjopen-2020-038276.

Abstract

INTRODUCTION

Although topical use of moisturisers is slightly effective for the prevention and avoiding the aggravation of hand-foot syndrome induced by multikinase inhibitors, there is still room for improvement. Hydrocolloid dressing is a type of wound dressing often used for wounds such as decubitus ulcers. The purpose of this study is to verify the usefulness of application of hydrocolloid dressings as prophylaxis against development of hand-foot syndrome induced by multikinase inhibitors by comparing the effects of this dressing and standard supportive care (moisturising care alone) within the same individuals.

METHODS

This study is a phase 3 randomised, self-controlled study to compare prophylactic moisturising care with or without hydrocolloid dressing for hand-foot syndrome induced by multikinase inhibitors. Patients with radically unresectable advanced or recurrent colorectal carcinoma, gastrointestinal stromal tumour and hepatocellular carcinoma who scheduled to receive regorafenib or sorafenib therapy are eligible for enrolment.Supportive care for hand-foot syndrome will consist of basic moisturising care with or without hydrocolloid dressing. If hand-foot syndrome occurs, a steroid ointment will be applied two times per day at the affected sites. The primary endpoint is an incidence rate of grade 2 or more severe hand-foot syndrome (soles of the feet only) assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events V.4.0. Grading of hand-foot syndrome will be performed by central review using photographs taken weekly by blinded trained physicians. The ethical approval was obtained from National Cancer Center Hospital. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conference.

DISCUSSION

If the positive results are found in this study, it is shown that hydrocolloid dressing is effective not only as a symptom management but also as a prevention in hand-foot syndrome induced by multikinase.

TRIAL STATUS

The enrolment was started in January 2019, and planned to closed in January 2021. As of February 2020, 26 patients enrolled in this study.

TRIAL REGISTRATION NUMBER

UMIN Clinical Trial Registry (UMIN000034853).

PROTOCOL VERSION

V.1.4, 9 January 2020.

摘要

简介

尽管局部使用保湿剂对预防和避免多激酶抑制剂引起的手足综合征的恶化有一定效果,但仍有改进的空间。水胶体敷料是一种常用于压疮等伤口的伤口敷料。本研究旨在通过比较水胶体敷料与标准支持性护理(仅保湿护理)在同一患者中的效果,验证水胶体敷料作为预防多激酶抑制剂引起的手足综合征的有效性。

方法

这是一项 3 期随机、自身对照研究,比较多激酶抑制剂引起的手足综合征的预防性保湿护理加用水胶体敷料与不用水胶体敷料的效果。适合入组的患者为根治性不可切除的晚期或复发性结直肠癌、胃肠道间质瘤和肝细胞癌患者,计划接受regorafenib 或 sorafenib 治疗。手足综合征的支持性护理将包括基础保湿护理加用水胶体敷料或不用水胶体敷料。如果发生手足综合征,将在受影响的部位每天涂抹两次类固醇软膏。主要终点是根据美国国立癌症研究所(NCI)不良事件通用术语标准第 4.0 版(NCI CTCAE v.4.0)评估的 2 级或更严重手足综合征(仅足底)的发生率。手足综合征的分级将由中心审查使用盲法训练的医生每周拍摄的照片进行。本研究已获得国家癌症中心医院的伦理批准。本研究的结果将提交国际同行评议期刊发表,并将在国际科学会议上报告主要研究结果。

讨论

如果本研究结果为阳性,则表明水胶体敷料不仅在管理症状方面有效,而且在预防多激酶引起的手足综合征方面也有效。

试验状态

该试验于 2019 年 1 月开始入组,计划于 2021 年 1 月关闭。截至 2020 年 2 月,已有 26 名患者入组本研究。

试验注册编号

UMIN 临床试验注册(UMIN000034853)。

方案版本

V.1.4,2020 年 1 月 9 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d2/7539604/7ae7967b016a/bmjopen-2020-038276f01.jpg

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