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预防和治疗胃癌术后复发与转移的处方:一项随机对照试验方案

prescription for preventing and treating postoperative recurrence and metastasis of gastric cancer: a randomized controlled trial protocol.

作者信息

Cao Luchang, Zhu Guanghui, Wang Xinmiao, Kuang Ziyu, Song Xiaotong, Ma Xinyi, Zhu Xiaoyu, Gao Ruike, Li Jie

机构信息

Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Graduate School, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Front Oncol. 2024 Jul 5;14:1326970. doi: 10.3389/fonc.2024.1326970. eCollection 2024.

Abstract

INTRODUCTION

Postoperative recurrence and metastasis of gastric cancer (GC) are primary factors that contribute to poor prognosis. GC recurs at a rate of approximately 70%-80% within 2 years after local treatment and approximately 90% within 5 years. "" is the core pathogenesis of GC recurrence and metastasis. The prescription (YWJP), a form of complementary and alternative medicine in China, is an empirical remedy to prevent postoperative recurrence and metastasis of GC. Taking the main therapeutic principles of "nourishing and warming , strengthening , and detoxifying" can aid in preventing the recurrence and metastasis of GC in patients during the watchful waiting period after surgery and adjuvant chemotherapy. This approach aims to enhance the quality of life of patients. However, high-quality evidence to support this hypothesis is lacking. This study will aim to investigate the efficacy and safety of YWJP to prevent and treat postoperative metastasis and GC recurrence.

METHODS

The study will be a multicenter, randomized, double-blind, placebo-parallel-controlled clinical trial. A total of 212 patients who completed adjuvant chemotherapy within 8 months of radical gastrectomy will be enrolled. Patients in the intervention group will receive the YWJP, whereas those in the control group will receive a placebo. The main outcome was the disease-free survival (DFS) rate 2 years after surgery. The secondary outcomes included DFS time, overall survival, annual cumulative recurrence and rate of metastasis after 1-3 years, cumulative annual survival after 1-3 years, fat distribution-related indicators, tumor markers, peripheral blood inflammatory indicators, prognostic nutritional index, symptoms and quality of life evaluation, medication compliance, and adverse reaction rate.

DISCUSSION

There is a lack of effective therapy after the completion of adjuvant therapy during the postoperative period of watchful waiting. This study will be the first randomized clinical trial to evaluate whether complementary and alternative medical interventions can effectively prevent recurrence and metastasis during the watchful waiting period after GC surgery and to provide evidence for surveillance treatment management after GC surgery.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT05229809.

摘要

引言

胃癌(GC)术后复发和转移是导致预后不良的主要因素。GC在局部治疗后2年内的复发率约为70%-80%,5年内约为90%。“”是GC复发和转移的核心发病机制。益胃煎剂(YWJP)是中国的一种补充和替代医学形式,是预防GC术后复发和转移的经验性疗法。遵循“滋养胃阳、温阳、健脾、解毒”的主要治疗原则,有助于在术后观察等待期和辅助化疗期间预防GC患者复发和转移。该方法旨在提高患者的生活质量。然而,缺乏支持这一假设的高质量证据。本研究旨在探讨益胃煎剂预防和治疗术后转移及GC复发的有效性和安全性。

方法

本研究将是一项多中心、随机、双盲、安慰剂平行对照临床试验。共纳入212例在根治性胃切除术后8个月内完成辅助化疗的患者。干预组患者将接受益胃煎剂,而对照组患者将接受安慰剂。主要结局是术后2年的无病生存率(DFS)。次要结局包括DFS时间、总生存期、1-3年后的年度累积复发率和转移率、1-3年后的年度累积生存率、脂肪分布相关指标、肿瘤标志物、外周血炎症指标、预后营养指数、症状和生活质量评估、用药依从性以及不良反应率。

讨论

在术后观察等待期辅助治疗完成后,缺乏有效的治疗方法。本研究将是第一项评估补充和替代医学干预措施是否能有效预防GC手术后观察等待期复发和转移的随机临床试验,并为GC手术后的监测治疗管理提供证据。

临床试验注册

ClinicalTrials.gov,标识符NCT05229809。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4eb/11257841/551990e5af0a/fonc-14-1326970-g001.jpg

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