| 試験進捗状況 | 参加者募集終了‐試験継続中/No longer recruiting |
| UMIN試験ID | UMIN000044167 |
| 受付番号 | R000050436 |
| 科学的試験名 | 臨床的に確定診断が困難な胃癌腹膜転移疑い例に対するCTコロノグラフィーのfeasibility研究 |
| 一般公開日(本登録希望日) | 2021/05/11 |
| 最終更新日 | 2022/05/13 (2版) |
| 基本情報/Basic information | |||
| 一般向け試験名/Public title | 臨床的に確定診断が困難な胃癌腹膜転移疑い例に対するCTコロノグラフィーのfeasibility研究 | Feasibility study of CT colonography for peritoneal metastasis of gastric cancer clinically difficult to diagnose definitely | |
| 一般向け試験名略称/Acronym | 臨床的に確定診断が困難な胃癌腹膜転移疑い例に対するCTコロノグラフィーのfeasibility研究 | Feasibility study of CT colonography for peritoneal metastasis of gastric cancer clinically difficult to diagnose definitely | |
| 科学的試験名/Scientific Title | 臨床的に確定診断が困難な胃癌腹膜転移疑い例に対するCTコロノグラフィーのfeasibility研究 | Feasibility study of CT colonography for peritoneal metastasis of gastric cancer clinically difficult to diagnose definitely | |
| 科学的試験名略称/Scientific Title:Acronym | 臨床的に確定診断が困難な胃癌腹膜転移疑い例に対するCTコロノグラフィーのfeasibility研究 | Feasibility study of CT colonography for peritoneal metastasis of gastric cancer clinically difficult to diagnose definitely | |
| 試験実施地域/Region |
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| 対象疾患/Condition | |||
| 対象疾患名/Condition | 胃がん | gastric cancer | |
| 疾患区分1/Classification by specialty |
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| 疾患区分2/Classification by malignancy | 悪性腫瘍/Malignancy | ||
| ゲノム情報の取扱い/Genomic information | いいえ/NO | ||
| 目的/Objectives | ||
| 目的1/Narrative objectives1 | 身体所見、検査所見、画像所見から胃癌腹膜転移/再発が疑われるが確定診断に至らない症例に対し、診断能向上を目的としたCTコロノグラフィーを行う。大腸壁の腹膜播種を疑う変形の有無は担当医と放射線診断医が合同で診断し、臨床経過との相関を解析する。 | CTC will be performed aiming at improvement of diagnostic performance in patients in whom peritoneal metastasis/recurrence of stomach cancer is suspected based on physical, laboratory test, and imaging findings, but no definite diagnosis can be made. The presence or absence of deformation suggesting peritoneal dissemination in the large intestinal wall will be diagnosed jointly by the physician in charge and radiologist and correlation with the clinical course will be analyzed. |
| 目的2/Basic objectives2 | 有効性/Efficacy | |
| 目的2 -その他詳細/Basic objectives -Others | ||
| 試験の性質1/Trial characteristics_1 | 探索的/Exploratory | |
| 試験の性質2/Trial characteristics_2 | 実務的/Pragmatic | |
| 試験のフェーズ/Developmental phase | 該当せず/Not applicable | |
| 評価/Assessment | ||
| 主要アウトカム評価項目/Primary outcomes | Primary endpointは診断感度。従来法の診断感度は報告により幅があるが、現在主流のMDCTでの感度はおよそ60%と想定される。CTCでの感度は期待値75%、閾値55%と設定するとSimon 2-stage designでα=0.05, β=0.2で43例必要になる.再発の確定診断は、ほとんどの症例で組織学的な確認ができないため困難であるが、CTC施行後、大量腹水/消化管狭窄/水腎症など臨床的に明らかに腹膜播種再発に至ったものとする。期間は化学療法施行中の症例で6か月、非施行例で3か月以内とする。CTC所見陰性で、同期間内に明らかに腹膜再発した場合はfalse negativeとし、15例の段階で中間解析を行い、15例中6例false negativeが判明した場合は登録を中断する。 | The primary endpoint of this study was the diagnostic sensitivity of CTC for PM. The secondary endpoints included overall survival (OS) and progression-free survival (PFS). Ideally, a pathological diagnosis is required to confirm PM; however, suspicious PM lesions detected by CTC are difficult to confirm using endoscopy or laparoscopy. Thus, we adopted the wait-and-see method to confirm PM. Patients were followed-up until the definitive development of PM. In this cohort study, the treatment to be administered after PM diagnosis was not specified. Accordingly, decisions regarding the timing of treatment initiation and the treatments to be administered were made on a case-by-case basis after a discussion between the patient and attending doctors. However, fluorouracil-compound plus cisplatin was administered as first-line chemotherapy when the patient did not undergo gastrectomy or developed recurrence, with the interval between S-1 adjuvant chemotherapy and recurrence being <6 months. All oncological definitions were in accordance with the Japanese Classification of Gastric Carcinoma 15th edition |
| 副次アウトカム評価項目/Key secondary outcomes | Secondary endpointは全生存期間ろ無再発生存期間とし、再発の確定診断は、ほとんどの症例で組織学的な確認ができないため困難であるが、CTC施行後、大量腹水/消化管狭窄/水腎症など臨床的に明らかに腹膜播種再発に至ったものとする。期間は化学療法施行中の症例で6か月、非施行例で3か月以内とする。CTC所見陰性で、同期間内に明らかに腹膜再発した場合はfalse negativeとし、15例の段階で中間解析を行い、15例中6例false negativeが判明した場合は登録を中断する。 | The primary endpoint of this study was the diagnostic sensitivity of CTC for PM. The secondary endpoints included overall survival (OS) and progression-free survival (PFS). Ideally, a pathological diagnosis is required to confirm PM; however, suspicious PM lesions detected by CTC are difficult to confirm using endoscopy or laparoscopy. Thus, we adopted the wait-and-see method to confirm PM. Patients were followed-up until the definitive development of PM. In this cohort study, the treatment to be administered after PM diagnosis was not specified. Accordingly, decisions regarding the timing of treatment initiation and the treatments to be administered were made on a case-by-case basis after a discussion between the patient and attending doctors. However, fluorouracil-compound plus cisplatin was administered as first-line chemotherapy when the patient did not undergo gastrectomy or developed recurrence, with the interval between S-1 adjuvant chemotherapy and recurrence being <6 months. All oncological definitions were in accordance with the Japanese Classification of Gastric Carcinoma 15th edition |
| 基本事項/Base | ||
| 試験の種類/Study type | 介入/Interventional | |
| 試験デザイン/Study design | ||
| 基本デザイン/Basic design | 単群/Single arm | |
| ランダム化/Randomization | 非ランダム化/Non-randomized | |
| ランダム化の単位/Randomization unit | ||
| ブラインド化/Blinding | オープン/Open -no one is blinded | |
| コントロール/Control | 無対照/Uncontrolled | |
| 層別化/Stratification | いいえ/NO | |
| 動的割付/Dynamic allocation | いいえ/NO | |
| 試験実施施設の考慮/Institution consideration | 施設を考慮していない/Institution is not considered as adjustment factor. | |
| ブロック化/Blocking | いいえ/NO | |
| 割付コードを知る方法/Concealment | 知る必要がない/No need to know | |
| 介入/Intervention | |||
| 群数/No. of arms | 1 | ||
| 介入の目的/Purpose of intervention | 診断/Diagnosis | ||
| 介入の種類/Type of intervention |
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| 介入1/Interventions/Control_1 | 身体所見、検査所見、画像所見から胃癌腹膜転移/再発が疑われるが確定診断に至らない症例に対し、診断能向上を目的としたCTコロノグラフィーを行う。大腸壁の腹膜播種を疑う変形の有無は担当医と放射線診断医が合同で診断し、臨床経過との相関を解析する。 | In this study, we aimed to use CTC for early detection of PM in patients in whom PM was suspected based on clinical symptoms and general CT findings but not yet diagnosed, and to administer anticancer agents in a timely and effective manner. | |
| 介入2/Interventions/Control_2 | |||
| 介入3/Interventions/Control_3 | |||
| 介入4/Interventions/Control_4 | |||
| 介入5/Interventions/Control_5 | |||
| 介入6/Interventions/Control_6 | |||
| 介入7/Interventions/Control_7 | |||
| 介入8/Interventions/Control_8 | |||
| 介入9/Interventions/Control_9 | |||
| 介入10/Interventions/Control_10 | |||
| 適格性/Eligibility | |||||
| 年齢(下限)/Age-lower limit |
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| 年齢(上限)/Age-upper limit |
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| 性別/Gender | 男女両方/Male and Female | ||||
| 選択基準/Key inclusion criteria | 3.1. 適格基準
1) 内視鏡生検、または手術検体において組織学的に胃癌と診断されている。 2) 身体所見(腹部膨満、腹痛、テネスムス、悪心嘔吐)、検査所見(腫瘍マーカーの正常からの逸脱)、画像所見から胃癌腹膜転移/再発が疑われる(腹水、腸管壁肥厚、腹膜脂肪組織濃度の不整な上昇、腹腔内結節)。 3) ECOG performance statusが0または1または2。 4) 経口摂取が可能。 5) 本人から文書による同意が得られている。 |
Inclusion criteria
(i) histologically diagnosed gastric cancer via endoscopic biopsy or surgical specimen retrieval; (ii) suspected PM/recurrence of gastric cancer based on at least one of the following clinical findings: abnormal physical symptoms with causes that could not be explained by other diseases, elevation of serum tumor markers, and suspicious but not definitive signs of PM on conventional CT images; (iii) Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2; (iv) oral intake ability; and (v) provision of written consent by each patient. |
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| 除外基準/Key exclusion criteria | 3.2. 除外基準
1) 消化管の前処置ができない。 2) 明らかな消化管通過障害を有する。 3) 大量腹水。 4) 直腸からの送気ができない。 |
Exclusion criteria were
(i) inability to undergo bowel preparation; (ii) obvious intestinal stenosis; (iii) presence of massive ascites; and (iv) inability to undergo carbon dioxide (CO2) insufflation through the rectum. |
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| 目標参加者数/Target sample size | 18 | ||||
| 責任研究者/Research contact person | ||||||||||||||
| 責任研究者/Name of lead principal investigator |
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| 所属組織/Organization | 神奈川県立がんセンター | Kanagawa Cancer Center | ||||||||||||
| 所属部署/Division name | 消化器外科 | Department of Gastrointestinal Surgery | ||||||||||||
| 郵便番号/Zip code | 241-0815 | |||||||||||||
| 住所/Address | 神奈川県横浜市旭区中尾1-1-2 | 2-3-2 Nakao, Asahi Ward, Yokohama, Kanagawa, Japan | ||||||||||||
| 電話/TEL | 045-391-5761 | |||||||||||||
| Email/Email | choharuhiko@kcch.jp | |||||||||||||
| 試験問い合わせ窓口/Public contact | ||||||||||||||
| 試験問い合わせ窓口担当者/Name of contact person |
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| 組織名/Organization | 神奈川県立がんセンター | Kanagawa Cancer Center | ||||||||||||
| 部署名/Division name | 消化器外科 | Department of Gastrointestinal Surgery | ||||||||||||
| 郵便番号/Zip code | 241-0815 | |||||||||||||
| 住所/Address | 神奈川県横浜市旭区中尾1-1-2 | 2-3-2 Nakao, Asahi Ward, Yokohama, Kanagawa, Japan | ||||||||||||
| 電話/TEL | 045-391-5761 | |||||||||||||
| 試験のホームページURL/Homepage URL | ||||||||||||||
| Email/Email | rika.takahasi@kcch.jp | |||||||||||||
| 実施責任組織/Sponsor | ||
| 機関名/Institute | 地方独立行政法人神奈川県立病院機構神奈川県立がんセンター(臨床研究所) | Department of Gastrointestinal Surgery, Kanagawa Cancer Center |
| 機関名/Institute (機関選択不可の場合) |
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| 部署名/Department | 消化器外科 | |
| 研究費提供組織/Funding Source | ||
| 機関名/Organization | 地方独立行政法人神奈川県立病院機構神奈川県立がんセンター(臨床研究所) | Department of Gastrointestinal Surgery, Kanagawa Cancer Center |
| 機関名/Organization (機関選択不可の場合) |
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| 組織名/Division | ||
| 組織の区分/Category of Funding Organization | 自己調達/Self funding | |
| 研究費拠出国/Nationality of Funding Organization | ||
| その他の関連組織/Other related organizations | ||
| 共同実施組織/Co-sponsor | ||
| その他の研究費提供組織/Name of secondary funder(s) | ||
| IRB等連絡先(公開)/IRB Contact (For public release) | ||
| 組織名/Organization | 神奈川県立がんセンター | Department of Gastrointestinal Surgery, Kanagawa Cancer Center |
| 住所/Address | 神奈川県横浜市旭区中尾1-1-2 | 2-3-2 Nakao, Asahi Ward, Yokohama, Kanagawa, Japan |
| 電話/Tel | 045-391-5761 | |
| Email/Email | rika.takahasi@kcch.jp | |
| 他機関から発行された試験ID/Secondary IDs | ||
| 他機関から発行された試験ID/Secondary IDs | いいえ/NO | |
| 試験ID1/Study ID_1 | ||
| ID発行機関1/Org. issuing International ID_1 | ||
| 試験ID2/Study ID_2 | ||
| ID発行機関2/Org. issuing International ID_2 | ||
| 治験届/IND to MHLW | ||
| 試験実施施設/Institutions | ||
| 試験実施施設名称/Institutions | ||
| その他の管理情報/Other administrative information | ||||||||
| 一般公開日(本登録希望日)/Date of disclosure of the study information |
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| 関連情報/Related information | ||
| プロトコル掲載URL/URL releasing protocol | ||
| 試験結果の公開状況/Publication of results | 未公表/Unpublished | |
| 結果/Result | ||
| 結果掲載URL/URL related to results and publications | ||
| 組み入れ参加者数/Number of participants that the trial has enrolled | 18 | |
| 主な結果/Results | ||
| 主な結果入力日/Results date posted | ||
| 結果掲載遅延/Results Delayed | ||
| 結果遅延理由/Results Delay Reason | ||
| 最初の試験結果の出版日/Date of the first journal publication of results | ||
| 参加者背景/Baseline Characteristics | ||
| 参加者の流れ/Participant flow | ||
| 有害事象/Adverse events | ||
| 評価項目/Outcome measures | ||
| 個別症例データ共有計画/Plan to share IPD | ||
| 個別症例データ共有計画の詳細/IPD sharing Plan description | ||
| 試験進捗状況/Progress | ||||||||
| 試験進捗状況/Recruitment status | 参加者募集終了‐試験継続中/No longer recruiting | |||||||
| プロトコル確定日/Date of protocol fixation |
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| 倫理委員会による承認日/Date of IRB |
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| 登録・組入れ開始(予定)日/Anticipated trial start date |
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| フォロー終了(予定)日/Last follow-up date |
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| 入力終了(予定)日/Date of closure to data entry |
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| データ固定(予定)日/Date trial data considered complete |
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| 解析終了(予定)日/Date analysis concluded |
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| その他/Other | ||
| その他関連情報/Other related information | 論文作成が完了しました。 | |
| 管理情報/Management information | ||||||||
| 登録日時/Registered date |
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| 最終更新日/Last modified on |
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| 閲覧ページへのリンク/Link to view the page | |
| URL(日本語) | https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050436 |
| URL(英語) | https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050436 |