NCT05314946

Brief Summary

Patients diagnosed with esophageal cancer have difficulty eating, as the food pipe becomes obstructed by the cancer. This may impair the ability for the patient to receive appropriate calorie intake, especially during administration of chemotherapy and radiation therapy given prior to surgical resection. A strategy is to place a feeding tube directly in the stomach or in the small bowel to have an access to the patient's gastrointestinal tract during administration of chemo radiation therapy. However, these feeding tubes may lead to adverse events, including dislodgement, infection, the tube may be plugged, etc. If these complications were to happen, patients may have their treatment delayed, may have to come to the emergency department or even be admitted. In some cases, patients may need to have a surgery performed to treat the complication. Most centres in Canada have moved away from placement of these feeding tubes due to the high incidence of complications associated with the feeding tubes placement, and due to the high efficacy from the chemoradiation therapy in shrinking the tumour, allowing for the patient to swallow. In London, the preference from the Medical and Radiation Oncologists was to have these feeding tubes placed to avoid delay in treating the patients. There is therefore significant controversy as to what is the best approach in this patient population. Our goal is to run a feasibility randomized controlled trial studying this question.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
26

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Nov 2022

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 5, 2022

Completed
1 month until next milestone

First Posted

Study publicly available on registry

April 7, 2022

Completed
7 months until next milestone

Study Start

First participant enrolled

November 1, 2022

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2024

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2024

Completed
Last Updated

April 3, 2024

Status Verified

April 1, 2024

Enrollment Period

1.9 years

First QC Date

March 5, 2022

Last Update Submit

April 2, 2024

Conditions

Keywords

canceresophagusenteral nutritionfeeding tubeadverse eventsrandomized controlled trialfeasibility

Outcome Measures

Primary Outcomes (1)

  • Feasibility of the trial

    The trial will be deemed feasible if 60% or more of eligible patients are recruited, 80% or more of data is collected, and 5% or less patients are lost to follow-up.

    From randomization to 90-day post-operative

Secondary Outcomes (12)

  • Rate of unplanned visits (ED or outpatient clinic)

    From randomization to 90-day post-operative

  • Time from PET scan to beginning of induction treatment

    From randomization to 90-day post-operative

  • Total weight loss (kilograms)

    From randomization to 90-day post-operative

  • Nutritional status

    From randomization to 90-day post-operative

  • Any grade adverse event rate

    From randomization to 90-day post-operative

  • +7 more secondary outcomes

Study Arms (2)

Percutaneous enteral access

ACTIVE COMPARATOR

Feeding tube, either gastrostomy (G-) tube or gastrojejunostomy (GJ-) tube (placed by Interventional Radiology) or J-tube (surgically placed)

Procedure: Placement of a percutaneous feeding tube

No percutaneous enteral access

EXPERIMENTAL

No feeding tube placed.

Procedure: No feeding tube placed

Interventions

The experimental arm will forego placement of a feeding tube.

No percutaneous enteral access

The standard arm will have a feeding tube placed (G-tube or GJ-tube by IR; or surgically placed J-tube)

Percutaneous enteral access

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult patient
  • Non-cervical biopsy-proven esophageal or gastroesophageal junction (Siewert I or II) cancer
  • Patient eligible for induction therapy then esophagectomy (stage Ib to III)

You may not qualify if:

  • Impossibility to pass an endoscope beyond the tumour
  • metastatic disease
  • early-stage disease with either upfront esophagectomy or endoscopic resection planned
  • patient refusal of the feeding tube
  • inability to swallow their pill
  • inability to tolerate a full fluid diet

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

London Health Sciences Centre - Victoria Hospital

London, Ontario, N6A 5W9, Canada

RECRUITING

MeSH Terms

Conditions

Esophageal NeoplasmsNeoplasms

Condition Hierarchy (Ancestors)

Gastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteHead and Neck NeoplasmsDigestive System DiseasesEsophageal DiseasesGastrointestinal Diseases

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Associate Scientist

Study Record Dates

First Submitted

March 5, 2022

First Posted

April 7, 2022

Study Start

November 1, 2022

Primary Completion

September 30, 2024

Study Completion

December 31, 2024

Last Updated

April 3, 2024

Record last verified: 2024-04

Data Sharing

IPD Sharing
Will not share

Locations