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Endovascular Brachytherapy Combined With Stent Placement and TACE for HCC With Main Portal Vein Tumor Thrombus

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Fudan University

Status and phase

Unknown
Phase 3

Conditions

Hepatocellular Carcinoma
Portal Vein Tumor Thrombus

Treatments

Procedure: Stent and Iodine-125 seed strand implantation
Device: Stent
Drug: Epirubicin
Other: Gelatin sponge articles
Device: Iodine-125 seed
Drug: Ultra-fluid lipiodol

Study type

Interventional

Funder types

Other

Identifiers

NCT02971345
ZS-IR-2016

Details and patient eligibility

About

It is a prospective and multi-center clinical research in China to compare the efficacy, safety and related impact factors between TACE alone and endovascular brachytherapy combined with stent placement and TACE for HCC with main portal vein tumor thrombus.

Full description

It is an open random prospective phase III clinical trial conducted by Principal Investigator Professor Zhi-ping Yan.Investigators in twenty-seven hospitals in China participate in.Patients with unresectable HCC with main portal vein tumor thrombus are enrolled. The investigators propose to recruitment 253 patients who are randomly assigned into the combined group (treated with endovascular brachytherapy combined with stent placement and TACE) and the control group (treated with TACE alone).There are 127 patients in combined group and 126 patients in control group. The criteria of inclusion and exclusion, and the methods of lab tests, imaging modality and treatment procedures are the same.

Enrollment

253 estimated patients

Sex

All

Ages

18 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • (1) Hepatocellular carcinoma(HCC) diagnosis confirmed by needle biopsy or by two coincidental imaging techniques associated with increased α-fetoprotein according to the American Association for the Study of Liver Diseases (AASLD) guidelines;
  • (2) According to the Barcelona Clinic Liver Cancer staging classification, HCC was unsuitable for resection, liver transplantation or percutaneous radiofrequency ablation;
  • (3) Tumor thrombus, a low-attenuation intraluminal filling defect extending from intrahepatic portal vein branches adjacent to primary tumor into main portal vein, was confirmed by contrast-enhanced abdominal computer tomography (CT) or magnetic resonance imaging (MRI)
  • (4) At least the first-order branch of the intrahepatic portal vein was patent in one lobe;
  • (5) Child-Pugh classification grade A or B;
  • (6) Eastern Cooperative Oncology Group (ECOG) performance status score of 2 or less;

Exclusion criteria

  • (1) Patients had a history of any therapy for HCC or portal vein tumor thrombus;
  • (2) Advanced liver disease (bilirubin levels >3 mg/dL, Aspartate transaminase or Alanine aminotransferase >5 × upper limit of normal);
  • (3) Tumor invade the Inferior Vena Cava, extrahepatic spread;
  • (4) Any contraindication to an arterial procedure such as impaired clotting tests (platelet count below 50 × 109/L or prothrombin activity below 50 %);
  • (5) Renal failure,cardiac ejection fraction (<50 %) or end-stage disease;
  • (6) Patients who were not capable of cooperation during the procedure.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

253 participants in 2 patient groups

Endovascular Brachytherapy&Stent&TACE
Experimental group
Description:
Transarterial chemoembolization (TACE) is performed immediately following Iodine-125 seed strand and stent implantation. Epirubicin,ultra-fluid lipiodol and gelatin sponge articles are used in TACE.
Treatment:
Drug: Epirubicin
Drug: Ultra-fluid lipiodol
Procedure: Stent and Iodine-125 seed strand implantation
Device: Stent
Other: Gelatin sponge articles
Device: Iodine-125 seed
TACE alone
Active Comparator group
Description:
Only TACE is performed. Epirubicin, ultra-fluid lipiodol and gelatin sponge articles are used in TACE.
Treatment:
Drug: Epirubicin
Drug: Ultra-fluid lipiodol
Other: Gelatin sponge articles

Trial contacts and locations

1

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Central trial contact

Zihan Zhang, MD; Wen Zhang, MD

Data sourced from clinicaltrials.gov

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