Non Small Cell Lung CancerNCT00364663
The Utility and Cost-Effectiveness Analysis of 18F-FDG PETin Staging Potential Operable Non-Small Cell Lung Cancer
An observational study of Non Small Cell Lung Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.
Trial summary
We plan to conduct a prospective study: 1. to evaluate the accuracy of PET in staging patients with potentially operable non-small cell lung cancer; 2. to evaluate the percentage of futile thoracotomy after PET is introduced in the routine staging modalities for NSCLC patient; 3. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Non Small Cell Lung Cancer
- How many people
- 100 participants
- Where
- 1 siteTaiwan
- Study dates
- Aug 2006to not given
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- patients with non-small-cell lung cancer
Who cannot join
- patients who are pregnant
- patients who are under 18 years old
- patients who do not undergone surgery
- patients who have other known malignancy
Trial locations and contacts
1 site in 1 country.
Taiwan1 site, 1 recruiting
- Recruiting
National Taiwan University Hospital
Taipei, 100
Ruoh-Fang Yen, MD, PhD, 886-2-23123456 ext. 5581, rfyen@ha.mc.ntu.edu.tw
Ruoh-Fang Yen, MD, PhD
About this study
Official title: The Utility and Cost-Effectiveness Analysis of 18-Fluoro-2-Deoxyglucose Positron Emission Tomography in Staging Potential Operable Non-Small Cell Lung Cancer
We plan to conduct a prospective study:
- to evaluate the accuracy of PET in staging patients with potentially operable non-small cell lung cancer;
- to evaluate the percentage of futile thoracotomy after PET is introduced in the routine staging modalities for NSCLC patient;
- to establish a decision tree model based on choices between conventional imaging only and additional PET imaging to analyze their cost-effectiveness.
Read the detailed description
Lung cancer has been a major health issue worldwide, including Taiwan. According to the data published by the Department of Health, Executive Yuan, Taiwan, 2004, lung cancer is already the leading cause of cancer-related death in Taiwan. Non-small cell lung cancer (NSCLC) represents approximately 75-85% of all primary lung tumors. The strongest prognostic factor for survival is whether the tumor can be completely resected. Surgical resection may be performed for those patients without distant or extended lymph node metastasis. Because of the significant morbidity and mortality for surgical procedure of lung cancer, it is therefore very important to identify and exclude those patients who can't benefit from surgical treatment. Conventional staging, using chest/brain X-ray computed tomography, abdominal echography and radionuclide bone scintigraphy, leads to futile thoracotomies in up to 50% of patients.
Since early 1990s, when 18F-FDG PET has emerged as a promising diagnostic imaging tool in nuclear medicine, a large number of studies have been reported without exception that PET is a better staging tool than CT for patients with NSCLC. However, due to the prohibitive cost, PET is not routinely used for the staging of NSCLC in Taiwan. The extra cost accruing from the introduction of this new technology has been the major concerns from the clinical physicians and health policy makers.
A number of economic evaluation studies overseas have shown that PET is cost-effective in NSCLC when added to conventional work-up. However, due to that the sensitivity and specificity of 18F-FDG PET in staging NSCLC, the cost structure of medical expense, the severity of disease for NSCLC patients when they first present in the hospital, may be different between different countries. To the best of our knowledge, there has been no report that provides a practical guide to introduce PET in staging NSCLC. A cost-effectiveness economic evaluation in Taiwan is thus in demand.
Patient eligibility:
Inclusion criteria: Patients with early NSCLC (stage I \& II) Exclusion criteria: (1) patients who are pregnant (2) patients under 18 years old (3) patients who refuse surgical intervention (4) patients who have other known malignancy
- Conditions
- Non Small Cell Lung Cancer
- Keywords
- NSCLC, staging, 18F-FDG PET, decision tree model, cost-effectiveness
- Medical subject headings
- Carcinoma, Non-Small-Cell Lung
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Aug 2006 (estimated)
- Study startAug 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Non Small Cell Lung CancerStudies of the same condition, open and under way.
- More trials run by National Taiwan University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Defined population
- Time perspective
- Other
- Enrolment
- 100 participants
Sponsor and investigators
- Lead sponsor
- National Taiwan University Hospital
- Sponsor type
- University, hospital or other
- Investigators
- Ruoh-Fang Yen, MD, PhD, Principal investigator, National Taiwan University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00364663
- Sponsor's protocol ID
- 950307
- Other IDs
- NSC 95-2314-B-002 -268 -MY2
- Status last verified
- Aug 2006
- First submitted
- 15 Aug 2006
- Last updated
- 16 Aug 2006
- Results posted
- No
Publications
Herder GJ, Verboom P, Smit EF, van Velthoven PC, van den Bergh JH, Colder CD, van Mansom I, van Mourik JC, Postmus PE, Teule GJ, Hoekstra OS. Practice, efficacy and cost of staging suspected non-small cell lung cancer: a retrospective study in two Dutch hospitals. Thorax. 2002 Jan;57(1):11-4. doi: 10.1136/thorax.57.1.11.
PubMed 11809983Webb WR, Gatsonis C, Zerhouni EA, Heelan RT, Glazer GM, Francis IR, McNeil BJ. CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiologic Diagnostic Oncology Group. Radiology. 1991 Mar;178(3):705-13. doi: 10.1148/radiology.178.3.1847239.
PubMed 1847239Investigation for mediastinal disease in patients with apparently operable lung cancer. Canadian Lung Oncology Group. Ann Thorac Surg. 1995 Nov;60(5):1382-9. doi: 10.1016/0003-4975(95)00758-d.
PubMed 8526631van Tinteren H, Hoekstra OS, Smit EF, Verboom P, Boers M; PLUS Study Group. Toward less futile surgery in non-small cell lung cancer? A randomized clinical trial to evaluate the cost-effectiveness of positron emission tomography. Control Clin Trials. 2001 Feb;22(1):89-98. doi: 10.1016/s0197-2456(00)00119-7.
PubMed 11165427Dwamena BA, Sonnad SS, Angobaldo JO, Wahl RL. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s--meta-analytic comparison of PET and CT. Radiology. 1999 Nov;213(2):530-6. doi: 10.1148/radiology.213.2.r99nv46530.
PubMed 10551237Yen RF, Chen ML, Liu FY, Ko SC, Chang YL, Chieng PU, Su CT. False-positive 2-[F-18]-fluoro-2-deoxy-D-glucose positron emission tomography studies for evaluation of focal pulmonary abnormalities. J Formos Med Assoc. 1998 Sep;97(9):642-5.
PubMed 9795534Gambhir SS, Hoh CK, Phelps ME, Madar I, Maddahi J. Decision tree sensitivity analysis for cost-effectiveness of FDG-PET in the staging and management of non-small-cell lung carcinoma. J Nucl Med. 1996 Sep;37(9):1428-36.
PubMed 8790186
Study at a glance
From the registry record, last updated by the sponsor on 16 Aug 2006. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Utility and Cost-Effectiveness Analysis of 18-Fluoro-2-Deoxyglucose Positron Emission Tomography in Staging Potential Operable Non-Small Cell Lung Cancer
- ClinicalTrials.gov ID
- NCT00364663
- Acronym / sponsor ID
- 950307
- Conditions
- Non Small Cell Lung Cancer
- Keywords
- NSCLC, staging, 18F-FDG PET, decision tree model, cost-effectiveness
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 100 participants
- Lead sponsor
- National Taiwan University HospitalUniversity, hospital or other
- Study start
- Aug 2006
- First posted
- 16 Aug 2006 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
We plan to conduct a prospective study:
- to evaluate the accuracy of PET in staging patients with potentially operable non-small cell lung cancer;
- to evaluate the percentage of futile thoracotomy after PET is introduced in the routine staging modalities for NSCLC patient;
- to establish a decision tree model based on choices between conventional imaging only and additional PET imaging to analyze their cost-effectiveness.
Detailed description
Lung cancer has been a major health issue worldwide, including Taiwan. According to the data published by the Department of Health, Executive Yuan, Taiwan, 2004, lung cancer is already the leading cause of cancer-related death in Taiwan. Non-small cell lung cancer (NSCLC) represents approximately 75-85% of all primary lung tumors. The strongest prognostic factor for survival is whether the tumor can be completely resected. Surgical resection may be performed for those patients without distant or extended lymph node metastasis. Because of the significant morbidity and mortality for surgical procedure of lung cancer, it is therefore very important to identify and exclude those patients who can't benefit from surgical treatment. Conventional staging, using chest/brain X-ray computed tomography, abdominal echography and radionuclide bone scintigraphy, leads to futile thoracotomies in up to 50% of patients.
Since early 1990s, when 18F-FDG PET has emerged as a promising diagnostic imaging tool in nuclear medicine, a large number of studies have been reported without exception that PET is a better staging tool than CT for patients with NSCLC. However, due to the prohibitive cost, PET is not routinely used for the staging of NSCLC in Taiwan. The extra cost accruing from the introduction of this new technology has been the major concerns from the clinical physicians and health policy makers.
A number of economic evaluation studies overseas have shown that PET is cost-effective in NSCLC when added to conventional work-up. However, due to that the sensitivity and specificity of 18F-FDG PET in staging NSCLC, the cost structure of medical expense, the severity of disease for NSCLC patients when they first present in the hospital, may be different between different countries. To the best of our knowledge, there has been no report that provides a practical guide to introduce PET in staging NSCLC. A cost-effectiveness economic evaluation in Taiwan is thus in demand.
Patient eligibility:
Inclusion criteria: Patients with early NSCLC (stage I \& II) Exclusion criteria: (1) patients who are pregnant (2) patients under 18 years old (3) patients who refuse surgical intervention (4) patients who have other known malignancy
Study design
- Observational model
- Defined population
- Time perspective
- Other
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- patients with non-small-cell lung cancer
Key exclusion criteria (4 listed)
- patients who are pregnant
- patients who are under 18 years old
- patients who do not undergone surgery
- patients who have other known malignancy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Aug 2006.
- Background: PubMed 11809983Herder GJ, Verboom P, Smit EF, van Velthoven PC, van den Bergh JH, Colder CD, van Mansom I, van Mourik JC, Postmus PE, Teule GJ, Hoekstra OS. Practice, efficacy and cost of staging suspected non-small cell lung cancer: a retrospective study in two Dutch hospitals. Thorax. 2002 Jan;57(1):11-4. doi: 10.1136/thorax.57.1.11.
- Background: PubMed 1847239Webb WR, Gatsonis C, Zerhouni EA, Heelan RT, Glazer GM, Francis IR, McNeil BJ. CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiologic Diagnostic Oncology Group. Radiology. 1991 Mar;178(3):705-13. doi: 10.1148/radiology.178.3.1847239.
- Background: PubMed 8526631Investigation for mediastinal disease in patients with apparently operable lung cancer. Canadian Lung Oncology Group. Ann Thorac Surg. 1995 Nov;60(5):1382-9. doi: 10.1016/0003-4975(95)00758-d.
- Background: PubMed 11165427van Tinteren H, Hoekstra OS, Smit EF, Verboom P, Boers M; PLUS Study Group. Toward less futile surgery in non-small cell lung cancer? A randomized clinical trial to evaluate the cost-effectiveness of positron emission tomography. Control Clin Trials. 2001 Feb;22(1):89-98. doi: 10.1016/s0197-2456(00)00119-7.
- Background: PubMed 10551237Dwamena BA, Sonnad SS, Angobaldo JO, Wahl RL. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s--meta-analytic comparison of PET and CT. Radiology. 1999 Nov;213(2):530-6. doi: 10.1148/radiology.213.2.r99nv46530.
- Background: PubMed 9795534Yen RF, Chen ML, Liu FY, Ko SC, Chang YL, Chieng PU, Su CT. False-positive 2-[F-18]-fluoro-2-deoxy-D-glucose positron emission tomography studies for evaluation of focal pulmonary abnormalities. J Formos Med Assoc. 1998 Sep;97(9):642-5.
- Background: PubMed 8790186Gambhir SS, Hoh CK, Phelps ME, Madar I, Maddahi J. Decision tree sensitivity analysis for cost-effectiveness of FDG-PET in the staging and management of non-small-cell lung carcinoma. J Nucl Med. 1996 Sep;37(9):1428-36.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ruoh-Fang Yen, MD, PhD principal investigator
National Taiwan University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Non Small Cell Lung Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 16 Aug 2006. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Ruoh-Fang Yen, MD, PhD (886-2-23123456 ext. 5581, rfyen@ha.mc.ntu.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00364663, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Aug 2006.