AzTrials
AzTrials

Chronic Radiation InjuryPhase 3PE-BaconNCT05607927

PE-Bacon for Late Complications of Chronic Radiation-induced Rectal Injury

A Phase 3 study testing Parks surgery and PE-Bacon surgery in people with Chronic Radiation Injury, run by Sixth Affiliated Hospital, Sun Yat-sen University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Chronic radiation-induced injury (CRII) is a common complication after radiation therapy for pelvic malignancies. Resection surgery could be an optimal surgical approach when CRII is complicated by late complications. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Chronic Radiation Injury
What is being tested?
Parks surgery and PE-Bacon surgery
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
316 participants
Where
No sites listed yet
Study dates
20 Nov 2022to 30 Aug 2028
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. Patients aged 18-70 years;
  • 2. Patients with Eastern Cooperative Oncology Group (ECOG) physical condition score of 0-2;
  • 3. Patients with previous pathological diagnosis of pelvic tumors (Gynecology, prostate, urinary system);
  • 4. Patients with a history of pelvic radiotherapy, at least 6 months from the end of the last radiotherapy;
  • 5. Patients without recurrence or metastasis of primary tumor;
  • 6. The late complications of CRII patients, such as deep rectal ulcer (VRS score >=3), rectal sigmoid colon stenosis, obstruction, chronic perforation, rectal necrosis, rectovaginal fistula, intractable anal pain caused by rectal lesions, intractable rectal bleeding which is still difficult to be relieved by stoma operation, and patients who need sigmoid colorectal resection;
  • 7. Patients who can tolerate general anesthesia;
  • 8. The subjects and their families are able to understand the study plan, willing to participate and sign the informed consent.

Who cannot join

  • 1. Patients with acute intestinal obstruction, acute intestinal perforation and intestinal hemorrhage who need emergency operation;
  • 2. Patients with severe pelvic adhesion and frozen pelvis;
  • 3. Patients with unstable primary tumor or tumor in other parts;
  • 4. Patients who need to undergo combined organ resection;
  • 5. Patients with a history of sigmoidostomy;
  • 6. American society of anesthesiologists (ASA) level IV to V;
Show all 9Show fewer
  • 7. Patients with serious mental illness;
  • 8. Pregnant or lactating women;
  • 9. Patients with serious cardiovascular disease, uncontrollable infection, or other uncontrollable combined diseases.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

About this study

Official title: Laparoscopic Proximally Extended Colorectal Resection With Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Late Complications of Chronic Radiation-induced Rectal Injury: A Prospective, Multicenter, Randomized Controlled Clinical Trail

Chronic radiation-induced injury (CRII) is a common complication after radiation therapy for pelvic malignancies. Resection surgery could be an optimal surgical approach when CRII is complicated by late complications. However, because of high incidence of postoperative complications like anastomotic leakage rate and mortality, doctors try to avoid performing surgical resection. In addition, there is sparse agreement on the types of surgery.

Previous study proved that anastomosis with at least one end of bowel without radiation damage can greatly reduce postoperative anastomotic leakage rate and mortality. And in Bacon surgery, primary anastomosis is not performed, and the anastomotic tension markedly reduced and the blood supply of anastomosis can be judged intuitively to improve the quality of anastomosis in the second stage of intestinal anastomosis to decrease the anastomotic leakage rate. Combining the advantages of proximally extended resection and two-stage anastomosis could minimize potential complications and maximize the therapeutic efficacy in theory, and a small sample prospective clinical study by the investigator have already preliminarily confirmed it. The investigator has also preliminarily proved that Parks surgery is safe and feasible for the treatment of late complications of CRII.

Therefore, this study aims to observe the safety and effectiveness of PE-Bacon surgery with Parks surgery as a control, in order to select more optimal surgical methods and provide a high-level evidence-based medical basis for patients with late complications of CRII.

Read the detailed description

Chronic radiation-induced injury (CRII) is a common complication after radiation therapy for pelvic malignancies. Compared with diversion surgery, resection surgery removes the damaged tissue completely to avoid the risks of recurrence and improve patients' outcome. Hence, resection surgery could be an optimal surgical approach when CRII is complicated by late complications. However, because of high incidence of postoperative complications like anastomotic leakage rate and mortality, doctors try to avoid performing surgical resection. In addition, there is sparse agreement on the types of surgery.

With the advances of surgical techniques and perioperative care, the morbidity and mortality of resection surgery has been decreased significantly. In addition, previous study proved that anastomosis with at least one end of bowel without radiation damage can greatly reduce postoperative anastomotic leakage rate and mortality. And in Bacon surgery, primary anastomosis is not performed, and the anastomotic tension markedly reduced and the blood supply of anastomosis can be judged intuitively to improve the quality of anastomosis in the second stage of intestinal anastomosis to decrease the anastomotic leakage rate. Combining the advantages of proximally extended resection and two-stage anastomosis could minimize potential complications and maximize the therapeutic efficacy in theory, and a small sample prospective clinical study by the investigator have already preliminarily confirmed it. And the investigator has also preliminarily proved that Parks surgery is safe and feasible for the treatment of late complications of CRII.

Therefore, this study aims to observe the safety and effectiveness of PE-Bacon surgery with Parks surgery as a control, in order to select more optimal surgical methods and provide a high-level evidence-based medical basis for patients with late complications of CRII.

Being tested
Parks surgery, PE-Bacon surgery
Keywords
PE-Bacon, Parks, complication

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Parks surgeryProcedure or surgery

    Parks surgery

  • PE-Bacon surgeryProcedure or surgery

    PE-Bacon surgery

Study groups in NCT05607927
Study groupRoleWhat they receive
Parks surgery groupOtherThe CRII patients received Parks surgery
Receives: Procedure: Parks surgery
PE-Bacon surgery groupExperimentalThe CRII patients received PE-Bacon surgery
Receives: Procedure: PE-Bacon surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ostomy reversal rate within 1 year after surgery

    Ostomy reversal rate within 1 year after surgery

    Measured: 1 year after surgery

  2. Incidence of anastomotic leakage within 6 months after surgery

    Incidence of anastomotic leakage within 6 months after surgery

    Measured: 6 months after surgery

Secondary outcomes (15)
  1. Ostomy reversal rate within 2 years after surgery

    Ostomy reversal rate within 2 years after surgery

    Measured: 2 years after surgery

  2. Ostomy reversal rate within 3 years after surgery

    Ostomy reversal rate within 3 years after surgery

    Measured: 3 years after surgery

  3. Incidence of anastomotic leakage within 1 year after surgery

    Incidence of anastomotic leakage within 1 year after surgery

    Measured: 1 year after surgery

  4. Incidence of anastomotic leakage within 2 years after surgery

    Incidence of anastomotic leakage within 2 years after surgery

    Measured: 2 years after surgery

  5. Incidence of anastomotic leakage within 3 years after surgery

    Incidence of anastomotic leakage within 3 years after surgery

    Measured: 3 years after surgery

  6. Incidence of anastomotic stricture within 6 months after surgery

    Incidence of anastomotic stricture within 6 months after surgery

    Measured: 6 months after surgery

  7. Incidence of anastomotic stricture within 1 year after surgery

    Incidence of anastomotic stricture within 1 year after surgery

    Measured: 1 year after surgery

  8. Incidence of anastomotic stricture within 2 years after surgery

    Incidence of anastomotic stricture within 2 years after surgery

    Measured: 2 years after surgery

  9. Incidence of anastomotic stricture within 3 years after surgery

    Incidence of anastomotic stricture within 3 years after surgery

    Measured: 3 years after surgery

  10. Incidence of severe intestinal dysfunction at 1 year after ostomy reversal

    Incidence of severe intestinal dysfunction at 1 year after ostomy reversal

    Measured: 1 year after ostomy reversal

  11. Incidence of severe intestinal dysfunction at 2 years after ostomy reversal

    Incidence of severe intestinal dysfunction at 2 years after ostomy reversal

    Measured: 2 years after ostomy reversal

  12. Incidence of severe intestinal dysfunction at 3 years after ostomy reversal

    Incidence of severe intestinal dysfunction at 3 years after ostomy reversal

    Measured: 3 years after ostomy reversal

  13. Quality of life at 1 year after ostomy reversal

    Quality of life at 1 year after ostomy reversal

    Measured: 1 year after ostomy reversal

  14. Quality of life at 2 years after ostomy reversal

    Quality of life at 2 years after ostomy reversal

    Measured: 2 years after ostomy reversal

  15. Quality of life at 3 years after ostomy reversal

    Quality of life at 3 years after ostomy reversal

    Measured: 3 years after ostomy reversal

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Nov 2022
  2. Study start20 Nov 2022 (estimated)
  3. Primary completion30 Aug 2025 (estimated)
  4. Study completion30 Aug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
316 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05607927
Sponsor's protocol ID
PE-Bacon2022
Acronym
PE-Bacon
Status last verified
Nov 2022
First submitted
26 Sep 2022
Last updated
7 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer. 2005 Sep 15;104(6):1129-37. doi: 10.1002/cncr.21324.

    PubMed 16080176
  • Andreyev J. Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients. Lancet Oncol. 2007 Nov;8(11):1007-17. doi: 10.1016/S1470-2045(07)70341-8.

    PubMed 17976611
  • Perrakis N, Athanassiou E, Vamvakopoulou D, Kyriazi M, Kappos H, Vamvakopoulos NC, Nomikos I. Practical approaches to effective management of intestinal radiation injury: benefit of resectional surgery. World J Gastroenterol. 2011 Sep 21;17(35):4013-6. doi: 10.3748/wjg.v17.i35.4013.

    PubMed 22046090
  • McCrone LF, Neary PM, Larkin J, McCormick P, Mehigan B. The surgical management of radiation proctopathy. Int J Colorectal Dis. 2017 Aug;32(8):1099-1108. doi: 10.1007/s00384-017-2803-y. Epub 2017 Apr 20.

    PubMed 28429071
  • Zhong Q, Yuan Z, Ma T, Wang H, Qin Q, Chu L, Wang J, Wang L. Restorative resection of radiation rectovaginal fistula can better relieve anorectal symptoms than colostomy only. World J Surg Oncol. 2017 Feb 2;15(1):37. doi: 10.1186/s12957-017-1100-0.

    PubMed 28153025
  • Meissner K. Late radiogenic small bowel damage: guidelines for the general surgeon. Dig Surg. 1999;16(3):169-74. doi: 10.1159/000018721.

    PubMed 10436361
  • Qin Q, Zhu Y, Wu P, Fan X, Huang Y, Huang B, Wang J, Wang L. Radiation-induced injury on surgical margins: a clue to anastomotic leakage after rectal-cancer resection with neoadjuvant chemoradiotherapy? Gastroenterol Rep (Oxf). 2019 Apr;7(2):98-106. doi: 10.1093/gastro/goy042. Epub 2018 Dec 11.

    PubMed 30976422
  • He Y, Zhou Z, Huang X, Guan Q, Qin Q, Zhu M, Wang H, Zhong Q, Chen D, Wang H, Fang L, Ma T. Laparoscopic Proximally Extended Colorectal Resection With Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Late Complications of Chronic Radiation Proctopathy. Front Surg. 2022 Apr 25;9:845148. doi: 10.3389/fsurg.2022.845148. eCollection 2022.

    PubMed 35548188
  • Anseline PF, Lavery IC, Fazio VW, Jagelman DG, Weakley FL. Radiation injury of the rectum: evaluation of surgical treatment. Ann Surg. 1981 Dec;194(6):716-24. doi: 10.1097/00000658-198112000-00010.

    PubMed 7305485
  • Jao SW, Beart RW Jr, Gunderson LL. Surgical treatment of radiation injuries of the colon and rectum. Am J Surg. 1986 Feb;151(2):272-7. doi: 10.1016/0002-9610(86)90086-3.

    PubMed 3946764

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Parks surgery and PE-Bacon surgery in people with Chronic Radiation Injury, run by Sixth Affiliated Hospital, Sun Yat-sen University.

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 8 inclusion and 9 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: opening soon, as of the sponsor's last update on 7 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Tenghui Ma, PhD (13560232462, matengh@mail.sysu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ostomy reversal rate within 1 year after surgery (time frame: 1 year after surgery). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05607927, which also lists 10 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 7 Nov 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in