Radiofrequency Ablation in Treating Patients With Liver Cancer and Cirrhosis

NCT ID: NCT00132041

Last Updated: 2020-09-10

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

51 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-12-31

Study Completion Date

2010-11-30

Brief Summary

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RATIONALE: Radiofrequency ablation uses a high-frequency, electric current to kill tumor cells. CT-, MRI-, or ultrasound-guided radiofrequency ablation may be an effective treatment for liver cancer and cirrhosis.

PURPOSE: This phase II trial is studying how well radiofrequency ablation works in treating patients with liver cancer and cirrhosis.

Detailed Description

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OBJECTIVES:

Primary

* Determine the 18-month successful disease control rate, defined as no identifiable liver tumor by CT scan, in patients with hepatocellular carcinoma and cirrhosis treated with solitary or repetitive percutaneous radiofrequency ablation (RFA).

Secondary

* Correlate tumor size, MELD score, and the number of RFA treatments (solitary or repetitive) with the 18-month successful disease control rate in patients treated with this procedure.
* Determine the local and remote intrahepatic and extrahepatic tumor recurrence rates in patients treated with this procedure.
* Correlate local and remote intrahepatic and extrahepatic tumor recurrence rates with the 18-month successful disease control rate in patients treated with this procedure.
* Correlate tumor size with the local disease control rate in patients treated with this procedure.
* Correlate solitary or repetitive RFA with or without local/regional tumor control with the development of extrahepatic tumor in these patients.
* Determine the local tumor eradication rate, as determined by examination of whole liver specimens or CT scan, in patients treated with this procedure.

OUTLINE: This is a multicenter study. Patients are stratified according to hepatic dysfunction using the MELD score (\< 15 vs 15-25 vs \> 25).

Patients undergo placement of an ablation electrode percutaneously into the tumor(s) by CT scan, MRI, or ultrasound guidance. Patients then undergo percutaneous radiofrequency ablation (RFA) directly to the tumor(s) for 12 minutes. Patients undergo CT scan of the liver within 1 week after RFA treatment and then every 3 months for up to 18 months. Patients with residual or recurrent intrahepatic tumor(s) detectable on the 3-month or subsequent CT scan undergo repeat RFA as is technically feasible and clinically indicated for up to 15 months after initial RFA treatment.

After completion of study treatment, patients are followed at 1 day, 1 week, 1 month, and then every 3 months for up to 18 months.

PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.

Conditions

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Liver Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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All Patients

patients with cirrhosis undergoing solitary or repetitive percutaneous RFA treatment sessions for the treatment of HCC.

Group Type OTHER

radiofrequency ablation

Intervention Type DEVICE

Interventions

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radiofrequency ablation

Intervention Type DEVICE

Other Intervention Names

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RFA

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of hepatocellular carcinoma (HCC), meeting 1 of the following criteria:

* Histologically confirmed HCC
* Discrete non-biopsied hepatic tumors, meeting 1 of the following criteria:

* Hypervascular tumor \> 2 cm by 2 imaging studies
* Hypervascular tumor \> 2 cm by a single imaging study AND alpha-fetoprotein ≥ 400 ng/mL
* Discrete non-biopsied hypervascular hepatic tumors by 2 consecutive imaging studies (e.g., CT scan or MRI) with documented tumor growth \> 1 cm in diameter
* Histologically confirmed cirrhosis OR typical findings of cirrhosis (i.e., nodular liver, splenomegaly, varices, or ascites) by CT scan and/or MRI scan
* Single hepatic tumor \> 3.0 cm but ≤ 5.0 cm in diameter OR 3 or fewer hepatic tumors ≤ 3.0 cm in diameter

* No excessive intrahepatic tumor burden (i.e., \> 3 hepatic tumors OR a single hepatic tumor \> 5 cm OR more than 3 vague hypervascular nodules \> 1 cm)
* Tumor(s) ≥ 1 cm from the main, right, and left portal veins and hollow viscera

* No hepatic or portal vein tumor invasion
* Tumor(s) \> 1 cm treatable by percutaneous radiofrequency ablation
* No extrahepatic tumor
* Not a surgical candidate due to any of the following reasons:

* Tumor in an unresectable location
* Comorbid disease
* Insufficient hepatic reserve

PATIENT CHARACTERISTICS:

Age

* 18 and over

Performance status

* Zubrod 0-2

Life expectancy

* Not specified

Hematopoietic

* No uncorrectable coagulopathy

Hepatic

* Not specified

Renal

* Creatinine ≤ 2.0 mg/dL

Other

* Not pregnant
* Negative pregnancy test
* Fertile patients must use effective contraception
* No active symptomatic bacterial or fungal infection that is newly diagnosed and/or requires treatment
* No absolute contraindication to IV iodinated contrast (i.e., history of significant contrast reaction not mitigated by appropriate premedication)

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No prior or concurrent chemotherapy for HCC
* No prior or concurrent chemoembolization for HCC

Endocrine therapy

* Not specified

Radiotherapy

* No prior or concurrent radiotherapy for HCC

Surgery

* No prior choledochoenteric anastomosis
* No prior sphincterotomy of duodenal papilla

Other

* No prior or concurrent cryoablation for HCC
* No other prior or concurrent therapy for HCC
* At least 7 days since prior aspirin
* At least 24 hours since prior ibuprofen
* At least 12 hours since prior low molecular weight heparin preparations
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

American College of Radiology Imaging Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gerald D. Dodd, MD

Role: STUDY_CHAIR

The University of Texas Health Science Center at San Antonio

Locations

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Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham

Birmingham, Alabama, United States

Site Status

Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

Jonsson Comprehensive Cancer Center at UCLA

Los Angeles, California, United States

Site Status

University of California Davis Cancer Center

Sacramento, California, United States

Site Status

Winship Cancer Institute of Emory University

Atlanta, Georgia, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

UMASS Memorial Cancer Center - University Campus

Worcester, Massachusetts, United States

Site Status

William Beaumont Hospital - Royal Oak Campus

Royal Oak, Michigan, United States

Site Status

Mayo Clinic Cancer Center

Rochester, Minnesota, United States

Site Status

Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill

Chapel Hill, North Carolina, United States

Site Status

Wake Forest University Comprehensive Cancer Center

Winston-Salem, North Carolina, United States

Site Status

Abramson Cancer Center of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Rhode Island Hospital Comprehensive Cancer Center

Providence, Rhode Island, United States

Site Status

Hollings Cancer Center at Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

M. D. Anderson Cancer Center at University of Texas

Houston, Texas, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

Scott and White Cancer Institute

Temple, Texas, United States

Site Status

Countries

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United States

Related Links

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https://clinicaltrials.gov/ct2/show/NCT00132041

Clinical trial summary from the National Cancer Institute's PDQ® database

Other Identifiers

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ACRIN-6673

Identifier Type: OTHER

Identifier Source: secondary_id

U01CA080098

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01CA079778

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CDR0000439446

Identifier Type: -

Identifier Source: org_study_id

NCT00399958

Identifier Type: -

Identifier Source: nct_alias

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