Plasma Citrulline: A Marker for Monitoring & Quantifying Radiation-Induced Small Bowel Toxicity
NCT ID: NCT01849107
Last Updated: 2020-01-13
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
49 participants
Study Classification
INTERVENTIONAL
Study Start Date
2013-04-30
Study Completion Date
2014-12-31
Brief Summary
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Small bowel irradiation results in epithelial cell loss and consequently impairs function and metabolism. A metabolic end product of small bowel enterocytes is plasma citrulline. The investigators evaluate the correlation between plasma citrulline level, dose-volume histogram of small bowel, and small bowel toxicity grade by Common Terminology Criteria for Adverse Events version 4.0 (CTCAE ver.4.0) to investigate whether citrulline can be used as a biomarker for quantifying radiation-induced epithelial cell loss.
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Detailed Description
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Conditions
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Diarrhea
Anorexia
Dyspepsia
Study Design
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Allocation Method
NA
Intervention Model
SINGLE_GROUP
Primary Study Purpose
DIAGNOSTIC
Blinding Strategy
NONE
Study Groups
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Plasma citrulline
Group Type
EXPERIMENTAL
Plasma citrulline
Intervention Type
BIOLOGICAL
Interventions
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Plasma citrulline
Intervention Type
BIOLOGICAL
Eligibility Criteria
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Inclusion Criteria
* Histologically confirmed cancer patients
* Appropriate liver, renal, and bone marrow function for radiotherapy
* Willing to provide informed written consent
* At least 20 years old
* Appropriate liver, renal, and bone marrow function for radiotherapy
* Willing to provide informed written consent
* At least 20 years old
Exclusion Criteria
* prior abdominopelvic radiation therapy or chemotherapy or abdominal surgery
* Any contraindication to radiotherapy (i.e. Severe connective tissue disorder, etc.)
* Prior or simultaneous history of other malignancy
* On medication for small bowel disease or CTCAE 4.0 Grade 1 or higher toxicity before radiation
* Any treatment delay more than 1 week during radiotherapy
* No radiotherapy due to any other reason except small bowel toxicity
* Any contraindication to radiotherapy (i.e. Severe connective tissue disorder, etc.)
* Prior or simultaneous history of other malignancy
* On medication for small bowel disease or CTCAE 4.0 Grade 1 or higher toxicity before radiation
* Any treatment delay more than 1 week during radiotherapy
* No radiotherapy due to any other reason except small bowel toxicity
Minimum Eligible Age
20 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Asan Medical Center
OTHER
Sponsor Role
lead
Responsible Party
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Young Seok Kim
Assistant Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Locations
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Asan Medical Center
Seoul, , South Korea
Site Status
Countries
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South Korea
References
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Atahan IL, Onal C, Ozyar E, Yiliz F, Selek U, Kose F. Long-term outcome and prognostic factors in patients with cervical carcinoma: a retrospective study. Int J Gynecol Cancer. 2007 Jul-Aug;17(4):833-42. doi: 10.1111/j.1525-1438.2007.00895.x. Epub 2007 Mar 15.
Reference Type
BACKGROUND
Letschert JG, Lebesque JV, Aleman BM, Bosset JF, Horiot JC, Bartelink H, Cionini L, Hamers JP, Leer JW, van Glabbeke M. The volume effect in radiation-related late small bowel complications: results of a clinical study of the EORTC Radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiother Oncol. 1994 Aug;32(2):116-23. doi: 10.1016/0167-8140(94)90097-3.
Reference Type
BACKGROUND
Crenn P, Vahedi K, Lavergne-Slove A, Cynober L, Matuchansky C, Messing B. Plasma citrulline: A marker of enterocyte mass in villous atrophy-associated small bowel disease. Gastroenterology. 2003 May;124(5):1210-9. doi: 10.1016/s0016-5085(03)00170-7.
Reference Type
BACKGROUND
Lutgens LC, Deutz NE, Gueulette J, Cleutjens JP, Berger MP, Wouters BG, von Meyenfeldt MF, Lambin P. Citrulline: a physiologic marker enabling quantitation and monitoring of epithelial radiation-induced small bowel damage. Int J Radiat Oncol Biol Phys. 2003 Nov 15;57(4):1067-74. doi: 10.1016/s0360-3016(03)00781-8.
Reference Type
BACKGROUND
Crenn P, Messing B, Cynober L. Citrulline as a biomarker of intestinal failure due to enterocyte mass reduction. Clin Nutr. 2008 Jun;27(3):328-39. doi: 10.1016/j.clnu.2008.02.005. Epub 2008 Apr 28.
Reference Type
BACKGROUND
Herbers AH, Feuth T, Donnelly JP, Blijlevens NM. Citrulline-based assessment score: first choice for measuring and monitoring intestinal failure after high-dose chemotherapy. Ann Oncol. 2010 Aug;21(8):1706-1711. doi: 10.1093/annonc/mdp596. Epub 2010 Jan 20.
Reference Type
BACKGROUND
Lutgens LC, Blijlevens NM, Deutz NE, Donnelly JP, Lambin P, de Pauw BE. Monitoring myeloablative therapy-induced small bowel toxicity by serum citrulline concentration: a comparison with sugar permeability tests. Cancer. 2005 Jan 1;103(1):191-9. doi: 10.1002/cncr.20733.
Reference Type
BACKGROUND
Packey CD, Ciorba MA. Microbial influences on the small intestinal response to radiation injury. Curr Opin Gastroenterol. 2010 Mar;26(2):88-94. doi: 10.1097/MOG.0b013e3283361927.
Reference Type
BACKGROUND
Lutgens LC, Deutz N, Granzier-Peeters M, Beets-Tan R, De Ruysscher D, Gueulette J, Cleutjens J, Berger M, Wouters B, von Meyenfeldt M, Lambin P. Plasma citrulline concentration: a surrogate end point for radiation-induced mucosal atrophy of the small bowel. A feasibility study in 23 patients. Int J Radiat Oncol Biol Phys. 2004 Sep 1;60(1):275-85. doi: 10.1016/j.ijrobp.2004.02.052.
Reference Type
BACKGROUND
Kim YS, Shin SS, Nam JH, Kim YT, Kim YM, Kim JH, Choi EK. Prospective randomized comparison of monthly fluorouracil and cisplatin versus weekly cisplatin concurrent with pelvic radiotherapy and high-dose rate brachytherapy for locally advanced cervical cancer. Gynecol Oncol. 2008 Jan;108(1):195-200. doi: 10.1016/j.ygyno.2007.09.022. Epub 2007 Oct 25.
Reference Type
BACKGROUND
Onal C, Kotek A, Unal B, Arslan G, Yavuz A, Topkan E, Yavuz M. Plasma citrulline levels predict intestinal toxicity in patients treated with pelvic radiotherapy. Acta Oncol. 2011 Nov;50(8):1167-74. doi: 10.3109/0284186X.2011.584557. Epub 2011 Aug 24.
Reference Type
BACKGROUND
Kim YS, Kim JH, Ahn SD, Lee SW, Shin SS, Nam JH, Kim YT, Kim YM, Kim JH, Choi EK. High-dose extended-field irradiation and high-dose-rate brachytherapy with concurrent chemotherapy for cervical cancer with positive para-aortic lymph nodes. Int J Radiat Oncol Biol Phys. 2009 Aug 1;74(5):1522-8. doi: 10.1016/j.ijrobp.2008.10.024. Epub 2009 Feb 21.
Reference Type
BACKGROUND
Kim YS, Kim JH, Yoon SM, Choi EK, Ahn SD, Lee SW, Kim JC, Yu CS, Kim HC, Kim TW, Chang HM. lymph node ratio as a prognostic factor in patients with stage III rectal cancer treated with total mesorectal excision followed by chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):796-802. doi: 10.1016/j.ijrobp.2008.08.065. Epub 2009 Mar 14.
Reference Type
BACKGROUND
Lee YS, Kim YS, Kim JH, Ahn SD, Lee SW, Shin SS, Nam JH, Kim YT, Kim YM, Kim JH, Choi EK. Feasibility and outcome of concurrent chemoradiotherapy for recurrent cervical carcinoma after initial surgery. Tumori. 2010 Jul-Aug;96(4):553-9. doi: 10.1177/030089161009600407.
Reference Type
BACKGROUND
Park JH, Kim YS, Ahn SD, Choi EK, Shin SS, Kim YT, Kim YM, Kim JH, Yi SY, Nam JH. Concurrent chemoradiotherapy or radiotherapy alone for locally advanced cervical cancer in elderly women. Tumori. 2010 Nov-Dec;96(6):959-65.
Reference Type
BACKGROUND
Kim JY, Kim JY, Kim JH, Yoon MS, Kim J, Kim YS. Curative chemoradiotherapy in patients with stage IVB cervical cancer presenting with paraortic and left supraclavicular lymph node metastases. Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):741-7. doi: 10.1016/j.ijrobp.2012.01.070. Epub 2012 Aug 14.
Reference Type
BACKGROUND
Kim YS, Park SH, Ahn SD, Lee JE, Choi EK, Lee SW, Shin SS, Yoon SM, Kim JH. Differences in abdominal organ movement between supine and prone positions measured using four-dimensional computed tomography. Radiother Oncol. 2007 Dec;85(3):424-8. doi: 10.1016/j.radonc.2007.10.031. Epub 2007 Nov 26.
Reference Type
BACKGROUND
Choi HJ, Kim YS, Lee SH, Lee YS, Park G, Jung JH, Cho BC, Park SH, Ahn H, Kim CS, Yi SY, Ahn SD. Inter- and intra-observer variability in contouring of the prostate gland on planning computed tomography and cone beam computed tomography. Acta Oncol. 2011 May;50(4):539-46. doi: 10.3109/0284186X.2011.562916. Epub 2011 Mar 10.
Reference Type
BACKGROUND
Other Identifiers
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CTR_SB_2013
Identifier Type: -
Identifier Source: org_study_id
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