Rehabilitation Strategies Following Oesophagogastric and Hepatopancreaticobiliary Cancer

NCT ID: NCT03958019

Last Updated: 2022-04-13

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-25

Study Completion Date

2024-12-01

Brief Summary

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The RESTORE II randomized controlled trial will examine the efficacy of a 12 week multidisciplinary rehabilitation program consisting of supervised and home-based exercise,1:1 dietetic counselling, and group education sessions for survivors of upper gastrointestinal cancer, namely cancers of the oesophagus, stomach, pancreas, and liver.

Detailed Description

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Curative treatment for upper gastrointestinal (UGI) cancers is associated with numerous side-effects including sarcopenia and nutritional compromise, increasing morbidity, compromising functional capacity and decreasing health-related quality of life (HR-QOL) in survivorship. As survival improves in UGI cancer, there is increasing focus on optimizing survivorship, however research examining rehabilitation programs in this newly-emergent complex clinical cohort is lacking.

The investigators recently designed, implemented, and evaluated the Rehabilitation Strategies following Oesophagogastric Cancer (RESTORE) program, a novel multidisciplinary rehabilitation program tailored for oesophagogastric cancer survivorship. The feasibility and preliminary efficacy of the RESTORE program was established and there is now recognized need to further examine program efficacy in a definitive trial.

Using a convergent parallel mixed-methods design, RESTORE II, implemented as a 2-armed randomized controlled trial, will examine if multidisciplinary rehabilitation can improve functional capacity and HRQOL in UGI cancer survivors. RESTORE II will prescribe a 12-week program of supervised aerobic and resistance training, self-directed unsupervised exercise, individualized dietetic counselling and multidisciplinary education for patients who are \>3 months following oesophagectomy, gastrectomy, pancreaticoduodenectomy, or major liver resection. A sample of 60 participants per arm will be recruited to establish a mean increase in functional capacity (cardio-respiratory fitness) of 3.5 ml/kg/min with 90% power, 5% significance and 20% drop-out.

Quantitative assessments including cardiopulmonary fitness and functional exercise capacity will be completed at baseline, post-intervention and 3-months post-intervention (Objective 1). HR-QOL will be quantitatively assessed pre and post-intervention, at 3-months post-intervention and 1 year post-enrollment (Objective 2). Impact on physical, mental and social well-being will be qualitatively examined during focus groups immediately post-intervention and 3-months post-intervention (Objective 3). The implementation costs of RESTORE II will be analysed in consideration of clinician salaries, overheads and equipment costs (Objective 4). Bio-samples will be collected pre and post-intervention and 3-months post-intervention, establishing the first National UGI Cancer Survivorship Biobank (Objective 5). A patient centered approach to enhancing trial recruitment in this complex cohort will also be evaluated (Objective 6).

Following this evaluation, the RESTORE II program will provide a unique model of multidisciplinary rehabilitation in nutritionally complex UGI cancer survivors.

Conditions

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Oesophageal Cancer Gastric Cancer Liver Cancer Pancreatic Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Convergent parallel mixed methods design
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Study outcomes will be assessed by a blinded assessor.

Study Groups

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Intervention Group

12 week multidisciplinary program consisting of; i) supervised and home-based aerobic and resistance training, ii) 1:1 dietary counselling, and iii) group education sessions.

Group Type EXPERIMENTAL

RESTORE II Program

Intervention Type OTHER

Detailed in arm description

Control

Usual care control group

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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RESTORE II Program

Detailed in arm description

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients \>3-months post oesophagectomy, total gastrectomy, pancreaticoduodenectomy or major liver resection +/- neo-adjuvant/adjuvant chemo/chemoradiotherapy with curative intent
* Completion of adjuvant oncological therapy
* Successful completion of baseline cardiopulmonary exercise test
* Medical clearance to participate.

Exclusion Criteria

* Ongoing serious post-operative morbidity
* Evidence of active or recurrent disease
* Co-morbidities that would preclude safe exercise participation;
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Health Research Board, Ireland

OTHER

Sponsor Role collaborator

St. James's Hospital, Ireland

OTHER

Sponsor Role collaborator

St Vincent's University Hospital, Ireland

OTHER

Sponsor Role collaborator

Tallaght University Hospital

OTHER

Sponsor Role collaborator

University of Dublin, Trinity College

OTHER

Sponsor Role lead

Responsible Party

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Prof Juliette Hussey

Professor Juliette Hussey

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Juliette Hussey, PhD

Role: PRINCIPAL_INVESTIGATOR

Professor in Physiotherapy

Locations

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Trinity College

Dublin, Leinster, Ireland

Site Status RECRUITING

Countries

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Ireland

Central Contacts

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Linda O'Neill, PhD

Role: CONTACT

+35318964809

Emer Guinan, PhD

Role: CONTACT

+35318964125

Facility Contacts

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Linda O'Neill, PhD

Role: primary

+35318964809

References

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O'Neill L, Knapp P, Doyle SL, Begic S, Smyth E, Kearney N, Grehan S, Parker A, Browne P, Segurado R, Connolly D, O'Sullivan J, Reynolds JV, Guinan E, Hussey J. Can a Public and Patient Involvement (PPI) Informed Participant Information Leaflet (PIL) Improve Trial Recruitment, Retention, and Quality of Decision Making? Results of a Randomised Controlled Double-Blind Study Within a Trial (SWAT). Health Expect. 2025 Jun;28(3):e70321. doi: 10.1111/hex.70321.

Reference Type DERIVED
PMID: 40485109 (View on PubMed)

O'Neill L, Murphy F, Reidy D, Poisson C, Hussey J, Guinan E. Development and Initial Implementation of a Clinical Monitoring Strategy in a Non-regulated Trial: a research note from the ReStOre II Trial. HRB Open Res. 2024 Oct 18;6:46. doi: 10.12688/hrbopenres.13763.3. eCollection 2023.

Reference Type DERIVED
PMID: 39280895 (View on PubMed)

O'Neill L, Knapp P, Doyle SL, Guinan E, Parker A, Segurado R, Connolly D, O'Sullivan J, Reynolds JV, Hussey J. Patient and family co-developed participant information to improve recruitment rates, retention, and patient understanding in the Rehabilitation Strategies Following Oesophago-gastric and Hepatopancreaticobiliary Cancer (ReStOre II) trial: Protocol for a study within a trial (SWAT). HRB Open Res. 2020 Nov 10;2:27. doi: 10.12688/hrbopenres.12950.2. eCollection 2019.

Reference Type DERIVED
PMID: 33392438 (View on PubMed)

O'Neill L, Guinan E, Doyle S, Connolly D, O'Sullivan J, Bennett A, Sheill G, Segurado R, Knapp P, Fairman C, Normand C, Geoghegan J, Conlon K, Reynolds JV, Hussey J. Rehabilitation strategies following oesophagogastric and Hepatopancreaticobiliary cancer (ReStOre II): a protocol for a randomized controlled trial. BMC Cancer. 2020 May 13;20(1):415. doi: 10.1186/s12885-020-06889-z.

Reference Type DERIVED
PMID: 32404096 (View on PubMed)

Other Identifiers

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HRB-DIFA RESTORE II Trial

Identifier Type: -

Identifier Source: org_study_id

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