Trial Outcomes & Findings for Testing Diet Intervention Versus Non-Diet Intervention for Management of Bowel Symptoms in Rectal Cancer Survivors (NCT NCT04205955)

NCT ID: NCT04205955

Last Updated: 2024-05-01

Results Overview

Will be measured by the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument (BFI) total score. Score range 18-90. Higher scores indicate better bowel function. Will be conducted according to a modified intention-to-treat principle. Study arm differences in BFI at 18 weeks will be assessed by a linear regression model as a function of randomization assignment, BFI baseline value, and stratification factors.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

95 participants

Primary outcome timeframe

At 18 weeks after randomization

Results posted on

2024-05-01

Participant Flow

95 participants were randomly assigned; 48 on the attention control arm and 47 on the intervention arm. Reasons for ineligibility include not completing run-in, withdraw of consent, and disease progression.

Participant milestones

Participant milestones
Measure
Arm I (Diet Modification Coaching, Motivational Messages)
Patients receive diet modification coaching via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Dietary Intervention: Receive diet modification coaching via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Arm II (Standard of Care, Motivational Messages)
Patients receive general healthy living education via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Best Practice: Receive healthy living education via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Overall Study
STARTED
47
48
Overall Study
COMPLETED
47
48
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Testing Diet Intervention Versus Non-Diet Intervention for Management of Bowel Symptoms in Rectal Cancer Survivors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm I (Diet Modification Coaching, Motivational Messages)
n=47 Participants
Patients receive diet modification coaching via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Dietary Intervention: Receive diet modification coaching via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Arm II (Standard of Care, Motivational Messages)
n=46 Participants
Patients receive general healthy living education via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Best Practice: Receive healthy living education via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Total
n=93 Participants
Total of all reporting groups
Age, Continuous
54.6 years
n=5 Participants
56.9 years
n=7 Participants
55.2 years
n=5 Participants
Sex: Female, Male
Female
27 Participants
n=5 Participants
24 Participants
n=7 Participants
51 Participants
n=5 Participants
Sex: Female, Male
Male
20 Participants
n=5 Participants
22 Participants
n=7 Participants
42 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian/Alaskan Native
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Unknown
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race/Ethnicity, Customized
White
38 Participants
n=5 Participants
39 Participants
n=7 Participants
77 Participants
n=5 Participants
Ethnicity
Hispanic
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Ethnicity
Non-Hispanic
42 Participants
n=5 Participants
40 Participants
n=7 Participants
82 Participants
n=5 Participants
Ethnicity
Unknown
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Highest Level of Education
Did not complete high school
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Highest Level of Education
Completed high school/GED/vocational/secretarial/business
7 Participants
n=5 Participants
10 Participants
n=7 Participants
17 Participants
n=5 Participants
Highest Level of Education
Any college
23 Participants
n=5 Participants
24 Participants
n=7 Participants
47 Participants
n=5 Participants
Highest Level of Education
Any graduate school
15 Participants
n=5 Participants
12 Participants
n=7 Participants
27 Participants
n=5 Participants
Body Mass Index (BMI)
27.3 kg/m^2
n=5 Participants
27.6 kg/m^2
n=7 Participants
27.3 kg/m^2
n=5 Participants
Body Mass Index (BMI)
<18.5 kg/m^2 (Underweight)
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Body Mass Index (BMI)
18.5-<25 kg/m^2 (Normal weight)
13 Participants
n=5 Participants
12 Participants
n=7 Participants
25 Participants
n=5 Participants
Body Mass Index (BMI)
25-<30 kg/m^2 (Overweight)
16 Participants
n=5 Participants
18 Participants
n=7 Participants
34 Participants
n=5 Participants
Body Mass Index (BMI)
>=30 kg/m^2 (Obese)
16 Participants
n=5 Participants
16 Participants
n=7 Participants
32 Participants
n=5 Participants
Smoking Status
Current
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Smoking Status
Former
9 Participants
n=5 Participants
15 Participants
n=7 Participants
24 Participants
n=5 Participants
Smoking Status
Never
35 Participants
n=5 Participants
28 Participants
n=7 Participants
63 Participants
n=5 Participants
Smoking Status
Unknown
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Current Marital Status
Divorced
7 Participants
n=5 Participants
6 Participants
n=7 Participants
13 Participants
n=5 Participants
Current Marital Status
Married or partnered
34 Participants
n=5 Participants
31 Participants
n=7 Participants
65 Participants
n=5 Participants
Current Marital Status
Single
5 Participants
n=5 Participants
7 Participants
n=7 Participants
12 Participants
n=5 Participants
Current Marital Status
Widowed
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Any Change in Marital Status Since Diagnosis
Yes
1 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
Any Change in Marital Status Since Diagnosis
No
46 Participants
n=5 Participants
41 Participants
n=7 Participants
87 Participants
n=5 Participants
Adjusted Diet because of Surgery/ostomy
Yes
35 Participants
n=5 Participants
35 Participants
n=7 Participants
70 Participants
n=5 Participants
Adjusted Diet because of Surgery/ostomy
No
12 Participants
n=5 Participants
11 Participants
n=7 Participants
23 Participants
n=5 Participants
Time to Comfort with Diet after your Surgery/ostomy
Less than 1 month
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Time to Comfort with Diet after your Surgery/ostomy
1 to 12 months
15 Participants
n=5 Participants
12 Participants
n=7 Participants
27 Participants
n=5 Participants
Time to Comfort with Diet after your Surgery/ostomy
More than 12 months
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Time to Comfort with Diet after your Surgery/ostomy
I am still not comfortable
22 Participants
n=5 Participants
25 Participants
n=7 Participants
47 Participants
n=5 Participants
Time to Comfort with Diet after your Surgery/ostomy
Not Answered
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Time Since Diagnosis
23.6 months
n=5 Participants
22.3 months
n=7 Participants
23.3 months
n=5 Participants
Type of Cancer
Rectal
39 Participants
n=5 Participants
38 Participants
n=7 Participants
77 Participants
n=5 Participants
Type of Cancer
Rectosigmoid colon
8 Participants
n=5 Participants
7 Participants
n=7 Participants
15 Participants
n=5 Participants
Type of Cancer
Other
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Prior Treatment: Chemotherapy
Yes
41 Participants
n=5 Participants
42 Participants
n=7 Participants
83 Participants
n=5 Participants
Prior Treatment: Chemotherapy
No
6 Participants
n=5 Participants
4 Participants
n=7 Participants
10 Participants
n=5 Participants
Prior Treatment: Radiation Therapy
Yes
33 Participants
n=5 Participants
38 Participants
n=7 Participants
71 Participants
n=5 Participants
Prior Treatment: Radiation Therapy
No
14 Participants
n=5 Participants
8 Participants
n=7 Participants
22 Participants
n=5 Participants
Prior Surgery: Anastomosis
Yes
24 Participants
n=5 Participants
16 Participants
n=7 Participants
40 Participants
n=5 Participants
Prior Surgery: Anastomosis
No
23 Participants
n=5 Participants
30 Participants
n=7 Participants
53 Participants
n=5 Participants
Prior Surgery: Ostomy
Yes
6 Participants
n=5 Participants
9 Participants
n=7 Participants
15 Participants
n=5 Participants
Prior Surgery: Ostomy
No
41 Participants
n=5 Participants
37 Participants
n=7 Participants
78 Participants
n=5 Participants
Prior Surgery: Temporary Ostomy and Re-anastomosis
Yes
17 Participants
n=5 Participants
21 Participants
n=7 Participants
38 Participants
n=5 Participants
Prior Surgery: Temporary Ostomy and Re-anastomosis
No
30 Participants
n=5 Participants
25 Participants
n=7 Participants
55 Participants
n=5 Participants
Time Since Surgery
15.9 months
n=5 Participants
13.6 months
n=7 Participants
14.0 months
n=5 Participants
Type of Low Anterior Resection Surgery
Abdominoperineal resection
5 Participants
n=5 Participants
10 Participants
n=7 Participants
15 Participants
n=5 Participants
Type of Low Anterior Resection Surgery
Low anterior resection
42 Participants
n=5 Participants
34 Participants
n=7 Participants
76 Participants
n=5 Participants
Type of Low Anterior Resection Surgery
Sigmoid colectomy
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
LAR Syndrome (LARS) Burden
Minor LARS
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
LAR Syndrome (LARS) Burden
Major LARS
35 Participants
n=5 Participants
31 Participants
n=7 Participants
66 Participants
n=5 Participants
LAR Syndrome (LARS) Burden
Not applicable, ostomy
6 Participants
n=5 Participants
9 Participants
n=7 Participants
15 Participants
n=5 Participants
Zubrod Performance Status
0
37 Participants
n=5 Participants
31 Participants
n=7 Participants
68 Participants
n=5 Participants
Zubrod Performance Status
1
8 Participants
n=5 Participants
14 Participants
n=7 Participants
22 Participants
n=5 Participants
Zubrod Performance Status
2
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Zubrod Performance Status
Missing
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Current Medication: Antibiotics
Yes
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Current Medication: Antibiotics
No
47 Participants
n=5 Participants
44 Participants
n=7 Participants
91 Participants
n=5 Participants
Current Medication: Antidiarrheal Medications
Yes
15 Participants
n=5 Participants
13 Participants
n=7 Participants
28 Participants
n=5 Participants
Current Medication: Antidiarrheal Medications
No
32 Participants
n=5 Participants
33 Participants
n=7 Participants
65 Participants
n=5 Participants
Current Medication: Medication for Constipation
Yes
11 Participants
n=5 Participants
10 Participants
n=7 Participants
21 Participants
n=5 Participants
Current Medication: Medication for Constipation
No
36 Participants
n=5 Participants
36 Participants
n=7 Participants
72 Participants
n=5 Participants
Current Medication: Probiotics
Yes
11 Participants
n=5 Participants
7 Participants
n=7 Participants
18 Participants
n=5 Participants
Current Medication: Probiotics
No
36 Participants
n=5 Participants
39 Participants
n=7 Participants
75 Participants
n=5 Participants
Used Alternative Therapies for Bowel Issues in Past 5 Months
Yes
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants
Used Alternative Therapies for Bowel Issues in Past 5 Months
No
42 Participants
n=5 Participants
42 Participants
n=7 Participants
84 Participants
n=5 Participants
AJCC clinical stage at diagnosis: T Stage
T1
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
AJCC clinical stage at diagnosis: T Stage
T2
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
AJCC clinical stage at diagnosis: T Stage
T3
33 Participants
n=5 Participants
31 Participants
n=7 Participants
64 Participants
n=5 Participants
AJCC clinical stage at diagnosis: T Stage
T4
1 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
AJCC clinical stage at diagnosis: T Stage
TX
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: N Stage
N0
18 Participants
n=5 Participants
13 Participants
n=7 Participants
31 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: N Stage
N1
14 Participants
n=5 Participants
21 Participants
n=7 Participants
35 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: N Stage
N2
12 Participants
n=5 Participants
10 Participants
n=7 Participants
22 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: N Stage
NX
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: M Stage
M0
41 Participants
n=5 Participants
42 Participants
n=7 Participants
83 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: M Stage
M1
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: M Stage
MX
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
AJCC Clinical Stage at Diagnosis: M Stage
Missing
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants

PRIMARY outcome

Timeframe: At 18 weeks after randomization

Population: 95 total participants were randomly assigned; 47 on the intervention arm and 46 on the attention control arm. 3 patients were deemed ineligible for missing assessments and for other ineligibility criteria. This leaves 46 participants on the intervention arm and 44 on the attention control arm.

Will be measured by the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument (BFI) total score. Score range 18-90. Higher scores indicate better bowel function. Will be conducted according to a modified intention-to-treat principle. Study arm differences in BFI at 18 weeks will be assessed by a linear regression model as a function of randomization assignment, BFI baseline value, and stratification factors.

Outcome measures

Outcome measures
Measure
Arm I (Diet Modification Coaching, Motivational Messages)
n=46 Participants
Patients receive diet modification coaching via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Dietary Intervention: Receive diet modification coaching via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Arm II (Standard of Care, Motivational Messages)
n=44 Participants
Patients receive general healthy living education via telephone for 10 sessions over 30-60 minutes over 17 weeks. Patients also receive 3 motivational messages per week via email and/or text message beginning after session 6. Best Practice: Receive healthy living education via phone call Message: Receive motivational messages via email and/or text message Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Bowel Function
30.8 MSK-BFI score on a scale (range 18-90)
Interval 29.2 to 32.4
29.5 MSK-BFI score on a scale (range 18-90)
Interval 27.3 to 31.7

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will describe using dietary, urgency, and frequency scales. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

LARS will be measured using the LARS Score. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured by the City of Hope-Quality of Life-Colorectal Cancer. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be based on the Healthy Eating Index 2015. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured using a 10-item scale assessing motivation to change dietary behaviors in rectal cancer survivors. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured using the Patient-Reported Outcomes Measurement Information System Self-Efficacy for Managing Symptoms - Short Form 4a. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured using the International Positive and Negative Affect Schedule Short Form. Will be assessed by a repeated measures linear regression model as a function of randomization assignment, baseline value of the outcome, stratification factors, and visit. Robust standard errors will be estimated via generalized estimating equations to adjust for correlation between repeated outcome measures. The dependent variables will be transformed to approximate normality as appropriate.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured by the percentage of patients who successfully complete ("pass") the run-in period, and randomized. Accrual rates and feasibility will be summarized.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 18

Will measure successful completion of intervention or attention control coaching calls. Adherence is defined as completing all five of sessions 1-5 and at least three of sessions 6-10 within 18 weeks after randomization. Study arm differences in adherence will be assessed by chi square tests.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be defined by completion of follow-up assessments in step 2, including those administered at follow-up site visits and the dietary recalls. Study arm differences in retention will be assessed by chi square tests.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to week 26

Will be measured using the Acceptability of Intervention measure. Study program acceptability will be compared across arms via t-test.

Outcome measures

Outcome data not reported

Adverse Events

Arm I (Diet Modification Coaching, Motivational Messages)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm II (Standard of Care, Motivational Messages)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Palliative and End of Life Care Committee Statistician

SWOG Statistics and Data Management Center

Phone: 2066677685

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60