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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12624001390572
Ethics application status
Approved
Date submitted
18/10/2024
Date registered
22/11/2024
Date last updated
30/03/2025
Date data sharing statement initially provided
22/11/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of ultrasound-guided percutaneous neuromodulation for the treatment of chemotherapy-induced peripheral neuropathies. A randomized clinical trial
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Scientific title
Efficacy of ultrasound-guided percutaneous neuromodulation on the quality of life in treating individuals with oxaliplatin-induced peripheral neuropathy
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Secondary ID [1]
313172
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cancer
335521
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Condition category
Condition code
Cancer
332089
332089
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Percutaneous Ultrasound-Guided Neuromodulation Group: The following steps will be undertaken:
1. Ultrasound Localization of the Nerve: A linear probe will be positioned on the anterior aspect of the elbow in a transverse plane. In this view, the median nerve will be visualized between the heads of the pronator teres muscle, medial to the brachial artery (1 min).
2. Selection of the Approach Type: Depending on the anatomical disposition of the nerve, either a short-axis approach (introducing the needle in a plane parallel to the probe) or a long-axis approach (introducing the needle from the medial end of the probe) may be employed (1 min).
3. Assessment of Safety Measures: Localization of surrounding veins and arteries will be conducted using the Doppler function of the ultrasound machine, along with measurement of the distance from the skin to the target nerve to determine the appropriate needle size (5 min).
4. Pre-Intervention Measures: Hand washing, donning gloves and a probe cover, and skin antisepsis using a chlorhexidine-based antiseptic will be performed (5 min).
5. Ultrasound-Guided Intervention: The needle will be inserted and advanced toward the target tissue with real-time visualization using ultrasound. The needle should be positioned within the epineurium of the median nerve. Subsequently, a transcutaneous electrode will be placed on the ventral aspect of the forearm, and a monopolar electrode will be connected to the needle, aiming to reproduce a motor or sensory response over the nerve (1 min).
6. Peripheral Nerve Electrostimulation: A peripheral nerve stimulator (Endomed 484) will be utilized to apply a continuous biphasic rectangular current, adjusting the frequency to 1-2 Hz and the pulse width to 200-250 µs. The intensity will be gradually increased to a tolerable threshold for the patient (the patient will be asked after each increase in intensity until the maximum point prior to reproducing pain is found) and maintained for the 30-minute duration of stimulation.
To ensure that the nerve is being correctly stimulated, involuntary contractions will be observed in the musculature that innervates and the patient will report a tingling sensation along the nerve territory.
7. Post-Intervention Measures: The needle will be withdrawn, followed by 30 seconds of compression with a sterile gauze (1 min).
The treatment will be performed in a treatment room of the hospital and will be applied by a physiotherapist with expertise in ultrasound.
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Intervention code [1]
329797
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Rehabilitation
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Intervention code [2]
329884
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Treatment: Devices
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Comparator / control treatment
Placebo Group for Percutaneous Ultrasound-Guided Neuromodulation:
For participants randomized into the NMP-e placebo group, the same procedure as in the experimental group will be conducted; however, in this case, the external stimulator will remain turned off, so they will not receive nerve electrostimulation.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Quality of life
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Assessment method [1]
339680
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European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire for assessing CIPN (QLQ-CIPN20).
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Timepoint [1]
339680
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Pre-intervention, after completing 4 weeks of intervention and post-intervention (after completing the 12 weeks of treatment).
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Secondary outcome [1]
440853
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Neural sensitivity. This will be evaluated as a composite result.
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Assessment method [1]
440853
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Quantitative sensory tests: Mechanical detection thresholds (using von Frey monofilaments), vibration and temperature detection thresholds (using the NerveCheck® device (Phi Med Europe, Barcelona, Spain)) and pressure pain thresholds (measured using an Algometer) will be measured. This will be evaluated as a composite result.
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Timepoint [1]
440853
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Pre-intervention, after completing 4 weeks of intervention and post-intervention (after completing the 12 weeks of treatment).
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Secondary outcome [2]
440854
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Degree of neurotoxicity
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Assessment method [2]
440854
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National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) scale. Adverse events: sensitivity to cold, cramps, tingling and pain in hands and feet.
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Timepoint [2]
440854
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Pre-intervention, after completing 4 weeks of intervention and post-intervention (after completing the 12 weeks of treatment).
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Secondary outcome [3]
440855
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Cumulative dose of oxaliplatin
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Assessment method [3]
440855
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Dosage administered (in mg). Medical data review.
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Timepoint [3]
440855
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Pre-intervention, after completing 4 weeks of intervention and post-intervention (after completing the 12 weeks of treatment).
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Eligibility
Key inclusion criteria
Subjects over 18 years of age, diagnosed with a gastrointestinal malignancy and on an oxaliplatin-based chemotherapy regimen, who have experienced symptoms of chemotherapy-induced peripheral neuropathy and have life expectancy greater than 6 months.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients will be excluded if they have a history of peripheral neuropathy caused by reasons other than chemotherapy, are diagnosed with peripheral vascular disease, uncontrolled arrhythmias, epilepsy, Raynaud's syndrome, diabetes or severe mental disorders, pregnant women, belonephobia, participants in other clinical trials for the treatment of neuropathy, and patients who cannot communicate in Spanish.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central computer randomization
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization by means of a randomization table created by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/01/2025
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Actual
9/01/2025
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
20
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Final
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Recruitment outside Australia
Country [1]
26641
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Spain
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State/province [1]
26641
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Funding & Sponsors
Funding source category [1]
317614
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University
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Name [1]
317614
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Universidad Europea de Madrid
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Address [1]
317614
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Country [1]
317614
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Spain
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Primary sponsor type
University
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Name
Universidad Europea de Madrid
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Address
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Country
Spain
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Secondary sponsor category [1]
319926
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Hospital
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Name [1]
319926
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Hospital de Fuenlabrada
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Address [1]
319926
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Country [1]
319926
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Spain
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316318
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Fuenlabrada Hospital's Drug Research Ethics Committee
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Ethics committee address [1]
316318
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Calle Camino del Molino, 2, Fuenlabrada, 28942, Madrid
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Ethics committee country [1]
316318
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Spain
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Date submitted for ethics approval [1]
316318
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07/03/2023
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Approval date [1]
316318
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21/03/2023
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Ethics approval number [1]
316318
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23/02
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Summary
Brief summary
To date, no randomized clinical trial (RCT) has been conducted to determine the feasibility and efficacy of peripheral nerve stimulation in the treatment of CIPN. Therefore, the present RCT aims to use ultrasound-guided percutaneous neuromodulation to improve quality of life and neuropathic symptomatology in individuals with colon cancer who have developed oxaliplatin-induced peripheral neuropathies during chemotherapy treatment. The hypothesis is that this treatment will increase the patients' quality of life and improve their neuropathic symptomatology.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
137510
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Ms Sara Mogedano Cruz
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Address
137510
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Universidad Europea de Madrid - Calle Tajo s/n, Villaviciosa de Odón, 28670
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Country
137510
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Spain
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Phone
137510
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+34662222713
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Fax
137510
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Email
137510
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[email protected]
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Contact person for public queries
Name
137511
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Sara Mogedano Cruz
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Address
137511
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Universidad Europea de Madrid - Calle Tajo s/n, Villaviciosa de Odón, 28670
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Country
137511
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Spain
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Phone
137511
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+34662222713
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Fax
137511
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Email
137511
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[email protected]
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Contact person for scientific queries
Name
137512
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Sara Mogedano Cruz
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Address
137512
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Universidad Europea de Madrid - Calle Tajo s/n, Villaviciosa de Odón, 28670
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Country
137512
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Spain
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Phone
137512
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+34662222713
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Fax
137512
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Email
137512
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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