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Radiofrequency in Differentiated Thyroid Cancer Metastatic Lymph Node: Prospective Study of Safety and Efficacy

Not Applicable
Conditions
Differentiated Thyroid Cancer
Interventions
Device: Radiofrequency (RF star electrode electrode_Fixed)
Registration Number
NCT03416686
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Radiofrequency (RF) could be technically feasible and effective in the treatment of lymph node metastases of differentiated thyroid cancer. It could constitute a minimally invasive and feasible therapeutic alternative in ambulatory, allowing a reduction of the tumoral volume sufficient to limit the symptoms even to induce a tumor remission, a normalization of the tumoral markers and a better quality of life.

The aim of this study is to evaluate the anti-tumor echographic efficacy at 12 months of radiofrequency on lymph node (LN) metastasis of thyroid cancer

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Patients over age of 18 years
  • with differentiated thyroid cancer (papillary, follicular) histologically confirmed, and absence of anaplastic component
  • Previous treatment by total thyroidectomy and cervical lymph node dissection.
  • Previous treatment by at least 1 therapeutic radioactive iodine (minimum activity 740MBq)
  • Persistence on cervical ultrasound of at least 1 cervical metastatic lymph node, visible at ultrasound, small diameter between ≥10 mm and ≤30mm, volume maximum 20ml, spotted on a picture, and confirmed by cyto-punction
  • Signed informed consent
Exclusion Criteria
  • Location of LN metastasis with significant risk of local complication (nervous, vascular) according baseline ultrasound assessment
  • Patient carrier of a pacemaker or a defibrillator
  • Congenital or acquired hemostasis abnormality, anticoagulant therapy or double platelet antiaggregatory (aspirin and clopidogrel)
  • Hypersensitivity to local anesthetic
  • Poor general condition (performance status Eastern Cooperative Oncology Group (ECOG) > 1)
  • Survival estimated less than 12 months
  • Patient who can't follow the instructions of RF therapy or who can't be followed during 2 years in order to meet the objectives of the study
  • Non affiliation to a social security
  • Pregnant or breast feeding women at the time of RF
  • Beta hormone chorionic gonadotrope (HCG) positive test (pregnancy) before RF therapy
  • Baseline cervical ultrasound, by expert operator trained to RF, not fulfilling feasibility criteria for RF realisation because of the location of LN metastasis or the way to reach it
  • Controlateral recurrent palsy on nasofibroscopy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
RadiofrequencyRadiofrequency (RF star electrode electrode_Fixed)-
Primary Outcome Measures
NameTimeMethod
Treatment response.12 months

Treatment success wil; be defined on the following three criteria that should be all fulfilled

* Loss of metastatic aspect on ultrasonography

* LN decreased volume at least 50%

* no vascularization in Doppler

Secondary Outcome Measures
NameTimeMethod
Response timewithin 38 months

response time for partial response, major response and disappearance of lymph node at ultrasound.

Percentage of patient in tumor response12 and 24 months

Tumor response is defined according American Thyroid Association's criteria

Percentage of patients who had a RF complete procedureday 0
Percentage of patients with good immediate toleranceday 0
Percentage of patients who had a RF incomplete procedureday 0
Percentage of patients with non-suspicious cyto-punction of treated LN at 6 months after RF6 months
Percentage of patients without any new suspicious cervical lesion3, 6, 12 and 24 months.
Reduction in thyroglobulin level in blood3, 6, 12 and 24 months
Reduction in thyroglobulin antibody level in blood3, 6, 12 and 24 months
Percentage of patients without any new therapeutic event12 and 24 months
36-item Medical Outcomes Study Short-Form Health Survey (SF-36)3, 6, 12 and 24 months

it measures the quality of life

Percentage of (either expected or unexpected) clinical complications3, 6, 12 and 24 months
Anxiety3, 6, 12 and 24 months

visual analog scale coted by the patient

EuroQol (EQ-5D)3, 6, 12 and 24 months

EQ-5D is a standardized instrument for measuring generic health status. Health status is measured in terms of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

Trial Locations

Locations (1)

Hôpital Saint Louis

🇫🇷

Paris, France

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