Selective COX-II Inhibitor as a Palliative Therapy in Patients With R1 or R2 Resection for Disseminated Stomach Cancer - A Multi-Centre Prospective Randomized Controlled Trial
Cyclo-oxygenase (COX) is a family of enzymes regulating the conversion of arachidonic acid
to prostaglandins. COX-II is an inducible enzyme, which expresses excessively when there
are stimuli such as inflammation or hypergastrinaemia. Up to 40% of patients with stomach
cancer are found to have disseminated disease during surgical exploration. While palliative
resection could offer a marginal benefit in the survival of these patients, almost all
patients will die of progression of disease within a short time span. Palliative
chemotherapy has been used in the past. However, there is no evidence that the chemotherapy
can confer any survival advantages, and the side-effects and toxicity of the treatment may
indeed compromise the quality of life of these patients. With a better understanding of the
relation between COX-II and stomach cancer, it may be possible to suppress the progression
of the residual cancer cells after the palliative resection by giving the patients selective
COX-II inhibitors.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
Symptom-free susrvival and the quality of life score within the two years of study period.
Enders K.W. Ng, MD
Principal Investigator
Chinese University of Hong Kong
Hong Kong: Department of Health
CRE-2001.462-T
NCT00165048
October 2004
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