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High-Grade Squamous Intraepithelial LesionsNCT06333743

Laser Ablation in the Treatment of High-grade Cervical Lesions

A study testing laser ablation and LEEP or Conization in people with High-Grade Squamous Intraepithelial Lesions, run by Peking Union Medical College Hospital.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Cervical laser ablation is an effective, minimally invasive treatment with a low incidence of perinatal complications and minimal impact on fertility. Research has confirmed that laser ablation treatment of cervical HSIL (including CIN2 and CIN3) is effective and feasible and is useful for young CIN3 patients who wish… Read more about this study

Who is it for?
Ages Up to 40 years, women only
What is being tested?
laser ablation and LEEP or Conization
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
308 participants
Where
No sites listed yet
Study dates
May 2024to May 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 40 years
  • Women only
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • < 40-year-old
  • Cervical HSIL confirmed by colposcopic biopsy pathology
  • Cervical transformation zone type 1 or 2
  • The lesion is completely visible and does not extend into the cervical canal, and the lesion area is less than 50% of the cervical surface area
  • Colposcopic evaluation ruled out invasive cancer
  • Voluntary participation in the study with full and informed consent

Who cannot join

  • Cervical transformation zone type 3
  • Glandular epithelial lesions
  • Lesions greater than 50% of cervical surface area, or with vaginal and vulvar intraepithelial lesions
  • The upper margin of the lesion was not visible or extended into the cervical canal
  • Cervical tube sampling was diagnosed with CIN2+ or CIN that could not be graded
  • Cervical biopsy is not sufficient to confirm a tissue diagnosis
Show all 11Show fewer
  • Suspected invasive cancer
  • History of cervical surgery
  • Pregnancy or planning a pregnancy during study participation
  • Autoimmune or immune deficiency diseases
  • Long-term use of immunosuppressive drugs

Trial locations and contacts

No sites are listed yet.

Jinhui Wang, MD contact

wjhpumch@163.com

About this study

Official title: Efficacy, Acceptability, and Safety of Laser Ablation in the Treatment of High-grade Cervical Lesions: a Randomized Clinical Trial

Cervical laser ablation is an effective, minimally invasive treatment with a low incidence of perinatal complications and minimal impact on fertility. Research has confirmed that laser ablation treatment of cervical HSIL (including CIN2 and CIN3) is effective and feasible and is useful for young CIN3 patients who wish to get pregnant in the future. There have been no randomized clinical trials of laser ablation therapy for cervical HSIL in Chinese women. This study focuses on the application of laser ablation in the treatment of cervical HSIL, explores the efficacy, feasibility, and safety of laser ablation in the treatment of cervical HSIL, and strives to promote the reasonable application of laser ablation in the treatment of cervical HSIL.

Read the detailed description
  1. Background This study focuses on the application of laser ablation in the treatment of cervical HSIL, explores the efficacy, feasibility, and safety of laser ablation in the treatment of cervical HSIL, and strives to promote the reasonable application of laser ablation in the treatment of cervical HSIL.
  2. Research objects Young patients with cervical HSIL underwent colposcopic evaluation, completed cervical biopsy, and were pathologically confirmed to be eligible for ablation.
  3. Methods 3.1 Sample size This study was a randomized controlled trial with parallel design. HSIL recurrence rate was the primary endpoint. According to previous literature reports, it is estimated that the recurrence rate of HSIL in the laser treatment group is 15%. The recurrence rate of HSIL in the resection group was 5%. Let α=0.05 (both sides), hold =0.80. Using PASS 11 software, the sample size of both groups was 138 cases. Assuming that the loss of follow-up rate of the study subjects was 10%, the sample size of each group was 138÷0.9=154 cases. Therefore, 308 patients were intended to be included in the study. 3.2 Statistical methods SPSS 24.0 software will be used for statistical analysis of all data. Measurement data with normal distribution will be described by mean ± standard deviation. Independent sample t-test or rank sum test will be used for inter-group comparison, and paired sample t-test will be used for intra-group comparison before and after treatment. Counting data will be expressed as examples or percentages (%), and the Chi-square test will be used for comparison between groups. The Kaplan-Meier method will be used to calculate the recurrence rate, and the rank sum test will be used to evaluate the difference between the two groups. Cox regression model will be used to analyze the factors influencing prognosis. P < 0.05 will be considered statistically significant.
  4. Results The primary endpoint is the HSIL recurrence rate at 12 months after treatment.

Other subjects were secondary study endpoints shown as follows:

Intraoperative and postoperative complications and side effects, including bleeding, pain, infection, cervical secretions, and healing; Psychological state change; Satisfaction; Cervical length; Recurrence rate; Fees

Being tested
laser ablation, LEEP or Conization
Keywords
HSIL, laser ablation
Medical subject headings
Squamous Intraepithelial Lesions

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • laser ablationProcedure or surgery

    Research has confirmed that laser ablation treatment of cervical HSIL is effective and feasible.

  • LEEP or ConizationProcedure or surgery

    The most common treatment for HSIL is LEEP or conization of the cervical lesion, but there are several perinatal complications involved in this surgery.

Study groups in NCT06333743
Study groupRoleWhat they receive
laser ablation treatmentExperimentalLaser vaporization is performed using a carbon dioxide laser under colposcopy. All patients received 1% mepivacaine hydrochloride paracervix block. No general anesthesia was used. Before laser vaporization began, scaly columnar nodules were visible in all patients. The evaporation depth is 8-10mm, and the edge is 5mm from the abnormal discovery or transition area.
Receives: Procedure: laser ablation
LEEP or conization treatmentActive comparatorThe cervix was stained with iodine solution and the diseased lesion was visualized. LEEP or conization was performed to a depth of approximately 1.5 cm to resect disease in the cervical canal.
Receives: Procedure: LEEP or Conization

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. the rate of HSIL recurrence

    12 months after the treatment, TCT, HPV, colposcopy, and biopsy will be tested again. If the result of the biopsy is HSIL again, we will record it as HSIL recurrence.

    Measured: 12 months after treatment

Secondary outcomes (3)
  1. the satisfaction with the treatment

    after the treatment, patients will fill in a questionnaire to describe their degree of satisfaction with the treatment

    Measured: 8 weeks and 12 months after treatment

  2. the length of the cervix

    the length of the cervix will be measured by B-ultrasound

    Measured: 8 weeks and 12 months after treatment

  3. Psychological state change related to the treatment

    State-Trait Anxiety Inventory,STAI-Form Y will be used to measure the patients' psychological state after treatment.

    Measured: 8 weeks and 12 months after treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Mar 2024
  2. Study startMay 2024 (estimated)
  3. Primary completionDec 2025 (estimated)
  4. Study completionMay 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
308 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06333743
Sponsor's protocol ID
ZhuLan
Status last verified
Mar 2024
First submitted
25 Feb 2024
Last updated
27 Mar 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, Huh WK, Kim JJ, Moscicki AB, Nayar R, Saraiya M, Sawaya GF, Wentzensen N, Schiffman M; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020 Apr;24(2):102-131. doi: 10.1097/LGT.0000000000000525. No abstract available.

    PubMed 32243307
  • Sadler L, Saftlas A, Wang W, Exeter M, Whittaker J, McCowan L. Treatment for cervical intraepithelial neoplasia and risk of preterm delivery. JAMA. 2004 May 5;291(17):2100-6. doi: 10.1001/jama.291.17.2100.

    PubMed 15126438
  • Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet. 2006 Feb 11;367(9509):489-98. doi: 10.1016/S0140-6736(06)68181-6.

    PubMed 16473126
  • Fallani MG, Penna C, Fambrini M, Marchionni M. Laser CO2 vaporization for high-grade cervical intraepithelial neoplasia: a long-term follow-up series. Gynecol Oncol. 2003 Oct;91(1):130-3. doi: 10.1016/s0090-8258(03)00440-2.

    PubMed 14529672
  • Mariya T, Nishikawa A, Sogawa K, Suzuki R, Saito M, Kawamata A, Shimizu A, Nihei T, Sonoda T, Saito T. Virological and cytological clearance in laser vaporization and conization for cervical intra-epithelial neoplasia grade 3. J Obstet Gynaecol Res. 2016 Dec;42(12):1808-1813. doi: 10.1111/jog.13113. Epub 2016 Aug 16.

    PubMed 27526956
  • Zhang L, Sauvaget C, Mosquera I, Basu P. Efficacy, acceptability and safety of ablative versus excisional procedure in the treatment of histologically confirmed CIN2/3: A systematic review. BJOG. 2023 Jan;130(2):153-161. doi: 10.1111/1471-0528.17251. Epub 2022 Jul 4.

    PubMed 35689493
  • Yoon BS, Seong SJ, Song T, Kim ML, Kim MK. Risk factors for treatment failure of CO2 laser vaporization in cervical intraepithelial neoplasia 2. Arch Gynecol Obstet. 2014 Jul;290(1):115-9. doi: 10.1007/s00404-014-3148-1. Epub 2014 Jan 24.

    PubMed 24458427
  • Kodama K, Yahata H, Okugawa K, Tomonobe H, Yasutake N, Yoshida S, Yagi H, Yasunaga M, Ohgami T, Onoyama I, Asanoma K, Hori E, Shimokawa M, Kato K. Prognostic outcomes and risk factors for recurrence after laser vaporization for cervical intraepithelial neoplasia: a single-center retrospective study. Int J Clin Oncol. 2021 Apr;26(4):770-776. doi: 10.1007/s10147-020-01848-x. Epub 2021 Jan 4.

    PubMed 33394202
  • Inaba K, Nagasaka K, Kawana K, Arimoto T, Matsumoto Y, Tsuruga T, Mori-Uchino M, Miura S, Sone K, Oda K, Nakagawa S, Yano T, Kozuma S, Fujii T. High-risk human papillomavirus correlates with recurrence after laser ablation for treatment of patients with cervical intraepithelial neoplasia 3: a long-term follow-up retrospective study. J Obstet Gynaecol Res. 2014 Feb;40(2):554-60. doi: 10.1111/jog.12196. Epub 2013 Oct 11.

    PubMed 24118526

Questions about this trial

What is this clinical trial studying?

A study testing laser ablation and LEEP or Conization in people with High-Grade Squamous Intraepithelial Lesions, run by Peking Union Medical College Hospital.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Lan Zhu, MD (86-010-69156874, zhulan@pumch.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

the rate of HSIL recurrence (time frame: 12 months after treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06333743, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2024.

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