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Local Hyperthermia for the Treatment of Cervical Intraepithelial Neoplasias

NCT03436251 — Not applicable, Completed, 53 participants, First Hospital of China Medical University

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Evaluation of Local Hyperthermia for the Treatment of Cervical Intraepithelial Neoplasias After 3 Months: a Multicenter, Single-blind, Randomized Controlled Trial

RegistryNCT03436251, acronym HPV
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment53 (Actual)
SponsorFirst Hospital of China Medical University (Other)
ConditionsCervical Intraepithelial Neoplasia, Human Papilloma Virus
InterventionsLocal Hyperthermia at 37℃, LEEP or cold knife, Local Hyperthermia at 44℃ (Device)
Datesstart 2018-01-28, primary completion 2020-05-08, completion 2020-08-01, first posted 2018-02-19, last updated 2021-08-18
Locations1 site in China

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-Summary

Human papillomavirus(HPV) infect epithelial cells and have the capacity to stimulate cell abnormal hyperplasia, especially by those high-risk HPV types. HPV vaccine primarily targeting HPV6/11/16/18 has been available and makes it possible to prevent cervical cancer. However, a large population was left unvaccinated, specifically for those aged ones. In clinic, patients harboring high-risk HPV is quite prevalent in China or other developing nations. Removing the virus and prevention of malignant transformation is required.

Mild local Hyperthermia with a certain temperature range has been successfully used in the treatment of some diseases. It has been utilised in the treatment of some neoplasm, fungal and HPV infections. Investigators' study found that local hyperthermia at 44°C could cleared HPV in more than half of the patients with plantar warts. Investigators also note the fact that in patients with multiple lesions, the clearance of the target lesion is commonly followed by clearance of other distant lesions, a phenomenon suggesting that local hyperthermia could aid in establishing a specific immune response to eliminate HPV.So the purpose of the study is to evaluation local hyperthermia in the treatment of cervical intraepithelial neoplasias grade I and II after 3 months, with positive high-risk type HPVs, and patients with positive testing for high risk HPVs. Appropriate control arms were designed for different conditions.

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+Detailed description

Mild local Hyperthermia with a certain temperature range has been successfully used in the treatment of some diseases. It has been utilised in the treatment of some neoplasm, fungal and HPV infections. Investigators' study found that local hyperthermia at 44°C could cleared HPV in more than half of the patients with plantar warts. Investigators also note the fact that in patients with multiple lesions, the clearance of the target lesion is commonly followed by clearance of other distant lesions, a phenomenon suggesting that local hyperthermia could aid in establishing a specific immune response to eliminate HPV.So the purpose of the study is to evaluation local hyperthermia in the treatment of cervical intraepithelial neoplasias grade I and II after 3 months, with positive high-risk type HPVs, and patients with positive testing for high risk HPVs. Appropriate control arms were designed for different conditions. One control arm is local hyperthermia at 37°C for 30 mins targeted for CINⅠ, the other control arm is LEEP targeted for CINⅡ. After 3 months, to evaluate the effectivity of local hyperthermia.

+Arms and interventions

ArmTypeInterventionsDescription
Local Hyperthermia at 44℃ for HPV+/CIN-1ExperimentalDevice: Local Hyperthermia at 44℃Local hyperthermia at 44℃ for 30 mins on cervical region, at days of 1,2,3 and 17, 18. HPV+ and normal cytology or HPV+/CIN-1
local hyperthermia at 37℃ for 30 minsSham comparatorDevice: Local Hyperthermia at 37℃HPV+/CIN-1
coniztion of the cervix treatmentActive comparatorDevice: LEEP or cold knifeconiztion of cervix for HPV+/CIN2, including LEEP or cold knife coniztion
Local Hyperthermia at 44℃ for CIN2/HPV+ExperimentalDevice: Local Hyperthermia at 44℃Local hyperthermia at 44℃ for 30 mins at days of 1,2,3 and 17, 18. HPV+ and CIN2.
  • Local Hyperthermia at 37℃ (Device): As a control, for patients with HPV+/CIN-1 or HPV+ with normal cytology, hyperthermia at 37℃ is applied
  • LEEP or cold knife (Device): For patients with HPV+ / CIN-2
  • Local Hyperthermia at 44℃ (Device): As an experimental arm, for patients with HPV+/CIN-1/CIN2 or HPV+ with normal cytology

+Outcome measures

Primary outcomes

  • clearance rates of HPV [3 months after the last time of treatment.]: to evaluate the clearance rates in different treatment groups 3 month after treatment.
  • scoring atypia by cytology/pathology [3 months after the last time of treatment.]: to evaluate atypia severity score of cervical cells 3 month after treatment.

Secondary outcomes

  • viral load measurement [3 months after the last time of treatment.]: to measure the HPV 16 viral load after 3 month of treatment

+Eligibility

Sex: Female, ages: 18 Years to 65 Years

Inclusion Criteria:

* 18-65 years old; generally healthy gynecological conditions, normal sexual life; high risk HPV; Cervical biopsy CIN or no cytological changes; signed informed consent

Exclusion Criteria:

* Pregnant woman;local or systematic treatment within 3 months; Comorbidity of other severe gynecological inflammation, infection, or tumor; Comorbidity of other serious illnesses; no guarantee of timely treatment and follow-up

+Locations (1)

FacilityCityCountryStatus
Yang YangShenyang, LiaoningChina

+Publications

  • Results publication: Yang Y, Zhang L, Zhang Y, Huo W, Qi R, Guo H, Li X, Wu X, Bai F, Liu K, Qiao Y, Piguet V, Croitoru D, Chen HD, Gao XH. Local Hyperthermia at 44 degrees C Is Effective in Clearing Cervical High-Risk Human Papillomaviruses: A Proof-of-Concept, Randomized Controlled Clinical Trial. Clin Infect Dis. 2021 Nov 2;73(9):1642-1649. doi: 10.1093/cid/ciab369. PMID 33905482

+Investigators

  • Xinghua Gao, Study director, First Hospital of China Medical University

My Notes