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Stereotactic Body Radiotherapy Dose Escalation in Pancreatic Cancer

Not Applicable
Completed
Conditions
Pancreatic Cancer
Interventions
Radiation: SBRT
Registration Number
NCT02454140
Lead Sponsor
University of California, San Diego
Brief Summary

This study is to determine the maximum tolerated dose (MTD) of five fraction stereotactic radiotherapy (SBRT) in pancreatic cancer.

Detailed Description

This trial is designed to find the maximum tolerated dose of radiation under a fixed 5-fraction SBRT regimen escalating the dose from 40 Gy in 5 fractions, to 60 Gy in 5 fractions, at 5 Gy intervals.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Diagnosis: Histologically-proven invasive adenocarcinoma of the pancreas.
  • Disease Status: Medically unresectable (any stage), or locally advanced (stage III).
  • Tumor Location: Primary tumor may be located anywhere in the pancreas.
  • Treatment eligibility: The patient must be able to have fiducial markers implanted into the pancreatic tumor, and receive radiation regimen as specified in the protocol.
  • Performance Level: Karnofsky Performance Status ≥ 60
  • Adequate Renal Function Defined As: Serum creatinine ≤ 1.5 x upper limit of normal
  • Informed Consent: All subjects must sign a written informed consent.
Exclusion Criteria
  • Pregnancy or Breast-Feeding: Pregnant or breast-feeding women will not be entered on this study due to risks of fetal and teratogenic adverse events. (Note: Serum Pregnancy tests must be obtained in women of child bearing potential). Sexually active females may not participate unless they have agreed to use an effective contraceptive method (such as abstinence, diaphragm, condom, or intrauterine device) to prevent pregnancy for the duration of the study.
  • Life expectancy < 6 months
  • The patient cannot have had prior radiation therapy to the thorax or upper abdomen.
  • Incarcerated individuals
  • Subjects unable to give informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort 1SBRTSBRT 40 Gy in 5 fractions
Cohort 2SBRTSBRT 45 Gy in 5 fractions (starting dose level)
Cohort 3SBRTSBRT 50 Gy in 5 fractions
Cohort 4SBRTSBRT 55 Gy in 5 fractions
Cohort 5SBRTSBRT 60 Gy in 5 fractions
Primary Outcome Measures
NameTimeMethod
Maximum Tolerated DoseFrom date of randomization to observed dose limiting toxicity (DLT) in 20% of patients assessed up to 3 years

The purpose of this study is to determine the maximum tolerated dose of five fraction stereotactic radiotherapy (SBRT) in pancreatic cancer.

Secondary Outcome Measures
NameTimeMethod
Local Tumor ProgressionFrom date of randomization until local disease progression defined as a ≥20% increase in size on CT compared with CT prior to SBRT assessed over 3 years

local tumor control remains a crucial part of treatment for patients with pancreatic cancer who are not candidates for curative therapy.

Distant Metastatic Progression RateFrom date of randomization until the appearance of new lesions or a ≥20% increase in size on CT of the previously noted metastatic lesions assessed over 3 years

The cumulative incidence of distant metastatic failure will be determined for all patients treating death as a competing risk. In patients initially presenting with locally advanced disease, distant disease progression will be defined as the appearance of new metastatic lesions. In patients presenting with metastatic disease, distant progression will be defined as a ≥20% increase in size on CT of the previously noted metastatic lesions.

Overall SurvivalFrom date of diagnosis and SBRT to date of death assessed over 3 years

Overall survival will be measured from the date of diagnosis through death of any cause. Survival will also be reported from the date of SBRT for comparisons to other trials in the literature. Finally, survival will be stratified by those with locally advanced disease, and those with metastatic disease on presentation.

Trial Locations

Locations (1)

UCSD Moores Cancer Center

🇺🇸

La Jolla, California, United States

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