EUS-guided Laser Complete Ablation of Advanced Pancreatic Ductal Adenocarcinoma: a Feasibility Study
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 5
- 试验地点
- 2
- 主要终点
- Tumor necrosis induction by EUS-guided laser ablation (LA) - Number of patients with necrosis of the tumor
研究概览
简要总结
This study evaluates the possibility of performing local therapy for PDAC using laser ablation of the tumor under ultrasonography (EUS) guidance.
Safety of the procedure as well as post procedural quality of life will be also evaluated.
详细描述
Pancreatic adenocarcinoma (PDAC) is projected to be the second cause of cancer death in Western societies within a decade. Management include chemotherapy and/or radiation therapy, while resectable disease is possible only in 15% of cases.
Despite these therapeutic approaches, the survival rate of unresectable pancreatic cancer remains disappointing. Recently, there is a growing interest in the development of alternative therapeutic approaches, which can work in parallel with standard chemoradiation therapy. These methods include intra-lesion injection/instillation of antitumoral agents performed through a laparoscopic approach, or percutaneously or under endoscopic ultrasound (EUS) guidance and tumor volume reduction procedures using ablative techniques.
In this context laser ablation has been reported to be effective in inducing coagulative necrosis of the tumour in absence of major adverse events. However, the available studies on the matter are limited by small sample size, lack of extended follow up and informations about the possibility to ablate the entire tumour mass.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Histological diagnosis of pancreatic ductal adenocarcinoma
- •Unresectable advanced, non-metastatic Stage III tumor
- •Stable disease without regression or progression after 6 months of chemotherapeutic treatment
- •Locally progressive disease after chemiotherapy, without evidence of metastases
- •Age >18 and <80 years
- •Willing to be followed up c/o the Fondazione Policlinico A. Gemelli University Hospital
- •Signed informed consent
排除标准
- •Stage I, Stage II, Stage IV disease
- •Absolute contraindications to general anesthesia or deep sedation
- •Absolute contraindications to perform digestive endoscopy
- •Known bleeding disorder that cannot be sufficiently corrected with co-fact or fresh frozen plasma (FFP)
- •Use of anticoagulants that cannot be discontinued
- •International Normalized Ratio (INR) >1.5 or platelet count <50.000
- •Pregnancy or lactation
- •Unable to sigh informed consent
研究组 & 干预措施
EUS-guided laser ablation
Laser ablation will be performed using a 1064-nm wavelength laser with the insertion of a 300-μm optical fiber through a 22-gauge needle under endoscopic ultrasonography guidance.
干预措施: EUS-guided laser ablation (Device)
结局指标
主要结局
Tumor necrosis induction by EUS-guided laser ablation (LA) - Number of patients with necrosis of the tumor
时间窗: at 1 month from the intervention
Number of patients with necrosis of the tumor, as demonstrated by the involution of the pancreatic mass on CT scan performed after one month from the treatment
次要结局
- Incidence of early and late adverse events after EUS-guided laser ablation (LA)(at 7 days and 3 months from the intervention)
- Disease response to EUS-guided laser ablation (LA)(From date of treatment, every 4 months, assessed until death or up to 2 years)
- Post-procedural quality of life(From date of enrollment (baseline), every 2 months, assessed until death or up to 2 years)
- Progression-free-survival (PFS)(From date of enrollment assessed until death or up to 2 years)
- Overall survival(From date of enrollment assessed until death or up to 2 years)
研究者
Guido Costamagna
Professor
Catholic University of the Sacred Heart