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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT01781728
Other study ID # J1273
Secondary ID NA_00070233
Status Active, not recruiting
Phase Phase 2
First received
Last updated
Start date January 1, 2013
Est. completion date December 2024

Study information

Verified date April 2024
Source Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The investigators are looking to see if a certain dose of stereotactic body radiation therapy (SBRT) may be a viable treatment option for recurrent or residual pancreatic or periampullary adenocarcinoma.


Description:

No standard treatment option has yet been established for patients with recurrent or residual disease after definitive treatment of pancreatic or periampullary cancers (duodenal, ampullary, bile duct). Linac based stereotactic body radiation therapy (SBRT) administered in 1-3 fractions has been shown to be an effective treatment option for patients with unresectable, locally advanced pancreatic adenocarcinoma, achieving local control rates of 84-92% at one year. Associated late gastrointestinal toxicity rates have been reported to be 22-25% at 1 year. We hypothesize that similarly excellent local control rates (80-90% at one year) with a reasonable rate of toxicity (≤20%) can be achieved using Linac based SBRT delivered as 5 Gy x 5 for patients with local failure (remaining disease) after previous treatment with conventional chemoradiation therapy (CRT) with or without surgery and as 6.6 Gy x 5 for radiation-naïve patients with local failure (remaining disease) after previous treatment with surgery and/or chemotherapy. The toxicities of note for this trial are grade 2 and greater gastritis, fistula, enteritis, ulcer, or any other grade 3 or greater gastrointestinal toxicity.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 120
Est. completion date December 2024
Est. primary completion date December 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 100 Years
Eligibility Inclusion Criteria: - 18 years of age or older - Karnofsky Performance Status greater than or equal to 70% - confirmed pancreatic or periampullary adenocarcinoma - pancreatic or periampullary tumor less than 8.0 cm in greatest axial dimension - Either: - standard of care treatment for pancreatic cancer that included radiation therapy * patients may be receiving continued chemotherapy post initial CRT. or - standard of care treatment for pancreatic cancer that did not include radiation therapy * patients must have attempted chemotherapy upon initial diagnosis - acceptable organ and marrow function as determined by blood tests - ability to understand and give consent - must be a patient to be treated with SBRT only at Johns Hopkins Hospital - life expectancy of greater than 3 months Exclusion Criteria: - extensive metastatic disease - performance status of less than 70 - children are excluded form the study - no uncontrolled intercurrent illness - no concurrent malignancy other than melanoma - pregnant or breast feeding women are excluded - women who are not post-menopausal and have a positive pregnancy test - life expectancy of less than 3 months

Study Design


Intervention

Radiation:
Stereotactic Body Radiation Therapy (SBRT)
SBRT 5 Gy x 5 (over 1-2 weeks)*
Stereotactic Body Radiation Therapy (SBRT)
SBRT 6.6 Gy x 5 (over 1-2 weeks)*

Locations

Country Name City State
United States The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore Maryland

Sponsors (1)

Lead Sponsor Collaborator
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Late GI toxicity grade 2 or greater gastritis, enteritis, fistula, or ulcer and any other grade 3 or greater gastrointestinal toxicity greater than 3 months after treatment
Secondary Acute GI toxicity Any gastrointestinal (GI) toxicities grade 3 or greater. within 3 months of treatment
Secondary Local progression free survival Local progression free survival rate at 3, 6, and 12 months.. 3, 6, and 12 months after treatment
Secondary Linac based SBRT pain control To evaluate the ability of Linac based SBRT to provide pain control among symptomatic patients as measured by pain medication requirement at 3, 6 and 12 months after treatment. 3, 6, and 12 months after treatment
Secondary FDG-PET use for planning and estimation of survival To evaluate the utility of FDG-PET for treatment planning and estimation of progression-free survival. 3, 6, and 12 months after treatment and then annually thereafter
Secondary Linac based SBRT standardization To develop and standardize Linac based SBRT delivery and dosimetric parameters 3, 6, and 12 months after treatment
Secondary Toxicity and outcomes for patients with chemotherapy, with or without surgery and radiation for tumor assessments To evaluate toxicity and outcomes among patients with recurrent or residual disease after previous chemoradiation therapy, with or without surgery, who will be treated with 5 Gy x 5. 3, 6, and 12 months after treatment and then annually thereafter
Secondary Toxicity and outcomes for chemotherapy only and radiation To evaluate toxicity and outcomes among patients with recurrent or residual disease after chemotherapy only, (with or without surgery), who will be treated with 6.6 Gy x 5. 3, 6, and 12 months after treatment and then annually thereafter
Secondary Health related Quality of Life (QoL) To evaluate health-related quality of life (QoL) before and after SBRT. 3, 6 and 12 months after treatment then annually thereafter
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