Pancreatic Neoplasms Clinical Trial
Official title:
Clinical Phase I/II Trial to Investigate Neoadjuvant Intensity-Modulated Short Term Radiation Therapy (5x5 Gy) and Intraoperative Radiation Therapy (15 Gy) in Patients With Primarily Resectable Pancreatic Cancer - NEOPANC
The current standard treatment for patients with primarily resectable pancreatic tumors
consists of surgery followed by adjuvant chemotherapy. But even in this prognostic
favourable group, long term survival is disappointing because of high local and distant
failure rates. Postoperative chemoradiation has shown improved local control and overall
survival compared to surgery alone but the value of additional radiation has been questioned
in case of adjuvant chemotherapy. However, there remains a strong rationale for the addition
of radiation therapy considering the high rates of microscopically incomplete resections
after surgery. As postoperative administration of radiation therapy has some general
disadvantages, neoadjuvant and intraoperative approaches theoretically offer benefits in
terms of dose escalation, reduction of toxicity and patients comfort especially if
hypofractionated regimens with highly conformal techniques like intensity-modulated
radiation therapy are considered.
Therefore the NEOPANC trial has been designed as a prospective, one armed single center
study to investigate a combination of neoadjuvant short course intensity-modulated radiation
therapy (5x5 Gy) in combination with surgery and intraoperative radiation therapy (15 Gy)
followed by adjuvant chemotherapy according to german treatment guidelines in patients with
primarily resectable pancreatic cancer. The primary objectives of the NEOPANC trial are to
evaluate the general feasibility of this approach and the local recurrence rate after one
year. Secondary endpoints are progression-free survival, overall survival, acute and late
toxicity, postoperative morbidity and mortality and quality of life.
n/a
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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