SPARC, a phase-I trial of pre-operative, margin intensified, stereotactic body radiation therapy for pancreatic cancer.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Daniel L P HolyoakeMaria A Hawkins

Abstract

Following resection of pancreatic cancer, risk of positive margins and local recurrence remain high, especially for borderline-resectable pancreatic cancer (BRPC). We aimed to establish the maximum tolerated dose of a margin-intensified five-fraction stereotactic body radiotherapy (SBRT) regimen designed to treat the region at risk. We conducted a prospective multicentre phase-1 rolling-six dose-escalation study. BRPC patients received pre-operative SBRT, with one dose to the primary tumour and an integrated boost to the region where tumour was in contact with vasculature. Four dose-levels were proposed, with starting dose 30 Gy to primary PTV and 45 Gy to boost volume (PTV_R), in five daily fractions. Primary endpoint was maximum tolerated dose (MTD), defined as highest dose where zero of three or one of six patients experienced dose-limiting toxicity (DLT). Twelve patients were registered, eleven received SBRT. Radiotherapy was well tolerated with all treatment completed as scheduled. Dose was escalated one level up from starting dose without encountering any DLT (prescribed 32.5 Gy PTV, 47.5 Gy PTV_R). Nine serious adverse reactions or events occurred (seven CTCAE Grade 3, two Grade 4). Two patients went on to have surgical ...Continue Reading

References

Apr 18, 2001·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·T A SohnK D Lillemoe
Apr 20, 2001·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·V K MehtaJ A Bastidas
Mar 6, 2004·International Journal of Radiation Oncology, Biology, Physics·Albert C KoongJ Augusto Bastidas
Sep 14, 2004·International Journal of Gastrointestinal Cancer·Aaron R SassonBurton L Eisenberg
Apr 14, 2005·Annals of Surgical Oncology·Rebekah R WhiteDouglas S Tyler
Jul 26, 2006·Annals of Surgical Oncology·Mark Talamonti
Jul 26, 2006·Annals of Surgical Oncology·Gauri R VaradhacharyRobert A Wolff
Dec 19, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Thomas J HowardKeith D Lillemoe
Jan 10, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeffrey M SkolnikPeter C Adamson
Mar 1, 2008·Journal of the American College of Surgeons·Sarah E GreerRichard J Barth
Apr 9, 2008·International Journal of Radiation Oncology, Biology, Physics·Devin SchellenbergAlbert C Koong
May 13, 2008·Journal of the American College of Surgeons·Matthew H G KatzRosa F Hwang
Oct 28, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·David CunninghamJohn P Neoptolemos
Sep 9, 2010·JAMA : the Journal of the American Medical Association·John P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Apr 26, 2011·International Journal of Radiation Oncology, Biology, Physics·Eric L H KhooJarad M Martin
May 10, 2011·International Journal of Radiation Oncology, Biology, Physics·Devin SchellenbergAlbert C Koong
May 13, 2011·The New England Journal of Medicine·Thierry ConroyUNKNOWN PRODIGE Intergroup
Jun 11, 2011·International Journal of Radiation Oncology, Biology, Physics·Anand MahadevanMark Callery
Sep 10, 2011·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jasper NijkampCorrie A M Marijnen
Apr 9, 2013·International Journal of Radiation Oncology, Biology, Physics·Michael D ChuongRavi Shridhar
Oct 10, 2013·JAMA : the Journal of the American Medical Association·Helmut OettleHanno Riess
Oct 18, 2013·The New England Journal of Medicine·Daniel D Von HoffMarkus F Renschler
Feb 4, 2014·Journal of the American College of Surgeons·Reena RavikumarUNKNOWN UK Vascular Resection in Pancreatic Cancer Study Group
Jan 24, 2015·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Takero HirataOsamu Ishikawa
Apr 29, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gregory M HeestandAndrew M Lowy
Aug 1, 2015·Perspectives in Clinical Research·Tiffany M Harris-Brown, David L Paterson
Aug 1, 2016·International Journal of Radiation Oncology, Biology, Physics·Walid L ShaibBassel F El-Rayes
Oct 27, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Daniel L P HolyoakeMaria A Hawkins
Oct 21, 2016·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Thomas B BrunnerAnca-Ligia Grosu

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.