Span-C-SBRT for Pancreatic Cancer (Span-C)
Stereotactic Body Radiotherapy [SBRT] for High Risk Localised Pancreatic Cancer: a Phase II Study of the Department of Radiation Oncology Royal North Shore Hospital (Span-C - SBRT for Pancreatic Cancer)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Patients must have histologically or cytologically confirmed high risk localised adenocarcinoma of the pancreas, including patients with extrapancreatic extension (Stage IIA), node positive (Stage IIB), borderline resectable or locally advanced pancreatic cancer as defined by Australasian Gastro-Intestinal Trials Group (AGITG) guidelines. ECOG performance status 0-1, suitable for chemotherapy and radiotherapy.
After a minimum of 2 months of neoadjuvant chemotherapy using either an oxaliplatin- based regimen (FOLFOX, FOLFIRINOX, mFOLFIRINOX)+/- immunotherapy/molecular agent or gemcitabine based chemotherapy (eg gemcitabine / gemcitabine/abraxane). Participants will receive SBRT (30-45Gray in 5 fractions over 2 weeks. Prior to SBRT, fiducial markers will be placed to aid with image guidance during radiation delivery. Four weeks after completion of SBRT participants will have re-staging using positron emission tomography (PET) and computed tomography (CT) scan. Participants will be discussed in the multidisciplinary team meeting for consideration of surgery. Those considered to be resectable will proceed to have surgery 6-10 weeks post SBRT.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Carol Kwong
- Phone Number: +61 2 9463 1339
- Email: carolyn.kwong@health.nsw.gov.au
Study Contact Backup
- Name: Heidi Tsang
- Phone Number: +61 2 9463 1340
- Email: heidi.tsang@health.nsw.gov.au
Study Locations
-
-
New South Wales
-
St Leonards, New South Wales, Australia, 2065
- Royal North Shore Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 and able to give informed consent
- Patients with histologically or cytologically confirmed locally advanced adenocarcinoma of the pancreas, including patients with extrapancreatic extension (Stage IIA), node positive (Stage IIB), borderline resectable or locally advanced as defined by AGITG guidelines
- ECOG performance status 0-1
- Measurable disease as defined by RECIST 1.1
- Have received or plan to receive chemotherapy
- Successful insertion of fiducial markers
Exclusion Criteria:
- Patients with metastatic pancreas cancer
- Prior abdominal radiotherapy
- Active malignancy excluding non melanomatous skin cancer
- Neuroendocrine pancreatic carcinoma
- Pregnant or lactating women
- Tumour size greater then 70mm
- Age >85
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Stereotactic Body Radiotherapy (SBRT)
Prior to SBRT, fiducial markers will be placed to aid with image guidance during radiation delivery. Fiducials will be inserted endoscopically (preferable) or intraoperatively. After this procedure, patients will have radiotherapy planning. During treatment, the fiducials will be used for registration with the images acquired during treatment (including kV fluoroscopy, MV or optical). The acquired images may be processed to determine fiducial location using KIM or MATT software from University of Sydney. SBRT 30-45Gray in 5 fractions will be given over 2 weeks. Four weeks after completion of SBRT participants will repeat a re-staging PET and CT scans. Those considered to be resectable will proceed to have surgery 6-10 weeks post SBRT. |
Stereotactic Body Radiotherapy (SBRT) 30-45 gray in 5 fractions over 2 weeks will be given to all eligible patients.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
freedom of local failure
Time Frame: 12 months from end of radiotherapy
|
patient who do no have local failure
|
12 months from end of radiotherapy
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of SBRT treatment related adverse events in this group of patients
Time Frame: Acute toxicity-from start of SBRT up to 3 months after SBRT. Late RT toxicity: from 3 months to 2 years after SBRT.
|
assess acute and late radiotherapy toxicity using CTCAE version 4.3, to compare toxicity with conventional treatment
|
Acute toxicity-from start of SBRT up to 3 months after SBRT. Late RT toxicity: from 3 months to 2 years after SBRT.
|
|
Response to neoadjuvant treatments
Time Frame: from date of surgery through to 24 months post surgery
|
Determine by pathology and radiological response rates after neoadjuvant treatment,
|
from date of surgery through to 24 months post surgery
|
|
Feasibility of internal-external correlation model (MATT)
Time Frame: during SBRT radiotherapy treatment
|
Determine the feasibility of the University of Sydney internal-external correlation model (MATT) to determine pancreas motion.
Feasibility is determined as predicted motion with MATT is within 2mm of actual motion measured with fluoroscopic x-rays of fiducial markers during treatment.
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during SBRT radiotherapy treatment
|
|
Surgical complications
Time Frame: 30 to 90 days post surgery
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To assess surgical complications
|
30 to 90 days post surgery
|
|
Duration of hospital admission after surgery
Time Frame: from date of surgery through study completion (ie 24 months)
|
to assess extended stay in the hospital after surgery
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from date of surgery through study completion (ie 24 months)
|
|
margin negative (R0) resection rate
Time Frame: through study completion, average of 2 years
|
to assess margin negative resection rate (i.e.
response to treatment)
|
through study completion, average of 2 years
|
|
median overall survival (OS)
Time Frame: 12 months after treatment
|
To assess median overall survival after treatment
|
12 months after treatment
|
|
progression free survival (PFS)
Time Frame: 12 months after treatment
|
To assess the PFS rate after treatment
|
12 months after treatment
|
|
Feasibility of Using Kilovoltage Intra-fraction Monitoring (KIM) to determine pancreas motion
Time Frame: during SBRT radiotherapy treatment
|
Determine the feasibility of the University of Sydney Kilovoltage Intra-fraction Monitoring (KIM) software to determine pancreas motion.
Feasibility is determined as predicted motion with KIM is within 2mm of actual motion measured with fluoroscopic x-rays of fiducial markers during treatment.
|
during SBRT radiotherapy treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: George Hruby, FRANZCR, Northern Sydney Local Health District
Publications and helpful links
General Publications
- Chan J, Kneebone A, Metz G, Booth J, Shepherd M, Kwong C, Brown C, Norton I, Clarke S, Diakos C, Pavlakis N, Mittal A, Samra J, Hruby G. SPAN-C: Results of a Phase II Clinical Trial of Stereotactic Body Radiotherapy in Pancreatic Ductal Adenocarcinoma. J Med Imaging Radiat Oncol. 2025 Aug;69(5):593-600. doi: 10.1111/1754-9485.13874. Epub 2025 Jun 16.
- Madden L, Ahmed A, Stewart M, Chrystall D, Mylonas A, Brown R, Nguyen DT, Keall P, Booth J. CBCT-DRRs superior to CT-DRRs for target-tracking applications for pancreatic SBRT. Biomed Phys Eng Express. 2024 Apr 26;10(3). doi: 10.1088/2057-1976/ad3bb9.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Endocrine System Diseases
- Digestive System Neoplasms
- Endocrine Gland Neoplasms
- Pancreatic Diseases
- Pancreatic Neoplasms
- Investigative Techniques
- Therapeutics
- Surgical Procedures, Operative
- Radiotherapy
- Stereotaxic Techniques
- Neurosurgical Procedures
- Radiosurgery
Other Study ID Numbers
Other Study ID Numbers
- Span-C
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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