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Gemcitabine and Radiation Therapy Compared With Gemcitabine Alone in Treating Patients Who Have Undergone Surgery for Pancreatic Cancer

Randomized Phase II/III Study Comparing Gemcitabine Followed by Gemcitabine Plus Concomitant Radiation (50.4 Gy) Versus Control After Curative Pancreaticoduodenectomy for Pancreatic Head Cancer

RATIONALE: Drugs used in chemotherapy such as gemcitabine use different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving these treatments after surgery may kill any tumor cells that remain after surgery. It is not yet known whether giving gemcitabine together with radiation therapy is more effective than gemcitabine alone following surgery in treating pancreatic cancer.

PURPOSE: This randomized phase II/III trial is studying how well giving gemcitabine together with radiation therapy works and compares it to gemcitabine alone in treating patients who have undergone surgery for pancreatic cancer.

Panoramica dello studio

Descrizione dettagliata

OBJECTIVES:

Phase II:

  • Determine the feasibility of gemcitabine followed by chemoradiotherapy with gemcitabine vs gemcitabine alone after prior curative resection in patients with pancreatic head adenocarcinoma.
  • Compare the tolerability of these regimens, in terms of acute and late toxicity, in these patients.

Phase III:

  • Compare the disease-free and overall survival of patients treated with these regimens .
  • Compare the quality of life of patients treated with these regimens.
  • Compare the toxicity of these regimens in these patients.
  • Determine the sites of recurrence in patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to ECOG/WHO performance status (0-1 vs 2), participating center, and N stage (N0 vs N1 vs NX). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Within 8 weeks after prior surgical resection, patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 2 courses.

Patients then receive additional gemcitabine IV over 30 minutes on days 57, 64, 71, 78, 85, and 92. Beginning on day 57, patients also undergo radiotherapy once daily, 5 days a week, for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

  • Arm II: Patients receive gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 4 weeks for 4 courses.

Quality of life (QOL) is assessed in both arms, according to the following schedules:

  • Arm I: QOL is assessed at baseline; at 3 weeks after the beginning of chemoradiotherapy; after the completion of chemoradiotherapy; every 3 months for 2 years; and then every 6 months for 1 year.
  • Arm II: QOL is assessed at baseline; at 12 weeks; at 16 weeks; every 3 months for 2 years; and then every 6 months for 1 year.

Patients are followed every 3 months for 2 years and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 538 patients (269 per treatment arm) will be accrued for this study within 3 years.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

97

Fase

  • Fase 2
  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Brussels, Belgio, 1070
        • Hopital Universitaire Erasme
      • Ghent, Belgio, B-9000
        • Universitair Ziekenhuis Gent
      • Haine Saint Paul, Belgio, 7100
        • Hopital de Jolimont
      • Kortrijk, Belgio, B-8500
        • Cazk Groeninghe - Campus St-Niklaas
      • Liege, Belgio, B-4000
        • CHU Liege - Domaine Universitaire du Sart Tilman
      • Wilrijk, Belgio, 2610
        • Algemeen Ziekenhuis Sint-Augustinus
      • Abbeville, Francia, 80101
        • Centre Hospitalier d'Abbeville
      • Annecy, Francia, 74011 Cedex
        • Centre Hospitalier d'Annecy
      • Avignon, Francia, 84902
        • Hopital Duffaut
      • Avignon, Francia, 84082
        • Institut Sainte Catherine
      • Beauvais, Francia, 60021
        • C.H.G. Beauvais
      • Blois, Francia, 41016
        • Centre Hospitalier de Blois
      • Bordeaux, Francia, F-33000
        • Clinique Tivoli
      • Boucher, Francia, 33300
        • Polyclinique Bordeaux Nord Aquitaine
      • Boulogne Billancourt, Francia, F-92104
        • Centre Hospitalier Universitaire Ambroise Pare - Boulogne
      • Boulogne Sur Mer, Francia, 62200
        • Centre Hospitalier Docteur Duchenne
      • Bourgoin-Jallieu, Francia, 38300
        • Centre Hospitalier Pierre Oudot
      • Caen, Francia, 14033
        • CHu de Caen
      • Clermont-Ferrand, Francia, 63003
        • CHR Clermont Ferrand, Hotel Dieu
      • Clichy, Francia, 92118
        • Hôpital Beaujon
      • Colombes Cedex, Francia, 92701
        • Louis Mourier Hospital
      • Creteil, Francia, 94010
        • Centre Hospitalier Universitaire Henri Mondor
      • Dax, Francia, 40107
        • Centre Hospitalier de Dax
      • Dijon, Francia, 21034
        • Hôpital du Bocage
      • Elbeuf, Francia, 76503
        • Centre Hospitalier Intercommunal St. Aubin les Elbeuf
      • Grenoble, Francia, 38043
        • CHU de Grenoble - Hopital de la Tronche
      • La Roche Sur Yon, Francia, F-85025
        • Centre Hospitalier Departemental
      • Le Mans, Francia, F-72000
        • Clinique Victor Hugo
      • Libourne, Francia, 33500
        • Hôpital Robert Boulin
      • Limoges, Francia, 87042
        • Centre Hospital Regional Universitaire de Limoges
      • Lyon, Francia, 69008
        • Clinique Saint Jean
      • Lyon, Francia, 69373
        • Centre Leon Berard
      • Marseille, Francia, 13385
        • CHU de la Timone
      • Mont-de-Marsan, Francia, 40000
        • Centre Hospitalier General de Mont de Marsan
      • Montpellier, Francia, 34298
        • Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
      • Mulhouse, Francia, 68051
        • Centre Hospitalier de Mulhouse
      • Nimes, Francia, 30029
        • C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau
      • Paris, Francia, 75015
        • Hôpital Européen Georges Pompidou
      • Paris, Francia, 75018
        • Hôpital Bichat - Claude Bernard
      • Paris, Francia, 75651
        • CHU Pitié-Salpêtrière
      • Paris, Francia, 75674
        • Hôpital Cochin
      • Paris, Francia, 75970
        • Hopital Tenon
      • Paris, Francia, 75571
        • Hôpital Saint Antoine
      • Pau, Francia, 64000
        • C.H.G. De Pau
      • Pierre Benite, Francia, 69495
        • Centre Hospitalier Lyon Sud
      • Poitiers, Francia, 86021
        • CHU Poitiers
      • Rouen, Francia, 76031
        • Hôpital Charles Nicolle
      • Strasbourg, Francia, 67098
        • Hopital Universitaire Hautepierre
      • Strasbourg, Francia, 67065
        • Centre Paul Strauss
      • Tours, Francia, 37044
        • Centre Hospitalier Universitaire Bretonneau de Tours
      • Vandoeuvre-les-Nancy, Francia, 54511
        • Centre Alexis Vautrin
      • Berlin, Germania, D-10117
        • Charité - Campus Charité Mitte
      • Berlin, Germania, D-13122
        • Robert Roessle Comprehensive Cancer Center at University of Berlin - Charite Campus Buch
      • Duesseldorf, Germania, D-40225
        • Universitaetsklinikum Duesseldorf
      • Mainz, Germania, D-55101
        • Johannes Gutenberg University
      • Munich, Germania, D-80335
        • Munich Oncologic Practice at Elisenhof
      • Haifa, Israele, 31096
        • Rambam Medical Center
      • Amsterdam, Olanda, 1105 AZ
        • Academisch Medisch Centrum at University of Amsterdam
      • Geneva, Svizzera, CH-1211
        • Hôpital Cantonal Universitaire de Genève

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS:

  • Histologically confirmed pancreatic head adenocarcinoma
  • Prior pancreaticoduodenectomy required

    • Documented histological examination of surgical margins (R0), including retroperitoneal margin
    • Performed within the past 8 weeks
  • Any number of lymph nodes (less than 10 OR 10 or more) allowed
  • No periampullary cancer

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2 OR
  • WHO 0-2

Life expectancy

  • Not specified

Hematopoietic

  • WBC greater than 3,500/mm^3
  • Platelet count greater than 150,000/mm^3
  • Hemoglobin greater than 9.0 g/dL

Hepatic

  • Bilirubin less than 1.5 times normal
  • AST and ALT less than 3.0 times normal

Renal

  • Creatinine less than 1.2 mg/dL

Other

  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • No other prior or concurrent malignancy except basal cell skin cancer or carcinoma in situ of the cervix
  • No psychological, familial, sociological, or geographical condition that would preclude study compliance and follow-up

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No concurrent immunotherapy

Chemotherapy

  • No prior chemotherapy
  • No other concurrent chemotherapy

Endocrine therapy

  • Not specified

Radiotherapy

  • No prior radiotherapy

Surgery

  • See Disease Characteristics
  • Recovered from prior surgery

Other

  • No other concurrent anticancer agents

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Feasibility of full completion of treatment as measured by the number of patients completing treatment 1 month after treatment in phase II
Tolerability in terms of acute toxicity as measured by NCI-CTC v2.0 1 month after completion of treatment in phase II
Tolerability in terms of late toxicity as measured by EORTC and RTOG 1 month after completion of treatment in phase II
Overall survival as measured by Logrank every 3 months in years 1-2, and every 6 months thereafter in phase III

Misure di risultato secondarie

Misura del risultato
Disease-free survival as measured by Logrank every 3 months in years 1-2, and every 6 months thereafter
Acute toxicity as measured by NCI-CTC v2.0 every 3 months in years 1-2, and every 6 months thereafter
Late toxicity as measured by EORTC and RTOG every 3 months in years1-2, and every 6 months thereafter
Quality of life as measured by Quality of Life Questionnaire Core 30 (QLQ-C30) v3.0 and EORTC QLQ PAN-26 every 3 months in years 1-2 and every 6 months thereafter

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Cattedra di studio: Volker G. Budach, MD, PhD, Charite University, Berlin, Germany
  • Cattedra di studio: Pascal Hammel, MD, PhD, Hôpital Beaujon
  • Cattedra di studio: Jean-Luc Van Laethem, MD, PhD, Erasme University Hospital

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 maggio 2003

Completamento primario (Effettivo)

1 gennaio 2007

Date di iscrizione allo studio

Primo inviato

8 luglio 2003

Primo inviato che soddisfa i criteri di controllo qualità

8 luglio 2003

Primo Inserito (Stima)

9 luglio 2003

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

24 settembre 2012

Ultimo aggiornamento inviato che soddisfa i criteri QC

20 settembre 2012

Ultimo verificato

1 settembre 2012

Maggiori informazioni

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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