Pancreatic Cancer
Conditions
Keywords
stage I pancreatic cancer, adenocarcinoma of the pancreas
Brief summary
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Gemcitabine may make tumor cells more sensitive to radiation therapy. Combining chemotherapy with radiation therapy after surgery may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining gemcitabine with radiation therapy in treating patients who have undergone surgery to remove cancer of the pancreas.
Detailed description
OBJECTIVES: * Determine the time to disease progression, local control, and survival of patients with previously resected pancreatic cancer treated with adjuvant gemcitabine and radiotherapy. OUTLINE: This is a multicenter study. Patients receive gemcitabine IV over 30-60 minutes on days 1, 4, 8, 11, 15, 18, 22, 25, 29, and 32 and undergo radiotherapy on days 1-5, 8-12, 15-19, 22-26, 29-33, and 36-38 in the absence of disease progression or unacceptable toxicity. Beginning at least 4 weeks after chemoradiotherapy, patients without disease progression and with less than 10% weight loss during study receive additional gemcitabine IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for a total of 2 courses. Patients are followed every 8 weeks for 6 months and then every 3 months for up to 2 years. PROJECTED ACCRUAL: A total of 72 patients will be accrued for this study within 2.2 or 3.4 years.
Interventions
DRUGgemcitabine hydrochloride
PROCEDUREadjuvant therapy
RADIATIONradiation therapy
Sponsors
National Cancer Institute (NCI)
Wake Forest University Health Sciences
Study design
Primary purpose
TREATMENT
Eligibility
Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed invasive adenocarcinoma of the pancreas * Prior gross total resection via a pancreaticoduodenectomy (Whipple resection or total pancreatectomy) within the past 2 months * No clinical evidence of gross residual disease at time of surgery * No focally positive margins (tumor at the margin) * No unresected nodal disease or metastatic disease to the liver, peritoneal surfaces, or elsewhere PATIENT CHARACTERISTICS: Age: * Over 18 Performance status: * ECOG 0-2 Life expectancy: * More than 6 months Hematopoietic: * Granulocyte count greater than 1,500/mm3 * Hemoglobin greater than 10 g/dL * Platelet count greater than 100,000/mm3 Hepatic: * Bilirubin less than 2.0 mg/dL Renal: * Creatinine less than 2.0 mg/dL Other: * Able to maintain adequate oral nutrition * Documented stable weight (no more than 5 lbs weight loss) for at least 2 weeks prior to study * No other malignancy within the past 2 years except inactive nonmelanoma skin cancer or carcinoma in situ of the cervix or breast * Non-metastatic prostate cancer allowed if more than 2 year survival likely * No other serious medical or psychiatric illness that would preclude study or limit survival to less than 2 years * Not pregnant * Negative pregnancy test * Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: * No concurrent routine growth factors Chemotherapy: * No prior chemotherapy for pancreatic cancer Endocrine therapy: * Not specified Radiotherapy: * No prior abdominal radiotherapy for pancreatic cancer Surgery: * See Disease Characteristics
Countries
United States
Outcome results
None listed