Adenocarcinomas of the Pancreas
Conditions
Keywords
Pancreas, Adenocarcinoma, Hyperthermic intraperitoneal chemotherapy, HIPEC, Pancreatic surgery, Gemcitabine
Brief summary
In patients with peritoneal metastases of colorectal cancer could be a radical removal of all tumor foci a significantly improved survival compared to a sole systemic chemotherapy are additionally achieved by a hyperthermic intraoperative chemotherapy (HIPEC).
Detailed description
Despite medical progress in recent years in pancreatic reach the 5-year survival rates even after radical surgical resection only 20%, which is due to high rates of local recurrence and distant metastases in the postoperative course. Due to the anatomical position of the pancreas resections are having a wide margin technically almost impossible, so that the tumor on postoperative preparation is often marginal forming. A further possible explanation for the high number of local recurrences, intraoperative tumor cell displacement in question. In patients with peritoneal metastases of colorectal cancer could be a radical removal of all tumor foci a significantly improved survival compared to a sole systemic chemotherapy are additionally achieved by a hyperthermic intraoperative chemotherapy (HIPEC). Purpose of HIPEC it is to kill any remaining microscopic residual tumor or residual tumor cells free. The aim of the present phase I / II study is therefore to examine the importance of HIPEC in addition to radical resection of ductal pancreatic cancer in terms of mortality and morbidity.
Interventions
DRUGGemcitabine
1000 milligram (mg)/square meters (m2) body surface 60 minutes (min) intraperitoneal hyperthermic lavage
Sponsors
University Hospital Tuebingen
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* ≥ 18 years * Computertomographic (CT) morphologically suspected pancreatic tumor without distant metastases, with the possibility of a macroscopically complete resection residual tumor classification (R) R0 / R1 . * Histological diagnosis of adenocarcinoma of the pancreas' in the frozen section intraoperatively * Karnofsky Index \> 70
Exclusion criteria
* Patients who are considered inoperable because of reduced general * Congestive heart failure New York Heart Association (NYHA) III / IV * Severe coronary heart disease, non-treatable arrhythmia or nonadjustable hypertension, * Severe asthma suffering, chronic obstructive pulmonary disease (COPD) * Renal insufficiency (serum creatinine ≥ 1.5 x of normal, or creatinine clearance \<60 milliliter (ml) / minutes (min)) * Patients where the intra-operative frozen section no adenocarcinoma of the pancreas can be demonstrated * Patients suffering from a second malignancy (within 5 years in the study of consent) except basal cell carcinoma and curative treated insitu carcinoma of the cervix * Distant metastases (M) \> 0 * Patients with a contraindication related to the present study * Allergy or intolerance to the study drug or a substance with chemical similarity to the study medication. * Patients under legal custodianship or incarcerated patients * Patients that can not understand the purpose of the study due to mental, intellectual or linguistic problem * Participation in Clinical Trials or other observation period of competing trials. * Pregnancy, lactation * Females of childbearing potential (FCBP) that do not agree * To utilize two reliable forms of contraception or practice complete abstinence from Simultaneously heterosexual contact for at least 28 days before start of treatment and for at least 28 days after administration of study treatment * To abstain from breastfeeding during study participation and 6 months after study treatment. * Males that do not agree * to use a latex condom during any sexual contact with FCBP during participation in the study and for at least 28 days study following treatment, even if he has undergone a successful vasectomy * to refrain from donating semen or sperm for at least 28 days after study treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30 days mortality after macroscopically complete Resection ( R0 / R1 ) of an adenocarcinoma of the pancreas in combined with hyperthermic intraperitoneal chemotherapy (HIPEC) | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Vomiting | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Diarrhea | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Stomatitis | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Nausea | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Neutrophilia | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Thrombocytopenia | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
| Hair loss | day 30 | Safety according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 |
Countries
Germany
Contacts
Primary ContactStefan Beckert, Prof. Dr.
Backup ContactAlfred Königsrainer, Prof. Dr.
Outcome results
None listed