A Pilot Trial to Determine the Extent of Inter- and Intra-Treatment Organ Motion Using Active Breathing Control Device (ABC) in Patients With Pancreatic Cancer

Study Overview
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Brief Summary
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This is a study to assess the motion of pancreatic tumors during radiation therapy using Computed Tomography (CT) Scans and an Active Breathing Control (ABC) Device.

Official Title
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A Pilot Trial to Determine the Extent of Inter- and Intra-Treatment Organ Motion Using Active Breathing Control Device (ABC) in Patients With Pancreatic Cancer

Conditions
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Pancreatic Cancer

Intervention / Treatment
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* Radiation: Standard Radiation Therapy
* Device: Active Breathing Control Device (ABC)
* Device: Computed Tomography Scan (CT)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients ≥ 18 years of age A working diagnosis (with or without histologic confirmation) of pancreatic cancer A plan to treat with radiotherapy (or chemoradiotherapy) Patients must have fiducial marker(s) endoscopically placed within the pancreas for clinical treatment. Exclusion Criteria: Previous abdominal radiotherapy. Patients with a history of major abdominal surgery. Patients who are pregnant.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Radiation Treatment<br>Patients undergoing standard of care radiation treatment with Active Breathing Control (ABC) | Radiation: Standard Radiation Therapy<br>* Radiotherapy will be planned and delivered according to institutional standard of care.<br>Device: Active Breathing Control Device (ABC)<br> <br> Device: Computed Tomography Scan (CT)<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distance traveled by the pancreatic tumor during radiation treatment using Computed Tomography (CT) Scans and an Active Breathing Control (ABC) Device | A marker (implanted near the radiation site, prior to treatment, as a point of reference) will be noted in space on an x, y and z plane using a CT scan. The excursion of this marker during treatment will be determined and the distance traveled, as well as the overall vector (distance and magnitude), will be calculated. Later scans will assess changes in the ability to calculate distance traveled and overall vector of travel. | Weeks -3 to -1, Week 1, Week 3, Week 5 | 
| Distance traveled by the pancreatic tumor between radiation treatments using Computed Tomography (CT) Scans and an Active Breathing Control (ABC) Device | A marker (implanted near the radiation site prior to treatment as a point of reference) will be noted in space on an x, y and z plane on a pre-treatment/planning Computed Tomography (CT) scan. The relative position of the marker on later CT scans will be compared to the pre-treatment/planning scan and the difference in position will be calculated. The change in the position between all CT scans will be calculated for statistical analysis of tumor movement while undergoing treatment with an Active Breathing Control (ABC) Device. | Week -3 to -1, Week 1, Week 3, Week 5 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Probability of surrounding normal tissue being a particular distance from the tumor marker at any time point. |  | Week -1 to -3, Week 1, Week 3, Week 5 | 
| Assess the impact of the determined treatment margins on the radiation dose to normal tissues and the ability to escalate dose to the tumor using Intensity-Modulated Radiation Therapy (IMRT) | To assess the impact of the determined treatment margins on radiation dose distribution, we will retrospectively recalculate the patient's treatment plan based on the measured motion of the tumor and normal tissue. This new treatment plan will be compared with the original treatment plan. If the new treatment plan suggests normal tissue was exposed to a reduced amount of radiation, multiple treatment plans will be generated to assess the extent to which this reduction will allow for increased tumor dose in the future. | Analysis will take place after treatment at approximately week 6 |