Intraoperative Radiation Therapy for Pancreatic Cancer

(PACER Trial)

This trial explores a new method for treating pancreatic cancer, particularly when the cancer involves blood vessels. The focus is on using intraoperative radiation therapy during surgery. Researchers are testing this treatment to determine its effectiveness alongside standard treatments like chemotherapy and radiation. Suitable candidates have pancreatic cancer affecting blood vessels and have previously undergone chemotherapy and radiation. The goal is to determine if this approach can improve treatment outcomes for patients with this specific condition. As an unphased trial, this study offers patients the chance to contribute to pioneering research that could lead to new treatment options.

Research has shown that intraoperative radiation therapy (IORT) is generally safe when combined with surgery. Most patients recover well and experience only minor side effects. In one study, about 2.2% of patients experienced a more serious side effect. Another study found that 4.9% of patients developed radiation necrosis, a type of tissue damage, though this remains uncommon.

Many patients in these studies healed their surgical wounds within four weeks after receiving IORT. The treatment also effectively prevents cancer from returning in the treated area.

Most treatments for pancreatic cancer with vascular involvement typically involve surgery followed by chemoradiation. However, this new approach, using Electron Beam Intraoperative Radiation Therapy (IORT), is different because it delivers targeted radiation directly to the tumor site during surgery. This innovative method allows for a higher dose of radiation with potentially fewer side effects on surrounding healthy tissue. Researchers are excited because this could improve precision and effectiveness, potentially enhancing outcomes for patients who have limited options with traditional treatments.

Research has shown that intraoperative radiation therapy (IORT), which participants in this trial may receive, can effectively treat cancers. For example, one study found high survival rates over several years with IORT. In breast cancer treatment, IORT has demonstrated survival rates similar to traditional radiation methods. Although primarily studied in breast cancer, the approach is similar for pancreatic cancer. IORT delivers radiation directly to the tumor during surgery, potentially protecting healthy tissue and improving outcomes. While more research is needed, early findings suggest it could be a promising option for pancreatic cancer.¹⁶⁷⁸⁹