The ARTIA-Pancreas trial is testing a new CT-guided adaptive radiation method called CT-STAR for patients with borderline resectable or locally advanced pancreatic cancer. Traditional high-dose radiation is risky because the pancreas is close to sensitive organs like the stomach and duodenum, often causing severe gastrointestinal side effects. CT-STAR aims to deliver strong, tumor-killing doses while minimizing harm to nearby organs.
CT-STAR works by taking a daily scan before each treatment and adjusting the radiation plan in real time if organs have shifted. This ensures the tumor receives the full dose while protecting the stomach and bowel. Patients first receive chemotherapy, then 50 Gy of radiation in 5 fractions, with each plan adapted daily to match that day’s anatomy. The trial aims to reduce severe acute GI toxicity to under 10%, compared with 20% seen historically, and late toxicity to under 10%, versus 25% historically.
Enrollment began in May 2023 at multiple centers, with 134 participants expected. If successful, CT-STAR could make high-dose, curative-intent radiation widely accessible for pancreatic cancer patients without needing the expensive MR-guided machines previously required.