A Prospective Phase II Dose Escalation Study Using IMRT for High Risk N0 M0 Prostate Cancer
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Purpose
This is a prospective, phase II non-randomised controlled clinical study. Dose escalation will be implemented using 1.8 Gy increments from baseline 75.6 Gy. Patients' RT prescription may be escalated up to max 81 Gy once dose volume constraints are adhered to.
All patients will be treated using the participating institution's standard rectal preparation protocol, bladder-filling protocol and appropriate immobilisation device(s).
Cone beam CT on-treatment imaging is recommended for this study. However, the use of individual institutional imaging equipment and techniques is permitted.
Acute GU/GI toxicities will be assessed weekly during treatment.
GU/GI toxicities will also be assessed 2 months post RT, 8 months post RT and 6 monthly thereafter to year nine and in line with the participating institution's standard routine follow-up (FU) thereafter.
| Condition | Intervention | Phase |
|---|---|---|
|
Prostate Cancer |
Other: questionnaire administration Procedure: quality-of-life assessment Radiation: image-guided radiation therapy Radiation: intensity-modulated radiation therapy Radiation: radiation therapy treatment planning/simulation |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Prospective Phase II Dose Escalation Study Using IMRT for High Risk N0M0 Prostate Cancer |
- Biochemical Failure Free survival [ Time Frame: 2017 ] [ Designated as safety issue: No ]
- Overall survival and disease free survival rates [ Time Frame: 2017 ] [ Designated as safety issue: No ]
- Maximum dose escalation [ Time Frame: 2017 ] [ Designated as safety issue: No ]
- Toxicity [ Time Frame: 2017 ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 180 |
| Study Start Date: | June 2008 |
| Estimated Study Completion Date: | September 2026 |
| Estimated Primary Completion Date: | September 2017 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Arm A
Treatment will be delivered in 1.8 Gy fractions; dose escalation will be in 1.8 Gy increments from 75.6 Gy to a maximum 81 Gy.
|
Other: questionnaire administration Procedure: quality-of-life assessment Radiation: image-guided radiation therapy Radiation: intensity-modulated radiation therapy Radiation: radiation therapy treatment planning/simulation |
Detailed Description:
Primary Objective:
To determine if dose escalated IMRT for high risk localised prostate cancer can provide PSA relapse free survival similar to that reported by Memorial Sloan Kettering (Alicikus et al 20102)
Secondary Objectives:
- Overall survival and disease-free survival rates.
- To evaluate the significance of published prognostic/ stratification factors such as the UCSF-CAPRA score and assess their application to the data from this study.
- To achieve the maximum dose escalation (up to 81Gy). This will be assessed as the percentage of patients that receive each dose level for all categories (dose increments of 1.8 Gy from 75.6 Gy up to max 81 Gy).
- The incidence and severity of acute and late GU and GI toxicities will be described, and correlated with DVH parameters
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients undergoing a radical course of RT for high-risk disease (defined according to the National Comprehensive Cancer Network Practice Guidelines in Oncology v.1 as one or more of the NCCN high risk criteria > or equal to T3, > or equal to Gleason 8, PSA > 20ng/ml)
- Only patients requiring neo-adjuvant / adjuvant hormonal therapy will be included in this study
- Absence of distant metastases as demonstrated by history and physical examination, FBC, screening profile including liver function tests, PSA and bone scan
- All patients must have an MRI/CT of the prostate and pelvis to investigate the nodal status and precise T-stage. This MRI/CT scan must be performed prior to commencement of hormonal therapy. Suspicious nodes need to be histologically proven to be benign before the patient can be included in the study). M0 on staging.
- No previous surgery for urinary conditions except TURP or TRUS
- KPS > or equal to 60
- Age >18 years
- Provision of written informed consent in line with ICH-GCP guidelines
Exclusion Criteria:
- Previous RT to the pelvic region
- The patient has nodal involvement or it is decided to electively treat pelvic lymph nodes
- The patient has had a bilateral orchidectomy
- The patient has previously received a full course of hormonal treatment for his prostate cancer
- The patient has or has had other malignancies within the last 5 years (non-melanoma skin cancer is permitted)
- Evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the trial or if it is felt by the research/ medical team that the patient may not be able to comply with the protocol
- Patients who have had a prostatectomy
- The presence of hip prostheses
Contacts and Locations| Ireland | |
| Saint Luke's Hospital | Recruiting |
| Dublin, Ireland, 6 | |
| Contact: John Gerard Armstrong, MD, MB, MRCPI +353 1 4065000 | |
| UPMC Whitfield Cancer Centre | Recruiting |
| Waterford, Ireland | |
| Contact: Dayle Hacking 353 51 337444 | |
| Principal Investigator: | John Gerard Armstrong, MD, MB, MRCPI | Saint Luke's Hospital |
More Information
Additional Information:
No publications provided
| Responsible Party: | ICORG- All Ireland Cooperative Oncology Research Group |
| ClinicalTrials.gov Identifier: | NCT00951535 History of Changes |
| Other Study ID Numbers: | CDR0000639289, ICORG-08-17, EU-20924 |
| Study First Received: | August 1, 2009 |
| Last Updated: | January 4, 2013 |
| Health Authority: | Ireland: Research Ethics Committee |
Keywords provided by ICORG- All Ireland Cooperative Oncology Research Group:
|
stage I prostate cancer stage IIB prostate cancer stage IIA prostate cancer stage III prostate cancer |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site |
Neoplasms Genital Diseases, Male Prostatic Diseases |
ClinicalTrials.gov processed this record on May 19, 2013