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Single Fraction Early Prostate Irradiation (SiFEPI) (SiFEPI)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02104362
Recruitment Status : Active, not recruiting
First Posted : April 4, 2014
Last Update Posted : July 23, 2019
Information provided by (Responsible Party):
Centre Antoine Lacassagne

Brief Summary:

Recently, HDR brachytherapy delivering only a 19 Gy fraction was proposed as exclusive treatment for low and intermediate risk prostate cancers. With a median 3-year follow-up, the Spanish team reported a biochemical control rate of 100% and 87%, respectively, for low risk and intermediate risk tumors. In parallel with these encouraging results regarding biochemical control, the authors described excellent urinary and digestive tolerance, notably the absence of grade > 2 complications. However, it should be noted, in this study, that special protection was provided to the anterior aspect of the rectum by means of a 10 ml transperineal injection of hyaluronic acid into the prostate-rectal interspace.

The idea of using a single high dose (in one fraction) was proposed at the MSKCC by the team of Fucks et al. which, in 2008, following a median 18-month follow-up, published a a 90% local control rate for spinal metastases after a single dose at 18 to 24 Gy.

The aim of the present study is to analyze acute urinary and digestive toxicity (< 180 days) observed following interstitial high dose rate prostate brachytherapy delivering a total dose of 20 Gy in one fraction.

Condition or disease Intervention/treatment Phase
Prostate Cancer Radiation: exclusive single-fraction irradiation Not Applicable

Detailed Description:

Expected benefit(s) of the trial

  • Improved quality of life during brachytherapy on account of the absence of radioactive seeds in the prostate:

    • Fewer early urinary complications,
    • No urine filtration,
    • No post-operative use of condoms,
    • No 2-year ban on cremation following treatment,
  • Health cost savings,
  • Acquisition of dosimetric data for inverse optimization.

Predictable risk(s) for patients Predictable risks in the context of this trial involve the frequency of essentially urinary disorders.

Methodology Open, monocentric, phase I-II study.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 35 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I-II Study to Evaluate Exclusive Single-fraction Irradiation by Interstitial High Dose Rate Brachytherapy in Patients With Prostate Cancer at Low Risk or at Low Intermediate Risk of Local Recurrence
Actual Study Start Date : February 2014
Actual Primary Completion Date : November 13, 2017
Estimated Study Completion Date : November 13, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer

Arm Intervention/treatment
exclusive single-fraction irradiation Radiation: exclusive single-fraction irradiation

Primary Outcome Measures :
  1. acute urinary toxicity occurring within 6 months after irradiation. [ Time Frame: up to 5 years ]
    to assess the acute urinary toxicity occurring within 6 months after irradiation.

Secondary Outcome Measures :
  1. acute digestive toxicity occurring during the 6 months following irradiation [ Time Frame: up to 5 years ]
    Assessment of acute digestive toxicity occurring during the 6 months following irradiation,

Other Outcome Measures:
  1. Local recurrence-free survival at 3 years [ Time Frame: up to 5 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients suffering from histologically-proven adenocarcinoma-type prostate cancer:

    • with low risk of biochemical recurrence
    • with a low intermediate risk of biochemical recurrence (maximum of 1 intermediate risk factor)*
    • stage T1c, T2a, T2b
    • Gleason score 6 (3+3) or 7 (3+4) with at most 3 positive biopsies
  • PSA < 15 ng/ml
  • Age ≥ 18 years
  • Karnofsky index ≥ 70%
  • Life expectancy ≥ 10 years
  • No contraindication to injection of hyaluronic acid in the prostate-rectal interspace
  • Patient aware of the information leaflet and having signed the informed consent form
  • Patient covered by medical insurance

Exclusion Criteria:

  • Stage ≥ T2c
  • Gleason score 7 (4+3) or ≥ 8
  • PSA > 15 ng/ml
  • Presence of the following anatomico-pathological criteria:

    • Involvement of the nerve fibers
    • Peri-tumoral vascular embolisms
    • Capsule involvement
    • Number of positive biopsies ≥ 50%
    • 100% positive biopsies in a lobe
    • Involvement of the seminal vesicle
  • Prostate volume ≥60 cc
  • Large prostatic transurethral resection and/or dating from less than 6 months
  • Poor urinary function in the absence of alpha-blockers

    • IPSS score > 15
    • Post-mictional residue > 50 cc
    • Flow rate with Qmax < 12 ml/s
  • Remote metastasis
  • Neoadjuvant anti-androgenic treatment
  • Prior treatment with pelvic irradiation and/or chemotherapy
  • Active infection or other underlying severe pathology likely to prevent the patient from receiving treatment
  • History of cancer other than basocellular cutaneous cancer or other form of cancer in complete remission for more than 5 years
  • Evolving psychiatric disorder
  • Vulnerable persons as defined by article L1121-5 to -8

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02104362

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Centre Antoine Lacassagne
Nice, France, 06000
Sponsors and Collaborators
Centre Antoine Lacassagne

Additional Information:
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Responsible Party: Centre Antoine Lacassagne Identifier: NCT02104362     History of Changes
Other Study ID Numbers: 2013-A01514-41
2013/16 ( Other Identifier: Centre Antoine Lacassagne )
First Posted: April 4, 2014    Key Record Dates
Last Update Posted: July 23, 2019
Last Verified: July 2019
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Genital Diseases, Male
Prostatic Diseases