Daily Adaptive Post-Prostatectomy Radiation With Stereotactic Ablative Radiotherapy (DAPPER)

Mayo Clinic2 个研究点分布在 1 个国家目标入组 50 人开始时间: 2023年7月28日最近更新: 2026年5月20日

适应症

干预措施

试验速览

阶段: 不适用
状态: 进行中（未招募）
发起方: Mayo Clinic
入组人数: 50
试验地点: 2
主要终点: Observe Grade 3 genitourinary and gastrointestinal toxicity rate to demonstrate safety of daily adaptive online replanning

研究概览研究设计入排标准研究组 & 干预措施结局指标研究者研究点记录与标识符相似试验

研究概览

简要总结

This clinical trial evaluates the feasibility, safety, and tolerability of stereotactic ablative radiotherapy (SABR) using daily adaptive radiation techniques to the prostate fossa and/or pelvic lymph nodes in patients with prostate cancer who have undergone surgical removal of the prostate (radical prostatectomy). For patients with prostate cancer who develop a rising prostate specific antigen (PSA) after radical prostatectomy, salvage radiation therapy is the standard of care treatment. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. All patients receiving salvage radiation following radical prostatectomy typically have treatment directed to the prostate fossa, which is the anatomical region around the operative bed that is at highest risk for containing left over tumor. Many patients receiving salvage radiation therapy can also benefit from treatment of the pelvic lymph nodes. Adaptive radiotherapy is an emerging treatment technique that uses daily imaging to adjust treatment volumes, ensure accurate dose delivery, and allow the use of smaller planning target volume margins. Adaptive radiation is ideally suited for the further implementation of SABR treatment regimens directed to the prostate fossa with or without inclusion of the pelvic lymph nodes. While daily adaptive radiation therapy has been reported in other disease settings, there is currently no data about its use for post-prostatectomy radiation. Using daily adaptive radiation techniques may help researchers learn how to minimize exposure to normal tissue and shorten the number of required treatments to better target the radiation dose in prostate cancer patients post-prostatectomy.

详细描述

PRIMARY OBJECTIVE:

I. To demonstrate the safety of daily, adaptive online replanning in patients treated with stereotactic body radiation therapy (SBRT) to the prostate +/- pelvic lymph nodes as defined by observation of a grade 3 genitourinary and gastrointestinal toxicity rate of less than or equal to 5%.

SECONDARY OBJECTIVES:

I. To determine the feasibility of daily, adaptive online replanning for patients receiving SBRT to the prostate fossa +/- pelvic lymph nodes.

II. To assess the efficacy of daily, adaptive SBRT to the prostate fossa. III. To measure the change in patient reported urinary, bowel, and sexual outcomes following protocol treatment.

研究设计

研究类型: Interventional
分配方式: Non Randomized
干预模型: Parallel
主要目的: Treatment
盲法: None

入排标准

年龄范围: 18 Years 至 —（Adult, Older Adult）
性别: Male
接受健康志愿者: 否

入选标准

•Males age >= 18 years who are receiving post-operative radiation therapy to the prostate fossa, with or without inclusion of the pelvic lymph nodes, for biochemical recurrences after radical prostatectomy.
•Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) =<
•Ability to complete questionnaire(s) by themselves or with assistance.
•Provide written informed consent.
•Willingness and ability to complete protocol-specified follow-up (during the active monitoring phase of the study).

排除标准

•Current evidence of untreated metastatic prostate cancer involving nonregional lymph nodes outside of the bony pelvis, bone, or visceral organs.
•Receipt of cytotoxic chemotherapy within 3 months prior to enrollment.
•Prior radiation therapy to pelvis such that the proposed study treatment volume received 10 Gy or greater.
•Co-morbid severe concurrent disease that would result in a life expectancy of < 5 years.
•Diabetes mellitus-associated vascular ulcers or wounding healing problems, inflammatory bowel disease, or a diagnosed connective tissue disorder.
•Medical or psychiatric conditions that preclude informed decision-making or adherence to study protocols.
•Men of childbearing potential who are unwilling to employ adequate contraception.
•History of a bladder neck contracture, urethral stricture that required dilation, or any surgical repair/reconstruction involving the bladder or urethra other than radical prostatectomy.

研究组 & 干预措施

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Computed Tomography (Procedure)

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Image-Guided Adaptive Radiation Therapy (Radiation)

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Magnetic Resonance Imaging (Procedure)

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Positron Emission Tomography (Procedure)

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Questionnaire Administration (Other)

Group I (daily adaptive online replanning, SBRT)

Experimental

Patients undergo daily adaptive online replanning for SBRT to the prostate fossa on study. Patients also undergo MRI and may undergo PET/CT during screening.

干预措施: Stereotactic Body Radiation Therapy (Radiation)