Towards Optimal Treatment for High Risk Prostate Cancer; Stereotactic Pelvic Radiotherapy with Focal Boost to the Primary Tumour
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 207
- 试验地点
- 2
- 主要终点
- Late gastrointestinal and genito-urinary toxicity, and erectile dysfunction
研究概览
简要总结
The goal of this clinical trial is to combine several optimized treatments of high risk prostate cancer. The main question to answer is: is it safe to combine these optimized treatments.
- patients will be irradiated on the prostate and (elective) lymph nodes more concentrated but with fewer hospital visits (hypofractionation)
- the tumor will get a higher dose
- androgen deprivation therapy will be reduced as much al possible preventing side effects
Researchers will compare oncological outcome and toxicity.
详细描述
Rationale: Recently several randomized trial have shown benefits of changes made to radiotherapy of (high risk) localized prostate cancer patients: A focal boost was shown to improve outcome in men with intermediate/high risk prostate cancer (FLAME trial). Elective lymph node irradiation was shown to improve outcome in high risk prostate cancer patients (POP-RT). (Extreme) hypo fractionation was shown to be safe for low/intermediate risk prostate cancer patients. In addition: the added benefit of ADT (with substantial toxicity) seems reduced with improvements made to treatment and diagnosis in recent years (DART 01/05); own recent work on this topic; to be published)). None off the above were combined into one ideal treatment for high risk prostate cancer.
Objective
Determine the safety (oncological outcome and toxicity) of an comprehensive treatment combining recent advances in the treatment of high risk prostate cancer.
Study design: prospective cohort study with matched contemporary control group Study population: Men with high risk prostate cancer with an indication for elective lymph node irradiation Intervention: hypo fractionated pelvic radiotherapy with boost to primary tumour in the prostate Main study parameters/endpoints: biochemical recurrence free survival and late toxicity Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The additional burden of the study is considered to be low, as additional tests or site visits in comparison to current clinical follow up are not planned. Regarding safety, different parts of the investigational treatment were already shown to be safe in previous studies. The current study aims to combine these different parts into one treatment. We estimate that the risks associated with combining these treatments are very limited.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 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
- •Men (aged ≥18 years of age) diagnosed within 6 months before inclusion with high risk prostate cancer:
- •T3 based on digital rectal examination AND/OR
- •Grade >= 4 AND/OR
- •PSA >=20 ug/L
- •Indication for elective lymph node irradiation (based on current clinical guidelines) OR N1 on imaging (with a maximum of 4 suspect lymph nodes)
排除标准
- •Prior pelvic radiotherapy
- •TransUrethral Resection of the Prostate (TURP) < 3 months ago
- •Prostatectomy or other primary treatment for prostate cancer (e.g. HIFU, cryotherapy, etc)
- •contraindications to MRI
- •no visible lesion on MRI in prostate for boost
- •no PSMA-PET scan
- •inflammatory bowel disease
- •metastatic disease (M1)
- •unsuitable for SBRT or WPRT
- •medical history of cancer other than basal cell carcinoma of the skin
结局指标
主要结局
Late gastrointestinal and genito-urinary toxicity, and erectile dysfunction
时间窗: at 6 months and 2 years
according to CTC-AE v5
Biochemical recurrence free survival
时间窗: 5 years
rise of PSA 2 ng/ml above nadir
次要结局
- Metastasis free survival(5 years)
- Pattern of failure(5 years)
- Overall survival(5 years)
研究者
Leonard Bokhorst
MD, PhD, radiation oncologist
Haaglanden Medical Centre