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Stereotactic Body Radiation Therapy in Treating Patients With Low- and Intermediate-Risk Prostate Cancer

Not Applicable
Terminated
Conditions
Prostate Adenocarcinoma
Stage I Prostate Cancer
Interventions
Radiation: stereotactic body radiation therapy
Radiation: four fraction split-course SBRT
Registration Number
NCT01737151
Lead Sponsor
Virginia Commonwealth University
Brief Summary

This clinical trial studies stereotactic body radiation therapy in treating patients with low- and intermediate-risk prostate cancer. Stereotactic body radiation therapy may be able to send x-rays directly to the tumor and cause less damage to normal tissue.

Detailed Description

PRIMARY OBJECTIVES:

I. To evaluate, in terms of late toxicity, the safety of stereotactic radiation therapy using the proposed fractionation schedule.

SECONDARY OBJECTIVES:

I. To evaluate, in terms of acute toxicity, the safety of stereotactic radiation therapy using the proposed fractionation schedule.

II. To determine stereotactic treatment efficacy through biochemical failure (Phoenix criteria).

III. To determine the protocol completion rate. IV. To describe patient-reported outcomes using International Index of Erectile Function (IIEF) and EPIC Urinary and Bowel Assessment questionnaires.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients undergo standard daily fractions of stereotactic body radiation therapy (SBRT) over 7-8.5 weeks.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
19
Inclusion Criteria
  • Patients must have low or intermediate risk adenocarcinoma of the prostate as defined by:

    • Low-risk disease - Histopathology score (Gleason sum): =<6, T-stage (per current AJCC staging criteria): T1c-T2a, and PSA: <10

    • Intermediate-risk disease as either:

      • Histopathology score (Gleason sum) =< 6, T-stage (per current American Joint Committee on Cancer [AJCC] staging criteria): T1c-T2a, and prostate-specific antigen (PSA) > 10 but =< 20; or
      • Histopathology score (Gleason sum) 7 with =< 50% of any cores positive, T-stage (per current AJCC staging criteria): T1c-T2a, and PSA < 10
  • Charlson index of comorbidity score =< 4

  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria
  • Patients with history of inflammatory bowel disease, or who require steroid or cytotoxic therapy for collagen vascular disease
  • Patients with a history of cancer other than skin cancer within 5 years of the initiation of protocol treatment
  • Patients with a history of pelvic irradiation for any reason
  • Life expectancy < 10 years - Prior treatment with an anti-androgen, luteinizing hormone-releasing hormone (LHRH) agonist, or a combination of the two
  • Prior radiation therapy, brachytherapy, or cryotherapy
  • Prior surgical procedure involving peri-rectal and peri-prostatic area

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm I (standard stereotactic body radiation therapy (SBRT)stereotactic body radiation therapyPatients undergo standard daily fractions of SBRT over 7-8.5 weeks
Arm II (four fraction split-course SBRT)four fraction split-course SBRTPatients undergo 2 fractions of SBRT in weeks 1 and 4
Primary Outcome Measures
NameTimeMethod
Late toxicity greater than or equal to grade 2 as defined by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 criteria2 years

Will be tested using a continuity corrected chi-square test

Secondary Outcome Measures
NameTimeMethod
Biochemical failure as defined by the Phoenix definitionUp to 5 years
Protocol completion rateUp to 5 years

The portion of patients completing the planned protocol with no unacceptable protocol violations is anticipated to be greater than 90%. A completion rate of 70% is deemed unacceptably low.

Patient-reported outcomesUp to 5 years

International Index of Erectile Function (IIEF) and Expanded Prostate Cancer Index Composite urinary Assessment (EPIC) urinary and bowel assessments will be used to collect patient-reported outcomes.

* IIEF is a widely used instrument for the evaluation of male sexual function. It is has been recommended as tool for clinical trials of erectile dysfunction and for diagnostic evaluation of erectile dysfunction severity. 15 questions 1=very low (worst) to 5=very high (best).

* The EPIC urinary and bowel assessments are comprehensive instruments designed to evaluate urinary and bowel symptoms, thereby providing a unique tool for assessment of quality of life issues important in prostate cancer management. 9 questions 0=no problem to 5=big problem

Acute toxicity greater than or equal to grade 2 as defined by the CTCAE version 4 criteriaUp to 90 days

Trial Locations

Locations (3)

University of Virginia Medical Center

🇺🇸

Charlottesville, Virginia, United States

Hunter Holmes McGuire VA Medical Center

🇺🇸

Richmond, Virginia, United States

Virginia Commonwealth University/Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

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