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Tumor-directed Radiation Therapy for Patients With the Highest Risk Category of Localized Prostate Cancer

Not Applicable
Recruiting
Conditions
Prostate Cancer
Interventions
Radiation: Ultra-hypofractionated radiotherapy regimen.
Registration Number
NCT06220435
Lead Sponsor
Region Skane
Brief Summary

HYPO-RT-PC boost is is an open-label, multicentre, phase II trial evaluating safety and efficacy of real-time image-guided tumor-directed ultra-hypofractionated radiation boost and lymph node irradiation for patients with node-negative high risk localized prostate cancer.

Detailed Description

HYPO-RT-PC boost is is an open-label, multicentre, phase II trial evaluating safety and efficacy of real-time image-guided tumor-directed ultra-hypofractionated radiation boost and lymph node irradiation for patients with node-negative high risk localized prostate cancer. 76 participants will be enrolled in the study.

Specific aims of the study are:

* To study the feasibility of ultra-hypofractionation target lesion boost for node-negative very high-risk prostate cancer together with lymph node irradiation (primary outcome).

* To study the effectiveness of ultra-hypofractionated target lesion boost for high-risk prostate cancer.

* To study the feasibility of defining focal boost during concomitant androgen deprivation therapy with advanced functional imaging methods.

Recruitment & Eligibility

Status
RECRUITING
Sex
Male
Target Recruitment
76
Inclusion Criteria
  • Life expectancy >5 years
  • Age ≥18 years
  • World Health Organization (WHO) performance status 0-2
  • Histological evidence of prostate cancer
  • Classified as very high-risk according to national guidelines (2-3 of following high risk criteria: T3 / Gleason grade 8 /Prostate-specific antigen (PSA) 20-49 μg/L or and/or Gleason score 9-10 and/or PSA ≥40 μg/L
  • At least one Prostate Imaging-Reporting and Data System (PI-RADS) 4-5 lesion on diagnostic Magnetic resonance imaging (MRI)
  • Patients must be able to comply with the protocol
  • Signed informed consent
  • Adequate laboratory findings: haemoglobin (Hb) >90 g/L, absolute neutrophil count >1.0x10^9/l, platelets >75x10^9/l, bilirubin <2.0 x upper limit of normal (ULN), alanine aminotransferase (ALAT) <5x ULN and creatinine <2.0x ULN)
Exclusion Criteria
  • Regional or distant metastasis
  • Any contraindications for MRI
  • PSA >150 ng/ml
  • Previous pelvic radiotherapy
  • Prior prostate surgery including transurethral resection of the prostate (TURP)
  • Endocrine treatment (past or present)
  • Other malignancies than prostate cancer and basalioma in the past five years
  • Serious disease state that makes study inclusion and treatment unsuitable
  • Severe lower urinary tract symptoms (International Prostate Symptom Score (IPSS) ≥20)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
HYPO-RT-PC boostUltra-hypofractionated radiotherapy regimen.Ultra-hypofractionated seven-fraction radiotherapy regimen including focal boost and lymph node irradiation.
Primary Outcome Measures
NameTimeMethod
Grade 3+ Genitourinary Adverse Eventsstart of treatment - 5 years

Acute grade 3+ genitourinary Adverse Events according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

Secondary Outcome Measures
NameTimeMethod
Biochemical failure-free survivalenrollment date - 5 years
Cancer-specific survivalenrollment date - 5 years
Overall survival failure-free survival, cancer-specific survival, and overall survivalenrollment date - 5 years
Failure-free survivalconsent date - 5 years
Grade 2+ Genitourinary Adverse Eventsstart of treatment - 5 years

Acute grade 2+ genitourinary Adverse Events according to CTCAE v5.0.

Adverse Events according to CTCAE v5.0start of treatment - 5 years
Health-related quality of life assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (EORTC QLQ-C-30)inclusion date - 5 years

All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems

Local failure-free survivalenrollment date - 5 years
Distant metastasis-free survival failure-free survival, cancer-specific survival, and overall survivalenrollment date - 5 years
Time to systemic therapy failure-free survival, cancer-specific survival, and overall survivalenrollment date - 5 years
Health-related quality of life assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire PR-25 (EORTC QLQ-PR25)inclusion date - 5 years

It includes subscales assessing urinary symptoms, bowel symptom), treatment-related symptom) and sexual functioning with score from 0 to 4 per item. A high scale score represents a higher response level.

Trial Locations

Locations (2)

Region Skåne, Skåne University Hospital

🇸🇪

Lund, Sweden

Region Västerbotten, Umeå University Hospital

🇸🇪

Umeå, Sweden

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