Reduced PTV Margins for the Treatment of Prostate Cancer With IMRT Using Real-Time, State-of-the-Art Motion Tracking With the Calypso 4D Localization System: A Feasibility Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Prostate Cancer
- Sponsor
- U.S. Army Medical Research Acquisition Activity
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Radiation therapy with reduced treatment margins can be adopted as feasible for routine clinical use
- Last Updated
- 9 years ago
Overview
Brief Summary
This prospective study evaluates the clinical utility of a novel real-time localization system allowing for smaller volumes of normal tissue to be included in radiation field and determines dosimetric parameters and adverse effect profiles of radiation therapy using this technology. Subjects will have beacon transponders implanted into the prostate to more precisely localize the position of the organ during radiation therapy. Hypothesis: 1. Treatment with highly targeted radiation therapy can be delivered in a daily treatment time consistent with routine clinical practice. 2. Highly targeted radiation therapy with reduced PTV margin will result in a significant decrease in rectal and bladder volume treated.
Detailed Description
This study will seek to establish the clinical feasibility of a novel real-time localization and tracking system for use of reduced PTV margins during intensity modulated radiation therapy (IMRT), which will allow treatment of smaller volumes of normal tissue during radiation therapy. Such a reduction in the PTV margins and the exposure of healthy tissue during treatment may allow for several future improvements in prostate radiotherapy including: * decreased acute and chronic adverse effects with similar local tumor control * dose escalation to achieve higher cure rates with similar adverse effects to standard dose treatment * hypofractionation to shorten the time of, and lower the expense of, treatment without increased adverse effects.
Investigators
Dusten Macdonald, MD
MD, MC
Madigan Army Medical Center
Eligibility Criteria
Inclusion Criteria
- •Histologically confirmed adenocarcinoma of the prostate
- •Low Risk: T1a, T1b, T1c, T2a; Gleason Score less than 7, PSA less than or equal to 10
- •Intermediate Risk: T2b, T2c; Gleason Score less than or equal to 7, PSA less than or equal to 15
- •Ability to comply with study schedule
- •Age 40 or older
- •Zubrod PS 0 or 1
- •Signed informed consent
Exclusion Criteria
- •Node positive or metastatic prostate cancer
- •Prior treatment of prostate cancer with surgery, chemotherapy, cryotherapy or brachytherapy
- •History of prior pelvic radiotherapy
- •History of abdominoperineal resection
- •History of HIV infection
- •History of chronic prostatitis or chronic cystitis
- •History of bleeding disorder or any active anticoagulation (excluding ASA)
- •PT or INR outside normal range for institution
- •Active implanted devices such as cardiac pacemakers and automatic defibrillators.
- •Prosthetic implants in the pelvic region that contain metal or conductive materials (eg., an artificial hip).
Outcomes
Primary Outcomes
Radiation therapy with reduced treatment margins can be adopted as feasible for routine clinical use
Time Frame: Approximately 8.5 weeks (43 fractions per pt.)
During each radiation treatment fraction, therapists will record set up time, treatment time, total time and number of treatment interventions (repositioning/pausing) as well as the duration of the intervention caused by organ/target motion beyond planning target volume (PTV) margin using real time localization and tracking.
Secondary Outcomes
- Assess incidence of acute bladder and rectal toxicity(approximately 25 months (assessed prior to beacons are placed and then throughout treatment and follow-up))
- Analyze dosimetric characteristics of treatment planning(usually within the first 2 weeks after beacon placement (done at simulation CT))