- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00643617
CyberKnife Radiosurgery For Low & Intermediate Risk Prostate Cancer: Emulating HDR Brachytherapy Dosimetry
Prospective Evaluation of CyberKnife Stereotactic Radiosurgery for Low and Intermediate Risk Prostate Cancer: Emulating HDR Brachytherapy Dosimetry
Study Overview
Status
Conditions
Detailed Description
In this study, CyberKnife radiosurgery will be used to produce dose distributions comparable to those created by High Dose Rate (HDR) brachytherapy treatment, without the use of invasive catheters. The radiosurgery volumes will closely be made to resemble HDR brachytherapy therapeutic volumes with similar dose limitation objectives to adjacent normal tissues.
The CyberKnife Robotic Radiosurgery System is a unique radiosurgical system capable of treating tumors anywhere in the body noninvasively and with sub-millimeter accuracy. The CyberKnife System delivers radiation using a precise targeting methodology allowing a focal treatment margin around the target, thus limiting the volume of adjacent tissue receiving high doses radiation. This in turn allows the delivery of high doses of radiation to the prostate over a short series of treatments.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alabama
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Mobile, Alabama, United States, 36604
- Mitchell Cancer Center University of South Alabama
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California
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Fresno, California, United States, 93721
- Community Regional Medical Center
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Long Beach, California, United States, 90806
- Long Beach Memorial Medical Center
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Pasadena, California, United States, 91105
- Pasadena Cyberknife Center
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San Diego, California, United States, 92101
- CyberKnife Centers of San Diego
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Colorado
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Colorado Springs, Colorado, United States, 80907
- Penrose Cancer Center
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Lafayette, Colorado, United States, 80026
- Colorado Cyberknife
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Florida
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Brandon, Florida, United States, 33511
- New Millenium CyberKnife
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Lake Worth, Florida, United States, 33461
- JFK Comprehensive Cancer Center
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Wellington, Florida, United States, 33449
- South Florida Radiation Oncology
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Illinois
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Elmhurst, Illinois, United States, 60126
- Elmhurst Memorial Hospital
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Montana
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Great Falls, Montana, United States, 59405
- Benefis Health System - Sletten Cancer Institute
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Nevada
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Las Vegas, Nevada, United States, 89128
- Comprehensive Cancer Centers of Nevada
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New Jersey
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Egg Harbor Township, New Jersey, United States, 08234
- Atlanticare Regional Medical Center
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North Carolina
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Chapel Hill, North Carolina, United States, 27599
- University of North Carolina
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73102
- St. Anthony Hospital
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Tennessee
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Nashville, Tennessee, United States, 37203
- Sarah Cannon Research Institute
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Texas
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Tyler, Texas, United States, 75701
- East Texas Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient must be at least 18 years of age
- Histologically proven prostate adenocarcinoma
- Biopsy within 1 year of date of registration
- Clinical Stage (CS) T1b-T2b, N0, M0
- Patients belonging to one of the following risk categories:
- Low Risk: CS T1b-T2a, Gleason Score 2-6, Prostate Specific Antigen (PSA) < or = 10 ng/ml
- Intermediate Risk: CS T2b, Gleason Score 2-6, PSA < or = 10 ng/ml or CS T1b-T2b, Gleason Score 2-6, PSA < or = 20 ng/ml or CS T1b-T2b, Gleason Score 7 and PSA < or = 10 ng/ml
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
Exclusion Criteria:
- Clinical Stage T2c or greater
- Prior prostatectomy or cryotherapy of the prostate
- Prior radiotherapy of the prostate or lower pelvis
- Implanted hardware or other material that would prohibit appropriate treatment planning or delivery
- History of an invasive malignancy other than basal or squamous skin cancers in the last 5 years
- Hormone ablation for two months prior to enrollment or during treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Other: Heterogeneous Dose
38 Gy delivered in 4 fractions of 9.5 Gy per fraction
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38 Gy delivered in 4 fractions of 9.5 Gy per fraction with a radial margin of 2 mm around the prostate
Other Names:
38 Gy delivered in 4 fractions of 9.5 Gy per fraction with a radial margin of 5mm posterolaterally
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Risk for Gastrointestinal (GI) and Genitourinary (GU) Toxicity
Time Frame: Primary Safety Endpoint was measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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To estimate the rates of acute and late Grade 3-5 gastrointestinal and genitourinary toxicities (adverse events [AE]) observed in both low-risk and intermediate-risk cohorts during the 5 years following CyberKnife (CK) treatment for prostate cancer. Kaplan Meier estimates for 5-yr and 10-yr are reported. Adverse events occurring within 3 months of treatment were categorized as acute toxicities, and those developing after 3 months were considered late toxicities. The rates were determined using the first Grade 3 or higher adverse event per patient, reported as possibly, probably, or definitely related to CK treatment. The Common Toxicity Criteria for Adverse Events (CTCAE) Version 3.0 was used to determine the Grade or severity of adverse events in this study, with Grade 3 being severe or medically significant but not immediately life-threatening, Grade 4 being life-threatening and Grade 5 being death related to the adverse event. |
Primary Safety Endpoint was measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Biochemical Disease-Free Survival (bDFS)
Time Frame: Primary Efficacy Endpoint was measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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To determine the rate of biochemical Disease-Free Survival (bDFS), using the Phoenix definition, following CyberKnife treatment. Kaplan Meier survival curves for bDFS were created and the 5-yr and 10-yr percentages are reported. The Phoenix definition uses a Prostate Specific Antigen (PSA) value exceeding the patients lowest PSA value (nadir) + 2 ng/mL as an indicator of disease recurrence. The percentage of patients who did not have such a PSA rise or receive any interventional therapy to treat prostate cancer are reported below. |
Primary Efficacy Endpoint was measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Disease Control and Survival Outcomes
Time Frame: Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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To determine the rates of local failure, distant failure, disease-free survival, disease-specific survival, and overall survival following CyberKnife treatment in prostate cancer patients.
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Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Quality of Life Assessments: American Urological Association (AUA) Symptom Index (SI)
Time Frame: AUA questionnaire was completed at Baseline, CK Treatment, and post treatment at: 1 week, 1 month, 3 months, 6 months, and then biannually up to 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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AUA-SI is a 7-item self-report measure used to assess urinary urgency, frequency, and voiding symptoms with scores ranging from 0 (no symptom) to 5 (symptom occurs almost always) Total score: 0-7 mild symptoms; 8-19 moderate symptoms; 20-35 severe symptoms
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AUA questionnaire was completed at Baseline, CK Treatment, and post treatment at: 1 week, 1 month, 3 months, 6 months, and then biannually up to 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Quality of Life Assessments: Expanded Prostate Cancer Index Composite (EPIC) -26 Urinary Incontinence
Time Frame: Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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EPIC-26 is a short form version of the Expanded Prostate Cancer Index Composite, and is a validated comprehensive instrument developed to measure the health-related quality of life among men with prostate cancer. EPIC-26 consists of 26 items under 5 domains of urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal. Answers qualitatively measure patient's bother for each symptom and are then normalized on a scale of 0 (worst) to 100 (best) to calculate domain scores if sufficient input is provided. |
Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Quality of Life Assessments: EPIC-26 Urinary Irritative Obstructive
Time Frame: Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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EPIC-26 is a short form version of the Expanded Prostate Cancer Index Composite, and is a validated comprehensive instrument developed to measure the health-related quality of life among men with prostate cancer. EPIC-26 consists of 26 items under 5 domains of urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal. Answers qualitatively measure patient's bother for each symptom and are then normalized on a scale of 0 (worst) to 100 (best) to calculate domain scores if sufficient input is provided. |
Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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Quality of Life Assessments: EPIC-26 Bowel
Time Frame: Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
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EPIC-26 is a short form version of the Expanded Prostate Cancer Index Composite, and is a validated comprehensive instrument developed to measure the health-related quality of life among men with prostate cancer. EPIC-26 consists of 26 items under 5 domains of urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal. Answers qualitatively measure patient's bother for each symptom and are then normalized on a scale of 0 (worst) to 100 (best) to calculate domain scores if sufficient input is provided. |
Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
|
Quality of Life Assessments: EPIC-26 Sexual
Time Frame: Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
|
EPIC-26 is a short form version of the Expanded Prostate Cancer Index Composite, and is a validated comprehensive instrument developed to measure the health-related quality of life among men with prostate cancer. EPIC-26 consists of 26 items under 5 domains of urinary incontinence, urinary irritative/obstructive, bowel, sexual, and hormonal. Answers qualitatively measure patient's bother for each symptom and are then normalized on a scale of 0 (worst) to 100 (best) to calculate domain scores if sufficient input is provided. |
Secondary outcomes were measured at 5 years. Sites and patients had the option of continuing follow-up through 10 years.
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Donald B Fuller, MD, CyberKnife Centers at San Diego, CA
- Study Chair: George Mardirossian, PhD, CyberKnife Centers of San Diego, CA
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- ACCP002.2
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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