Intraprostatic MAXimal Simultaneous Boost

July 9, 2018 updated by: James Morris, British Columbia Cancer Agency

A Dose-escalation Study Using a Maximal Simultaneous Intraprostatic Boost With RapidArc Intensity Modulated Radiotherapy in Intermediate Risk Prostate Cancer

This trial uses a type of radiotherapy called intensity modulated radiotherapy (IMRT), which is able to deliver the radiation to the prostate while delivering less dose to the surrounding normal organs compared with standard 3D conformal radiotherapy presently used at the BCCA. This trial will use RapidArc IMRT, which is a new way of delivering IMRT, where the radiation dose is delivered in a single rotation of the radiotherapy machine around the patient. This new method of delivering IMRT has been shown to be at least as good as conventional IMRT at delivering the dose, and takes less time to do so.

The aim of this study is to deliver a higher radiation dose to the prostate gland than the standard treatment while not increasing dose to the normal organs. In this way, it is hoped that the likelihood of the cancer coming back will be reduced without causing an increase in side-effects.

Study Overview

Status

Terminated

Conditions

Study Type

Interventional

Enrollment (Actual)

10

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • British Columbia
      • Vancouver, British Columbia, Canada, V5Z 4E6
        • British Columbia Cancer Agency - Vancouver Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  1. Patients must have histologically proven adenocarcinoma of the prostate.
  2. Registration must occur within 26 weeks of biopsy.
  3. History and physical examination (including digital rectal examination (DRE)) within 8 weeks prior to registration.
  4. Patients must have intermediate risk prostate cancer, as defined by:

    • PSA ≤ 20 ng/ml,
    • Gleason ≤ 7,
    • Stage ≤ T2c, and
    • Do not meet criteria for low-risk prostate cancer (Low-risk = All of: PSA ≤ 10 + Gleason ≤ 6 + stage ≤ T2b)
  5. Patients must have the following blood tests within two weeks of registration:

    • Prostate specific antigen (PSA), testosterone (TTT), complete blood count (CBC), electrolytes, creatinine.
    • Patients with values for one or more of these tests (not including PSA) that fall outside the normal range will need to be reviewed by the oncologist to determine their eligibility for this study.
  6. Patients must have an estimated life expectancy of at least 10 years.
  7. Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 2.
  8. Patients must have no contraindications to high dose pelvic irradiation.
  9. Patients must not have received prior radiation therapy to the pelvis.
  10. Patients must have no history of inflammatory bowel disease.
  11. Patients must not have received prior hormonal therapy or chemotherapy.
  12. Patients must not have any hormonal therapy planned as part of the therapeutic intervention.
  13. Patients must have no contraindication to MRI scanning.
  14. Patients should not have an artificial hip
  15. Patients should not have a body mass index (BMI) of > 32. Note: BMI = weight in kg ÷ (height in metres)2

Exclusion Criteria:

1. Subjects that do not meet inclusion criteria.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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
Other: IMAX

There is only one arm in this study.

Each patient will undergo a course of intensity modulated external beam radiation therapy (IMRT) using RapidArc for optimization and delivery.

Doses of radiotherapy are as follows:

  • The prescription dose will be 73.7 Gy in 28 fractions.
  • A simultaneous intraprostatic maximal simultaneous boost will be given to as much of the CTV as possible without contravening OAR dose constraints.

Each patient will undergo a course of intensity modulated external beam radiation therapy (IMRT) using RapidArc for optimization and delivery.

Doses of radiotherapy are as follows:

  • The prescription dose will be 73.7 Gy in 28 fractions
  • A simultaneous intraprostatic boost will be given to as much of the CTV as possible without contravening OAR dose constraints.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Incidence of grade 2-4 gastrointestinal and genitourinary toxicity
Time Frame: No time frame (post-treatment)
No time frame (post-treatment)

Secondary Outcome Measures

Outcome Measure
Time Frame
Quality of life (EPIC, IPSS and SHIM questionnaires)
Time Frame: Post-treatment; every 6 mos until 5 years - then annual
Post-treatment; every 6 mos until 5 years - then annual
Percentage of CTV treated to boost dose
Time Frame: Immediately post-treatment
Immediately post-treatment
Time-cost analysis compared to external-beam radiotherapy with brachytherapy boost
Time Frame: No time frame
No time frame
Accuracy of surrogate urethra compared to T2-MRI localization
Time Frame: No time frame
No time frame
Quantification of dose received by lesions identified by diffusion-weighted and dynamic contrast enhanced MRI
Time Frame: No time frame
No time frame

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: William J Morris, MD, British Columbia Cancer Agency

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2008

Primary Completion (Actual)

October 1, 2016

Study Completion (Actual)

October 1, 2016

Study Registration Dates

First Submitted

November 24, 2008

First Submitted That Met QC Criteria

November 25, 2008

First Posted (Estimate)

November 26, 2008

Study Record Updates

Last Update Posted (Actual)

July 11, 2018

Last Update Submitted That Met QC Criteria

July 9, 2018

Last Verified

July 1, 2018

More Information

Terms related to this study

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.

Subscribe