- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02790216
Deformable Registration of Multi-parametric MRI to Intra-operative Transrectal Ultrasound for Prostate Brachytherapy
Phase II Study of Focused Dose Painted I-125 Brachytherapy for Low to Intermediate Risk Prostate Cancer Using Deformable Registration of Multi-parametric MRI (Magnetic Resonance Imaging) to Intra-operative TRUS (Trans Rectal Ultrasound)
Objective:
To focus the high dose radiation to the gross tumor in the prostate while maintaining adequate dose for control of microscopic disease elsewhere in the prostate.
In order to test the incorporation of the robust MRI and TRUS fusion algorithm in the clinical setting the investigators planned a study of Focused therapy with a primary endpoint of accurate localization of the high risk region. This is a pilot study of dose painted permanent I-125 seed implant to verify absence of tumor cells outside a high risk region using multi-parametric MRI and deformable TRUS registration. The high risk region will be dose painted to 160 Gy and the rest of the prostate will receive the normal prescription dose.
Study Overview
Detailed Description
Primary end-point:
Feasibility of dose painting will be determined by the absence of tumor outside the high-risk region on an intra-operative trans-perineal biopsy.
Frozen sections will not be obtained, however on receipt of the final pathology 2-4 weeks after the procedure 2 possible scenarios arise:
- There is no evidence of cancer: this confirms the accuracy of the TRUS MRI registration.
- There is evidence of tumor on the stereotactic biopsy: In this case a regular dosimetric check (this is performed in the Standard of care procedure and is known as post-operative dosimetry) will be performed to determine whether adequate dose was delivered. If not, as the involved needle position was recorded in the treatment plan and labeled with co-ordinates, the regular possibility of accurately adding radioactive seeds is possible.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
-
-
Tel Hashomer, Israel, 5262160
- Sheba_Medical_Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
Men suitable for monotherapy with permanent Iodine 125 implant
- Age > 50 yrs
- PS 0-2 (WHO)
- Histologic diagnosis of prostate adenocarcinoma made on transrectal guided prostate biopsy with no fewer than 12 cores taken
- No more than 50% of cores involved (summary)
- MRI of Prostate with Diffusion Weighted Imaging and Dynamic Contrast Enhancement with demonstrable lesion compatible with biopsy result
- Gleason sum no greater than 3+4 =7 in any core
- Clinical T stage no higher than T T (tumor) 2A
- Prostate volume ≤60 cc
- Serum prostate-specific antigen (PSA) no higher than 15 ng/mL
- No prior history of malignancy except non-melanoma skin cancer
- Must be suitable for general or spinal anesthesia
Exclusion Criteria:
Have anesthesia surgical assignment category IV or greater
- Cannot cease anti-coagulant therapy
- Had a malignancy, other than prostate or skin cancer (except malignant melanoma), within 5 years
- urethral stricture
- Prior prostate cancer therapies
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Brachytherapy
men eligible for monotherapy seed implant brachytherapy
|
Biopsies will be obtained after intraoperative plan to rule out significant cancer outside a high risk planning target volume
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of patients with a positive biopsy outside the defined High risk Planning Target Volume
Time Frame: Pathological report due one month after brachytherapy implant
|
Negative biopsy outside the high risk planning target volume will confirm the accuracy of the MRI TRUS elastic fusion algorithm to locate the tumor
|
Pathological report due one month after brachytherapy implant
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Biochemical failure as determined by Prostate specific antigen greater than nadir+2 ng/ml
Time Frame: 3 years
|
3 years
|
|
Urinary , Sexual ,Bowel and Vitality function domains
Time Frame: 6 months and then at years one , two and three
|
Expanded Prostate Inventory Composite (EPIC)
|
6 months and then at years one , two and three
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Zvi Symon, MD, Chaim Sheba Medical Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
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
- SHEBA-15-2845-ZS-CTIL
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on Prostate Cancer
-
Roswell Park Cancer InstituteRecruitingObesity | Overweight | Cancer Survivor | Prostate Adenocarcinoma | Stage I Prostate Cancer | Stage II Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate Cancer | Stage IVA Prostate Cancer | Stage IVB Prostate Cancer | Stage A Prostate Cancer | Stage... and other conditionsUnited States
-
Sidney Kimmel Cancer Center at Thomas Jefferson...Regeneron Pharmaceuticals; Prostate Cancer FoundationWithdrawnStage III Prostate Cancer | Stage IV Prostate Cancer | Stage IVA Prostate Cancer | Stage IVB Prostate Cancer | Stage IIIA Prostate Cancer | Stage IIIB Prostate Cancer | Stage IIIC Prostate Cancer
-
Jonsson Comprehensive Cancer CenterProgenics Pharmaceuticals, Inc.TerminatedRandomized Trial of PSMA PET Scan Before Definitive Radiation Therapy for Prostate Cancer (PSMA-dRT)Stage II Prostate Cancer AJCC v8 | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IIA Prostate Cancer AJCC v8 | Stage IIB Prostate Cancer AJCC v8 | Stage I Prostate...United States
-
University of Southern CaliforniaNational Cancer Institute (NCI); SanofiTerminatedDiarrhea | Recurrent Prostate Cancer | Hormone-resistant Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI)CompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Ryan Kohlbrenner, MDRadiological Society of North AmericaCompletedProstate Adenocarcinoma | Stage IV Prostate Cancer AJCC v8 | Prostate Carcinoma | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IVA Prostate Cancer AJCC v8 | Stage...United States
-
Ohio State University Comprehensive Cancer CenterRiverside Methodist HospitalCompletedStage I Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Mayo ClinicNational Cancer Institute (NCI)WithdrawnStage I Prostate Cancer AJCC v8 | Stage II Prostate Cancer AJCC v8 | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IIA Prostate Cancer AJCC v8 | Stage IIB Prostate...United States
-
University of California, IrvineCompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Barbara Ann Karmanos Cancer InstituteGenentech, Inc.CompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
Clinical Trials on Brachytherapy
-
Weill Medical College of Cornell UniversityIsoRay Medical, Inc.WithdrawnLung CancerUnited States
-
Canadian Cancer Trials GroupCanadian Cancer Clinical Trials NetworkRecruitingEndometrial CancerCanada, Australia, Netherlands
-
University of California, San DiegoCompletedCervical Cancer | Uterine CancerUnited States
-
University of UtahRecruitingStage I Uterine Corpus Cancer | Stage II Uterine Corpus Cancer | Endometrial Clear Cell Adenocarcinoma | Endometrial Endometrioid Adenocarcinoma | Endometrial Serous Adenocarcinoma | Uterine Corpus Sarcoma | Uterine Corpus Carcinosarcoma | Stage IA Uterine Corpus Cancer | Stage IB Uterine Corpus CancerUnited States
-
Sidney Kimmel Comprehensive Cancer Center at Johns...CompletedProstate Cancer | Adenocarcinoma of the ProstateUnited States
-
Institut Paoli-CalmettesCompleted
-
University Hospital ErlangenUnknown
-
Massachusetts General HospitalDana-Farber Cancer Institute; Beth Israel Deaconess Medical Center; United States... and other collaboratorsUnknownProstate CancerUnited States
-
Brigham and Women's HospitalCompletedUterine Neoplasms | Vulvar Neoplasms | Vaginal Neoplasms | Cervix Neoplasms
-
Instituto de Investigacion Sanitaria La FeCompletedCarcinoma, Basal Cell