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MR-guided Single-fraction SBRT for Nodal Oligorecurrent Prostate Cancer (PINPOINT) (PINPOINT)

3. juni 2026 opdateret af: Odense University Hospital

Improved MR-Guided Single-fraction Stereotactic Sblative Radiotherapy in Pelvic and Abdominal Nodal Oliorecurrent Prostate Cancer

This single-arm phase 2 trial investigates whether a single high-dose radiotherapy treatment can safely treat men whose prostate cancer has come back in a small number of lymph nodes in the pelvis or abdomen after curative treatment. Participants receive one fraction of 24 Gy delivered with MR-guided stereotactic body radiotherapy (SBRT), which uses MRI to visualise the tumour and surrounding organs during treatment. The main goal is to assess safety (severe side effects). The trial also evaluates local tumour control, longer-term side effects, time until hormone (androgen deprivation) therapy is needed, survival, and quality of life. The trial aims to enrol 48 patients.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PINPOINT is a prospective, investigator-initiated, single-centre, single-arm phase 2 trial of single-fraction MR-guided SBRT in patients with nodal oligorecurrent prostate cancer. Eligible men have PSMA-PET/CT-verified nodal relapse in the pelvis or abdomen following curatively intended local treatment.

All patients are simulated with MRI in treatment position and treated with 24 Gy in 1 fraction to the gross tumour volume (GTV) using inverse-planned step-and-shoot IMRT on an MR-linac. No CTV margin is added (CTV = GTV); PTV margins account for motion and set-up uncertainty. Normal-tissue constraints are prioritised over target coverage.

The primary endpoint is cumulative CTCAE v5 grade ≥4 treatment-related toxicity within 6 months. Sample size follows a Simon two-stage design (H0: grade 4-5 TRAE rate 15%; H1: 4%; one-sided α = 5%, power 80%), with an interim analysis after 6-month follow-up of the first 16 patients and a total of 48 patients. Follow-up continues for 5 years. Toxicity (CTCAE v5), quality of life (EQ-5D-5L, EORTC QLQ-C30) and patient-reported outcomes (PRO-CTCAE) are collected at baseline and through follow-up; PSA and PSMA-PET/CT (on rising PSA) follow standard of care.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

48

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

Age ≥ 18 years Signed informed consent Histologically proven initial diagnosis of adenocarcinoma of the prostate ECOG performance status 0-2 Biochemical recurrence after curatively intended local treatment (radical prostatectomy and/or radiotherapy), with PSMA-PET/CT-verified nodal relapse in the pelvis or abdomen Any additional sites of disease beyond the protocol-specified target lymph nodes must be considered suitable for ablative treatment Life expectancy > 6 months Lymph node size ≤ 2 cm

Exclusion Criteria:

Medical contraindications to MRI Inability to tolerate the physical set-up required for SABR Overlap between prior radiation fields and the current target area leading to high risk of clinically significant normal-tissue injury Contraindications to pelvic radiotherapy (chronic pelvic inflammatory bowel disease) Uncontrolled intercurrent illness

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Single-fraction MR-guided SBRT
All participants receive 24 Gy in a single fraction to the GTV, delivered with MR-guided SBRT.
Stråling: Single-fraction SBRT
Participants will receive 24 Gy in 1 fraction to a lymph node.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Acute toxicity
Tidsramme: Within 6 months after completion of radiotherapy
The NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0 measures side-effects. Possible scores range from 0-5, with higher scores indicating a worse outcome.
Within 6 months after completion of radiotherapy

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Any late toxicity (CTCAE v5.0)
Tidsramme: 1, 1,5, 2, 3 and 5 years

The NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0 measures side-effect.

Possible scores range from 0-5, with higher scores indicating a worse outcome.
1, 1,5, 2, 3 and 5 years
Freedom from local progression (PSMA-verified relapse within/adjacent to PTV), assessed lesion by lesion
Tidsramme: From radiotherapy until local progression or last follow-up, up to 5 years
Defined as freedom from PSMA-verified relapse within the treated area. In the case of significant increase in PSA, a PSMA will be performed as to local guidelines. Local control will be evaluated at a lesion level, lesion by lesion. Within the treated area is defined as within or adjacent to the planning target volume (PTV).
From radiotherapy until local progression or last follow-up, up to 5 years
Clinical progression-free-survival (time to radiographic/clinical/biochemical progression or death)
Tidsramme: From radiotherapy up to 5 years
Defined as time from inclusion to any new node or distant metastases recurrence.
From radiotherapy up to 5 years
ADT-free-survival (time from inclusion to start of palliative ADT)
Tidsramme: From inclusion up to 5 years
ADT-free survival is defined as the time from trial randomization to start of hormonal treatment
From inclusion up to 5 years
Any acute toxicity (CTCAE v5.0 grade 1-3)
Tidsramme: Within 6 months after radiotherapy
The NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0 measures side-effects. Possible scores range from 0-5, with higher scores indicating a worse outcome.
Within 6 months after radiotherapy
Overall survival
Tidsramme: From inclusion up to 5 years
Overall survival is defined as time form inclusion to death from any cause
From inclusion up to 5 years
Quality of life - EQ-5D-5L
Tidsramme: Baseline, 2 weeks, 3,6 and 12 months
Baseline, 2 weeks, 3,6 and 12 months
Quality of life - EORTC QLQ-C30
Tidsramme: Baseline, 2 weeks, 3,6 and 12 months
Baseline, 2 weeks, 3,6 and 12 months
patient-reported symptomatic toxicity - PRO-CTCAE
Tidsramme: Baseline, 2 weeks, 3,6 and 12 months
Baseline, 2 weeks, 3,6 and 12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Odense University Hospital

Samarbejdspartnere

Danish Cancer Society

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. april 2030

Studieafslutning (Anslået)

1. september 2035

Datoer for studieregistrering

Først indsendt

3. juni 2026

Først indsendt, der opfyldte QC-kriterier

3. juni 2026

Først opslået (Faktiske)

9. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • OP-2499
  • S-20250058 (Anden identifikator: Ethics committee)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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