Hypofractionated Stereotactic Body Radiation Therapy (SBRT)
A Study of Hypofractionated Stereotactic Body Radiation Therapy (SBRT) Using Continuous Real-time Evaluation of Prostate Motion
The purpose of this study is to evaluate the safety and tolerability of using radiation therapy with 5 fractions of radiation to treat prostate cancer with guidance of radiation using the Calypso 4D Treatment System (Calypso).A number of recent studies have used 5 radiation fraction to treat prostate cancer over 2-3 weeks as compared to the typical treatment which would involve 40-42 smaller radiation fractions over 8-9 weeks. This type of radiation using a smaller number of treatments has been called hypofractionated radiation therapy.
The Calypso is a new technique which uses beacons implanted into the prostate which using radio signals are able to localize and track the position of the prostate continuously during radiation therapy. The Calypso system has been approved by the United States Food and Drug Administration (FDA) for guidance of radiation therapy during the treatment of prostate cancer and is being utilized all across the United States. However, it has not been tested for hypofractionated radiation therapy.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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California
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Sacramento, California, États-Unis, 95815
- The Radiological Associates of Sacremento
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Michigan
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Ann Arbor, Michigan, États-Unis
- University of Michigan Cancer Center
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- 18 years of age or older
- Histologically confirmed diagnosis of adenocarcinoma of the prostate within 180 days of enrollment
- Signed informed consent
- Gleason score ≤ 7
- If Gleason 7 (3+4=7 or 4+3=7) then <50% of biopsy cores must be positive for any pathologic grade of prostate cancer
- If Gleason score <7 then there is no limit on the percentage of biopsy cores involved by prostate cancer
- PSA (within 90 days prior to enrollment)
- ≤ 15 ng/ml prior to start of therapy if Gleason ≤ 6 and
- ≤ 10 ng/ml prior to start of therapy if Gleason 7
- No plan to use hormone therapy prior to evidence of biochemical failure(ie: No neoadjuvant or adjuvant ADT)
- Tumor stage: T1a, T1b, T1c, T2a, T2b
- ECOG Performance Status 0-1
Exclusion Criteria:
- A history of other malignancy diagnosed within the previous 60 months except for non-melanoma skin cancer.
- Any patients who have received other investigational therapy within the last 60 days
- Individuals that have previously been implanted with permanent Beacon transponders
- Patients that have any prosthetic implants in the pelvic region that contain metal or conductive materials (e.g., an artificial hip)
- Patients with implanted pacemaker or defibrillators
- Patients who are felt to have body habitus not conducive to tracking with Calypso beacons
- Positive lymph nodes or metastatic disease from prostate cancer
- Tumor stage: T2c, T3, or T4
- Previous pelvic radiation therapy
- Previous surgery or chemotherapy for prostate cancer
- Previous transuretheral resection of the prostate (TURP) or cryotherapy to the prostate
- Prior hormone therapy or plans for concurrent or post treatment adjuvant hormonal therapy or chemotherapy
- Hormone therapy to include LHRH agonist or oral anti-androgen
- Finasteride and Dutasteride use not excluded
- Concomitant antineoplastic therapy (including surgery, cryotherapy, conventionally fractionated radiation therapy, and chemotherapy) while on this protocol
- History of Crohn's Disease or Ulcerative Colitis
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Radiothérapie
|
Patients will receive 5 fractions of radiation (you will not receive radiation therapy on two consecutive days).
Each fraction size will be 7.4 Gy.
The total dose will be 37 Gy.
The 5 treatments will be scheduled to be delivered 2 fractions per business week (Monday through Friday).
The total duration of treatment will be no shorter than 15 days and no longer than 19 days.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Percentage of Patients With a Minimally Detected Decline (MDD) in Quality of Life (QOL)
Délai: 24 months
|
To evaluate the safety of the proposed hyperfractionation regimen of 5 fractions of radiation to treat prostate cancer with guidance of radiation using the Calypso 4D Treatment System (Calypso, and to compare it to that expected from conventional treatment, which would involve 40-42 smaller radiation fractions over 8-9 weeks. Percentage of patients with a MDD in Quality of Life (QOL) surveys for urinary incontinence (UI), urinary obstructive (UO), bowel (BS), and sexual (SS) domains were reviewed at 6 months and 24 months. |
24 months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Percentage of Patients With a PSA Nadir of <3.35 ng/ml at 12 Months
Délai: 1 Year
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To estimate one year prostate specific antigen (PSA)control of prostate cancer when treated with stereotactic body radiotherapy (SBRT) using continuous real-time evaluation of prostate motion.
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1 Year
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Relation Between Dose Distribution and Toxicities.
Délai: 5 years
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To look at the relation between dose distribution and toxicities and to determine if reconstructed delivered doses are more predictive of toxicity than planned doses.
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5 years
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Relation Between Reconstructed Delivered Dose Distributions.
Délai: 5 years
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To determine the relation between reconstructed delivered dose distributions, accounting for prostate translation and rotation, and tumor control probabilities.
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5 years
|
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Frequency of Required Interventions.
Délai: 5 years
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To assess the frequency of required interventions (interruptions) based on real-time prostate translations and rotations to verify that the proposed planning target volume(PTV) margins and action level are appropriate and practical.
This will be assessed by the percentage of patients with no interventions for any fraction, the percentage of patients with 1-2 fractions interrupted and the percentage of patients with more than two fractions interrupted and the percentage of patients that had an interruption of the beam at least once for all 5 fractions.
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5 years
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Collaborateurs et enquêteurs
Collaborateurs
Les enquêteurs
- Chercheur principal: Daniel Spratt, MD, University of Michigan Rogel Cancer Center
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 2010.064
- HUM00041474 (Autre identifiant: University of Michigan Medical School IRB)
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