Stereotactic Radiotherapy for Oligometastatic Prostate Cancer (CROP)
Comprehensive Stereotactic Radiotherapy for Oligometastatic Prostate Cancer: A Phase I/II Study
調査の概要
詳細な説明
Patients will receive androgen deprivation therapy (ADT) for a minimum of 1 year. After this, an intermittent hormone therapy approach will be taken, where ADT will not be restarted until the prostate specific antigen (PSA) reaches a minimum of 10-15 ng/mL. Lupron 30 mg IM will be delivered every 4 months when on ADT.
The prostate (if not previously treated) will be treated to a dose of 35-40 Gy in 5 fractions. All visible nodal metastases will be treated to a dose of 30-35 Gy in 5 fractions. It is very likely that nodal metastases will shrink significantly (often completely) with ADT. In this scenario, the involved nodal regions will be treated to a more modest dose of 25 Gy in 5 fractions (roughly equivalent to a dose of 46 Gy in 23 fractions assuming an α/β value of 1.4). Non-spine bone metastases will be treated to a dose of 30-40 Gy in 5 fractions. Metastases in the brain, spine, lung, liver, and adrenal will be treated according to established stereotactic radiotherapy (SRT) policies at Sunnybrook Odette Cancer Centre. Comprehensive SRT should be delivered within 3 months of starting ADT.
During any "off" period of ADT (before the PSA rises above 10-15 ng/mL), comprehensive SRT can be repeated if there are new oligometastases that become visible. One month after initiation comprehensive SRT, patients will be contacted to assess for acute toxicities.
After completion of radiotherapy to all disease sites, patients will be followed every 3-4 months with PSA testing until the development of castrate resistant prostate cancer. At the same time points, late toxicity and quality of life will be collected for a minimum of 2 years. Computed tomography (CT) of the chest/abdo/pelvis +/- magnetic resonance imaging (MRI) of previously irradiated body sites and bone scan will be performed whenever the PSA reaches ≥ 10 ng/mL (prior to re-starting androgen deprivation therapy during intermittent hormone therapy approach), or at a minimum frequency of once per year.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
-
-
Ontario
-
Toronto、Ontario、カナダ、M4N 3M5
- Sunnybrook Odette Cancer Centre
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Able to provide informed consent.
- ECOG performance status 0-1.
- Histologic confirmation of prostate adenocarcinoma.
- Stage IV disease, with up to 5 metastatic tumours outside of the prostate and pelvic lymph nodes.
- ≤ 3 tumours within any given organ system (e.g. up to 3 brain metastases, or 3 liver metastases).
- All sites of disease are amenable to stereotactic radiotherapy.
Exclusion Criteria:
- Castrate resistant prostate cancer.
- Evidence of spinal cord compression.
- Previous radiotherapy for current cancer (with the exception of upfront management of the primary prostate tumour, brain metastasis(es) prior to androgen deprivation therapy).
- Inability to safely treat all sites of visible disease.
- Prior malignancy within the past 5 years, excluding non-melanoma skin cancer, and in-situ cancer.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：Stereotactic radiotherapy
Stereotactic radiotherapy will be delivered to the prostate (if not previously treated) and to all metastatic tumours.
|
Patients will receive ADT for a minimum of 1 year. After this, an intermittent hormone therapy approach will be taken. The prostate (if not previously treated) will be treated to a dose of 35-40 Gy in 5 fractions. All visible nodal metastases will be treated to a dose of 30-35 Gy in 5 fractions. Non-spine bone metastases will be treated to a dose of 30-40 Gy in 5 fractions. Metastases in the brain, spine, lung, liver, and adrenal will be treated according to established SRT policies at the Sunnybrook Odette Cancer Centre. Comprehensive SRT should be delivered within 3 months of starting ADT.
他の名前：
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Incidence of late radiotherapy toxicities after stereotactic radiotherapy to all sites of disease
時間枠：cumulative incidence at 2 years
|
common terminology criteria for adverse events (CTCAE) version 4.0
|
cumulative incidence at 2 years
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
Quality of Life (EORTC QLQ-C30)
時間枠：proportion of patients who experience a significant decline in quality of life at 6 months, 12 months, 18 months, and 24 months
|
proportion of patients who experience a significant decline in quality of life at 6 months, 12 months, 18 months, and 24 months
|
|
Time to development of castrate resistant prostate cancer
時間枠：through study completion, an average of 2 years
|
through study completion, an average of 2 years
|
|
Radiographic local control of irradiated tumours
時間枠：actuarial rate at 2 years
|
actuarial rate at 2 years
|
|
Radiographic "distant" control rate
時間枠：actuarial rate at 2 years
|
actuarial rate at 2 years
|
|
Overall survival
時間枠：through study completion, an average of 4 years
|
through study completion, an average of 4 years
|
協力者と研究者
捜査官
- 主任研究者：Patrick Cheung, M.D.、Toronto Sunnybrook Regional Cancer Centre
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。