Using Ultrasound Spectrum Analysis (USA) to Guide Dose Escalated Prostate Brachytherapy (USA)
11 maart 2016 bijgewerkt door: Beth Israel Medical Center
Phase I/II Evaluation of Cancer-Specific Imaging Using Ultrasound Spectrum Analysis (USA) to Guide Dose Escalated Prostate Brachytherapy
In standard treatment, the seeds are placed throughout the prostate to treat the entire prostate.
This is done because it was impossible to know where the cancer was located within the prostate.
A new technique has been developed using the same ultrasound imaging that you probably had when you had your biopsy.
Using this technique, areas likely to contain prostate cancer can be identified.In this early study of 15 subjects, we will test if this method to plan your prostate seed implant is safe and can be done as part of regular care.
Areas identified as suspicious for cancer will be treated with higher doses of radiation while those areas not demonstrating cancer will be treated to the standard minimum dose.
The higher dose areas will receive two times the minimum dose the prostate usually receives.
Because this technique is not perfect, those areas not identified as cancerous should be treated in case there is a cancer area that the technique did not identify.
Subjects enrolled in this study will then be followed with this ultrasound technique over the next two years to monitor the changes to the cancerous areas and will undergo a biopsy two years after the procedure.
Subjects will, of course, be monitored to assess the success of the technique and its side effects.
Studie Overzicht
Toestand
Voltooid
Conditie
Gedetailleerde beschrijving
Prostate brachytherapy is an increasingly popular treatment for clinically localized prostate cancer.In properly selected patients, it is highly effective with biochemical (PSA) disease free survival rates of 80-87% at 5-10 years.However, the technique is currently limited by the inability to localize the cancer within the prostate.
The multifocal nature of prostate cancer is well established.
Because of the inability to know where within the prostate the cancer is located, radiation must be delivered throughout the gland.
Although this blind approach leads to good results, it is clear that there are regions of the prostate and surrounding tissue that are overexposed to radiation while others are underexposed relative to their true need based on their tumor burden and their proximity to the tumor areas.Feleppa et al. at Riverside Research Institute (New York, NY), a non-profit ultrasound research center, have developed an ultrasound-based technique to identify cancer-containing areas within the prostate.
This technique uses current ultrasound equipment already in use for prostate brachytherapy guidance.
By extracting and processing the radiofrequency signal obtained from the ultrasound transducer in ways not done to create the standard B-mode ultrasound image, areas of cancer can be identified and displayed overlying the standard B-mode ultrasound image.In this study, we propose to obtain these ultrasound-based cancer-specific images of the prostate prior to the brachytherapy and use them to direct the dosimetry planning.The primary goal of this study is to demonstrate that this imaging modality can be incorporated into the treatment planning process for brachytherapy.
Furthermore, we wish to demonstrate the improved dosimetry of the cancer-identified regions while maintaining the urethral dose guidelines noted above.
We also wish to compare the differences in dose to the other adjacent normal structures (anterior rectum and right and left neurovascular bundles).
Additionally, we seek to demonstrate, at a minimum, no increased toxicity with this approach and similar disease control rates.
Of course, ultimately the goal will be to demonstrate a superior therapeutic ratio with this technique.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
14
Fase
- Fase 2
- Fase 1
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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New York
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New York, New York, Verenigde Staten, 10019
- St.Luke's-Roosevelt Hospital Center
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Mannelijk
Beschrijving
Inclusion Criteria:
- Clinical stage ≤ T2b according to the American Joint Commission on Cancer 6th Edition28
- PSA ≤ 10 ng/ml
- Gleason sum on biopsy ≤ 6
- Prostate volume ≤ 50 cc
- Willing to continue follow-up for at least two years.
Exclusion Criteria:
- No prior hormone therapy
- No prior radiotherapy
- No history of collagen vascular disease
- No history of inflammatory bowel disease
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: pre-implant transrectal ultrasound images and planning
Transrectal ultrasound session will be performed at a separate session prior to the implant.
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The technique uses current ultrasound equipment already in use for prostate brachytherapy guidance.By extracting and processing the radiofrequency signal obtained from the ultrasound transducer in ways not done to create the standard B-mode ultrasound image, areas of cancer can be identified and displayed overlying the standard B-mode ultrasound image.
Comparing the results with this technique to the results of prostate biopsies demonstrates a high degree of accuracy with the area under the receiver-operator characteristic curve of 0.87, a result superior to any other imaging methods.
an ultrasound-based technique to identify cancer-containing areas within the prostate.
ultrasound-based cancer-specific images of the prostate prior to the brachytherapy and use them to direct the dosimetry planning
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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modified B+K ultrasound-based tissue-type images
Tijdsspanne: 2 years
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2 years
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Ronald Ennis, MD, St. Luke's-Roosevelt Hospital Center
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 februari 2007
Primaire voltooiing (Werkelijk)
1 augustus 2014
Studie voltooiing (Werkelijk)
1 augustus 2014
Studieregistratiedata
Eerst ingediend
22 oktober 2010
Eerst ingediend dat voldeed aan de QC-criteria
22 oktober 2010
Eerst geplaatst (Schatting)
25 oktober 2010
Updates van studierecords
Laatste update geplaatst (Schatting)
14 maart 2016
Laatste update ingediend die voldeed aan QC-criteria
11 maart 2016
Laatst geverifieerd
1 maart 2016
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 06-147
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