ONE SHOT - single shot radiotherapy for localized prostate cancer: study protocol of a single arm, multicenter phase I/II trial

Thomas Zilli, Marta Scorsetti, Daniel Zwahlen, Ciro Franzese, Robert Förster, Niccolò Giaj-Levra, Nikolaos Koutsouvelis, Aurelie Bertaut, Michel Zimmermann, Giuseppe Roberto D'Agostino, Filippo Alongi, Matthias Guckenberger, Raymond Miralbell, Thomas Zilli, Marta Scorsetti, Daniel Zwahlen, Ciro Franzese, Robert Förster, Niccolò Giaj-Levra, Nikolaos Koutsouvelis, Aurelie Bertaut, Michel Zimmermann, Giuseppe Roberto D'Agostino, Filippo Alongi, Matthias Guckenberger, Raymond Miralbell

Abstract

Background: Stereotactic body radiotherapy (SBRT) is an emerging treatment alternative for patients with localized prostate cancer. Promising results in terms of disease control and toxicity have been reported with 4 to 5 SBRT fractions. However, question of how far can the number of fractions with SBRT be reduced is a challenging research matter. As already explored by some authors in the context of brachytherapy, monotherapy appears to be feasible with an acceptable toxicity profile and a promising outcome. The aim of this multicenter phase I/II prospective trialis to demonstrate early evidence of safety and efficacy of a single-fraction SBRT approach for the treatment of localized disease.

Methods: Patients with low- and intermediate-risk localized prostate cancer without significant tumor in the transitional zone will be treated with a single SBRT fraction of 19 Gy to the whole prostate gland with urethra-sparing (17 Gy). Intrafractional motion will be monitored with intraprostatic electromagnetic transponders. The primary endpoint of the phase I part of the study will be safety as assessed by CTCAE 4.03 grading scale, while biochemical relapse-free survival will be the endpoint for the phase II. The secondary endpoints include acute and late toxicity, quality of life, progression-free survival, and prostate-cancer specific survival.

Discussion: This is the first multicenter phase I/II trial assessing the efficacy and safety of a single-dose SBRT treatment for patients with localized prostate cancer. If positive, results of ONE SHOT may help to design subsequent phase III trials exploring the role of SBRT monotherapy in the exclusive radiotherapy treatment of localized disease.

Trial registration: Clinicaltrials.gov identifier: NCT03294889 ; Registered 27 September 2017.

Keywords: Electromagnetic transponders; Prostate cancer; Quality of life; Single fraction; Stereotactic body radiotherapy; Urethra-sparing.

Conflict of interest statement

Ethics approval and consent to participate

Signature of the informed consent will be obtained from all patients before inclusion in the study.

This study was approved by the Ethics committee of the Geneva University Hospital (2017–01236) for all Swiss Centers. For Italian centers, the study was approved by the Ethics committee of Istituto Clinico Humanitas (n. 1958). The study is registered on Clinicaltrials.gov (Identifier: NCT03294889; Registered 27 September 2017).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Image-guided flowchart as per protocol

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