30 Participants Needed

Hypofractionated Radiotherapy for Prostate Cancer

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DN
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Overseen ByDeborah E Citrin, M.D.
Age: 18+
Sex: Male
Trial Phase: Phase 1
Sponsor: National Cancer Institute (NCI)
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Background: Sometimes prostate cancer comes back after a person's prostate is removed. In this case, radiation is a common treatment. Radiation kills prostate cancer cells. It can be very effective. It is usually given in short doses almost every day for 6 or 7 weeks. Researchers want to see if a shorter schedule can be as effective. They want to see if that causes the same or fewer side effects. Usually, radiation is used to treat the entire area where the prostate was before surgery. In some patients, an area of tumor can be seen on scans. Researchers are also trying to see if they can give less dose to the area usually treated with radiation if the full dose is given to the tumor seen on scans. Objective: To find the shortest radiation schedule that people can tolerate without strong side effects. Eligibility: People at least 18 years old who have had a prostatectomy and will get radiation. Design: Participants will be screened with: * Medical history * Physical exam * Blood and urine tests * Scan that uses a small amount of radiation to make a picture of the body * Scan that uses a magnetic field to make an image of the body * Participants will provide documents that confirm their diagnosis. * Participants may have a scan of the abdomen and pelvis. Before they start treatment, participants will have another physical exam and blood tests. Participants will get radiation each day Monday through Friday. Treatment may last 2, 3, or 4 weeks. Participants may provide a tissue sample from a previous procedure for research. Participants will answer questions about their general well-being and function. About 4-5 weeks after they finish radiation treatment, participants will have a follow-up visit. They will be examined and give a blood sample. They will have 6 follow-up visits for the next 2 years.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you cannot participate if you are taking investigational drugs or radiosensitizing drugs (medications that make cancer cells more sensitive to radiation).

What data supports the effectiveness of the treatment Hypofractionated Radiotherapy for Prostate Cancer?

Research shows that using hypofractionated radiotherapy (a treatment where higher doses of radiation are given in fewer sessions) with a simultaneous integrated boost (targeting the tumor more precisely) can effectively control prostate cancer while maintaining quality of life. Studies indicate that this approach can reduce the risk of cancer returning and manage side effects better than traditional methods.12345

Is hypofractionated radiotherapy for prostate cancer safe?

Research shows that hypofractionated radiotherapy, which involves giving higher doses of radiation over fewer sessions, is generally safe for treating prostate cancer. Studies have evaluated its safety, focusing on both short-term and long-term side effects, and found it to be tolerable for patients.23567

How is hypofractionated radiotherapy with integrated boost different from other prostate cancer treatments?

Hypofractionated radiotherapy with integrated boost for prostate cancer is unique because it delivers larger doses of radiation in fewer sessions, potentially increasing the effectiveness of the treatment without increasing side effects. This approach targets the prostate more precisely, allowing for a higher dose to the cancerous area while sparing surrounding healthy tissue.158910

Research Team

Deborah E. Citrin, M.D. | Center for ...

Deborah Citrin, MD

Principal Investigator

National Cancer Institute (NCI)

Eligibility Criteria

Men over 18 who've had their prostate removed and need radiation can join. They must use birth control, have a stable health status (ECOG ≤1), and no history of severe immune deficiency or opportunistic infections if HIV+. No current participation in other trials, prior pelvic radiation, inflammatory bowel disease, lupus, scleroderma, genetic hypersensitivity to radiation or metastases outside the pelvis are allowed.

Inclusion Criteria

I am mostly able to care for myself and carry out daily activities.
Ability of subject to understand and the willingness to sign a written informed consent document
I am HIV positive with a stable condition, meeting specific health criteria.
See 3 more

Exclusion Criteria

Subjects with any coexisting medical or psychiatric condition which, in the opinion of the Investigator likely to interfere with study procedures and/or results
I have had radiation in the same area where my prostate is.
My prostate cancer has spread outside the pelvis, but not beyond the prostate bed region.
See 3 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants receive hypofractionated radiation treatment to the prostate bed, with an integrated boost to visible tumors, Monday through Friday for 2, 3, or 4 weeks

2-4 weeks
Daily visits (in-person, Monday through Friday)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with follow-up visits including examinations and blood tests

2 years
6 visits over 2 years

Treatment Details

Interventions

  • Dose to prostate bed irradiation only
  • Dose to prostate bed with integrated boost
Trial Overview Researchers are testing shorter schedules of post-prostatectomy radiotherapy to see if they're as effective with fewer side effects. Some patients will receive standard doses while others get an increased dose focused on tumor areas identified by scans.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Arm 2/Prostate Bed Irradiation OnlyExperimental Treatment6 Interventions
Prostate bed irradiation only.
Group II: Arm 1/Prostate Bed with Integrated BoostExperimental Treatment6 Interventions
Prostate bed with integrated boost.

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Cancer Institute (NCI)

Lead Sponsor

Trials
14,080
Recruited
41,180,000+

Findings from Research

In a study of 41 patients with high-risk localized prostate cancer, combining whole-pelvis irradiation with a stereotactic body radiotherapy (SBRT) boost resulted in a high 4-year biochemical failure-free survival rate of 91.9%, indicating effective cancer control.
The treatment was associated with minimal toxicity, with no severe (grade 3) gastrointestinal or genitourinary side effects reported, suggesting that this approach is safe for patients.
The early result of whole pelvic radiotherapy and stereotactic body radiotherapy boost for high-risk localized prostate cancer.Lin, YW., Lin, LC., Lin, KL.[2020]

References

Image-guided Intensity-modulated Radiotherapy for Prostate Cancer Employing Hypofractionation and Simultaneous Integrated Boost: Results of a Consecutive Case Series with Focus on Erectile Function. [2018]
Hypofractionated boost to the dominant tumor region with intensity modulated stereotactic radiotherapy for prostate cancer: a sequential dose escalation pilot study. [2022]
Randomized trial of hypofractionated external-beam radiotherapy for prostate cancer. [2022]
Biological dose escalation and hypofractionation: what is there to be gained and how will it best be done? [2021]
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation. [2022]
Hypofractionated intensity-modulated simultaneous integrated boost and image-guided radiotherapy in the treatment of high-risk prostate cancer patients: a preliminary report on acute toxicity. [2022]
Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis. [2021]
The early result of whole pelvic radiotherapy and stereotactic body radiotherapy boost for high-risk localized prostate cancer. [2020]
Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized Prostate Cancer. [2022]
10.United Statespubmed.ncbi.nlm.nih.gov
Biological dose volume histograms during conformal hypofractionated accelerated radiotherapy for prostate cancer. [2018]
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