Magnetic Resonance Guided Focal Stereotactic Body Radiation Therapy for Localized Prostate Cancer

NCT ID: NCT02163317

Last Updated: 2024-05-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-16

Study Completion Date

2021-07-28

Brief Summary

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This pilot clinical trial studies magnetic resonance (MRI)-guided focal stereotactic radiosurgery (SRS) in treating patients with low- or intermediate-risk localized prostate cancer. Stereotactic radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue.

Detailed Description

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PRIMARY OBJECTIVES:

I. Evaluate the correlation of histopathology findings in comparison to regions of the prostate reported to be suspicious for harboring tumor burden on multiparametric MRI report/s.

II. Demonstration of the dosimetric and radiobiological advantages of focal stereotactic body radiation therapy (SBRT) versus whole-gland radiation therapy.

III. Evaluation of clinical outcomes in focal SBRT for localized prostate cancer.

OUTLINE:

Patients undergo 3 fractions of MRI-guided focal SRS every other day for 1 week. Patients undergo additional MRI scans between the 2nd and 3rd fractionated treatments, at 6 months following the end of radiation therapy, and at 12 and 24 months.

After completion of study treatment, patients are followed up every 3 months for up to 24 months.

Conditions

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Adenocarcinoma of the Prostate Recurrent Prostate Cancer Stage I Prostate Cancer Stage IIA Prostate Cancer Stage IIB Prostate Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (MRI-guided focal SRS)

Patients undergo 3 fractions of MRI-guided focal SRS every other day for 1 week. Patients undergo additional MRI scans between the 2nd and 3rd fractionated treatments, at 6 months following the end of radiation therapy, and at 12 and 24 months.

Group Type EXPERIMENTAL

stereotactic radiosurgery

Intervention Type RADIATION

Undergo MRI-guided focal SRS

magnetic resonance imaging

Intervention Type DEVICE

Undergo staging MRI with contrast

quality-of-life assessment

Intervention Type OTHER

Quality of life scores will be summarized graphically and repeated measures of variance will be conducted to test for changes in scores over time

Serum Prostate Antigen Test

Intervention Type PROCEDURE

Test of the PSA protein in blood. The test will be run every three months for up to two years during the study.

Digital Rectal Exam

Intervention Type PROCEDURE

Exam of rectal health. Performed every three months for up to two years throughout the study.

Expanded Prostate Cancer Index Composite

Intervention Type BEHAVIORAL

This survey measures a patient's function and bother after prostate cancer treatment. It will be analyzed using ANOVA using data collected every 6 months for up to 2 years of the study.

Interventions

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stereotactic radiosurgery

Undergo MRI-guided focal SRS

Intervention Type RADIATION

magnetic resonance imaging

Undergo staging MRI with contrast

Intervention Type DEVICE

quality-of-life assessment

Quality of life scores will be summarized graphically and repeated measures of variance will be conducted to test for changes in scores over time

Intervention Type OTHER

Serum Prostate Antigen Test

Test of the PSA protein in blood. The test will be run every three months for up to two years during the study.

Intervention Type PROCEDURE

Digital Rectal Exam

Exam of rectal health. Performed every three months for up to two years throughout the study.

Intervention Type PROCEDURE

Expanded Prostate Cancer Index Composite

This survey measures a patient's function and bother after prostate cancer treatment. It will be analyzed using ANOVA using data collected every 6 months for up to 2 years of the study.

Intervention Type BEHAVIORAL

Other Intervention Names

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MRI NMR imaging NMRI nuclear magnetic resonance imaging quality of life assessment International Prostate Symptom Score / Sexual Health Inventory for Men (IPSS/SHIM) QoL Scores Health related quality of life (HRQOL) PSA PSA response DRE EPIC

Eligibility Criteria

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Inclusion Criteria

* Patients must have a histologically confirmed diagnosis of adenocarcinoma of the prostate
* Patient must have a history/physical examination with digital rectal examination of the prostate within 90 days prior to screening
* Eastern Cooperative Oncology Group (ECOG) performance status must be level 0 or 1 within 60 days prior to registration
* Patient must have a histological evaluation of the prostate biopsy with assignment of a Gleason score to the biopsy material; Gleason scores ≤ 7(3+4)
* Serum creatinine ≤ 1.5 times upper limit of institutional normal (normal: ≤ 1.17 mL/min/1.73 m\^2)
* Clinical stage a ≤ T1-T2a (American Joint Committee on Cancer \[AJCC\] 7th edition)
* Prostate specific antigen (PSA) ≤ 10 ng/mL within 90 days prior to registration; PSA should not be obtained within 10 days after prostate biopsy
* Subjects must have the ability to understand and the willingness to sign a written informed consent document
* Patient willing and able to complete the Expanded Prostate Cancer Index Composite (EPIC) questionnaire (baseline, 6, 12 and 24 months post end of radiation therapy)
* Patients must be able to undergo an MRI with contrast
* Bone scan completed within 90 days

Exclusion Criteria

* Evidence of distant metastases
* Regional lymph node involvement
* Previous radical surgery (prostatectomy), cryosurgery, or high intensity focused ultrasound (HIFU) for prostate cancer
* Previous pelvic irradiation, prostate brachytherapy, or bilateral orchiectomy
* Previous hormonal therapy, such as luteinizing hormone-releasing hormone (LHRH) agonists (e.g., goserelin, leuprolide) or LHRH antagonists (e.g., degarelix), anti-androgens (e.g., flutamide, bicalutamide), estrogens (e.g., diethylstilbestrol \[DES\]), or surgical castration (orchiectomy)
* Use of finasteride within 30 days prior to registration; PSA should not be obtained prior to 30 days after stopping finasteride
* Use of dutasteride within 90 days prior to registration; PSA should not be obtained prior to 90 days after stopping dutasteride
* Previous or concurrent cytotoxic chemotherapy for prostate cancer
* Severe, active co-morbidity, defined as follows:
* Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
* Transmural myocardial infarction within the last 6 months
* Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
* Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
* Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol; (patients on Coumadin or other blood thinning agents are eligible for this study)
* Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease and Control (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol; protocol-specific requirements may also exclude immuno-compromised patients
* Patients unable to undergo an MRI with contrast
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Case Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elisha Fredman, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center

Locations

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University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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Fredman E, Traughber B, Kharouta M, Podder T, Lo S, Ponsky L, MacLennan G, Paspulati R, Ellis B, Machtay M, Ellis R. Focal Prostate Stereotactic Body Radiation Therapy With Correlative Pathological and Radiographic-Based Treatment Planning. Front Oncol. 2021 Sep 15;11:744130. doi: 10.3389/fonc.2021.744130. eCollection 2021.

Reference Type DERIVED
PMID: 34604088 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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NCI-2014-01170

Identifier Type: REGISTRY

Identifier Source: secondary_id

CASE11813

Identifier Type: -

Identifier Source: org_study_id

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