HDR vs LDR Brachytherapy as Monotherapy in the Treatment of Localized Prostate Cancer.

NCT ID: NCT02258087

Last Updated: 2014-10-07

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

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-30

Study Completion Date

2019-09-30

Brief Summary

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Investigators compare in a randomized clinical trial the results and side effects of high-dose- and low-dose-rate brachytherapy as monotherapy in the treatment of early, organ confined prostate cancer patients.

Detailed Description

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Permanent implant prostate brachytherapy (LDRPBT) is a well established and proved method in the treatment of patients with low or selected intermediate risk, organ confined prostate cancer.

There are number of studies with high-dose rate brachytherapy (HDRPBT) as monotherapy with several fractionation schedule treating the same group of patients. One phase II trial showed its effectiveness given in one fraction of 19 Gy.

In the trial investigators randomly select patients to treat with either LDR prostate brachytherapy (145Gy) or HDR prostate brachytherapy (1x19Gy) as monotherapy.

Patients are stratified into two pretreatment group: 1. low risk, 2. selected intermediate risk group.

Brachytherapy is given in spinal anaesthesia, using transrectal ultrasound based real time treatment planning. Dose constraints are defined for both methods.

Conditions

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Adenocarcinoma of Prostate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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LDRPBT

Patients with low and selected intermediate risk prostate cancer are treated with Prostate LDR brachytherapy as monotherapy. 145 Gy is prescribed to the prostate. I-125 radioactive sources are used. Transperineal approach, rectal ultrasound guidance, inverse treatment planning, real time dose optimization is applied.

Group Type ACTIVE_COMPARATOR

LDR Brachytherapy

Intervention Type RADIATION

In spinal anaesthesia patients' prostate are treated with low-dose-rate or brachytherapy using transrectal ultrasound guidance. Radiation sources (iodine-125 isotopes) are implanted into the prostate through transperineal needle insertion. Real time dose planning is applied. The prescribed dose to the whole prostate is 145 Gy.

HDRPBT

Patients with low and selected intermediate risk prostate cancer are treated with prostate HDR brachytherapy as monotherapy. The prescribed dose is 1x19 Gy to the whole prostate. Ir-192 radioactive source is used. Transperineal approach, rectal ultrasound guidance, inverse treatment planning, real time dose optimization is applied.

Group Type EXPERIMENTAL

HDR Brachytherapy

Intervention Type RADIATION

In spinal anaesthesia patients' prostate are treated with one fraction of HDR brachytherapy. The prescribed dose to the whole prostate is 1x19 Gy. Ir-192 radioactive stepping source is used for the treatment with after-loading technique. Transperineal approach, rectal ultrasound guidance, inverse treatment planning, real time intraoperative needle position update and dose optimization is applied.

Interventions

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LDR Brachytherapy

In spinal anaesthesia patients' prostate are treated with low-dose-rate or brachytherapy using transrectal ultrasound guidance. Radiation sources (iodine-125 isotopes) are implanted into the prostate through transperineal needle insertion. Real time dose planning is applied. The prescribed dose to the whole prostate is 145 Gy.

Intervention Type RADIATION

HDR Brachytherapy

In spinal anaesthesia patients' prostate are treated with one fraction of HDR brachytherapy. The prescribed dose to the whole prostate is 1x19 Gy. Ir-192 radioactive stepping source is used for the treatment with after-loading technique. Transperineal approach, rectal ultrasound guidance, inverse treatment planning, real time intraoperative needle position update and dose optimization is applied.

Intervention Type RADIATION

Other Intervention Names

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Seed brachytherapy Permanent implantation prostate brachytherapy temporary implant

Eligibility Criteria

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Inclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) status \<=1
* 40-75 years old
* expected life expectancy\>10 years
* low risk prostate cancer (Prostate specific antigen (PSA)\<=10ng/ml, gleason score \<7, T status\<=2a), less than 50 % positive biopsy cores
* selected intermediate prostate cancer (PSA)=10-\<15ng/ml or gleason score =3+4(but not 4+3), or T2b-c, less than 50 % positive biopsy cores)
* International prostate symptom score (IPSS) \<=15
* Prostate volume\<=50cm3
* no pubic interference
* no prior prostate operation, except biopsy
* no prior radiation to pelvis
* patient signed the informed consent

Exclusion Criteria

* \<40 years or \>75 years old
* PSA\>15 ng/ml gleason score 4+3 , score 8-10
* ECOG\>=2
* T3-4
* percent core positivity \>50 %
* TUR operation within six months prior to the brachytherapy prostate volume\<10 cm3 or \>50 cm3 IPSS \>15
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Oncology, Hungary

OTHER

Sponsor Role lead

Responsible Party

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Peter Agoston

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Peter Agoston, MD, PHD

Role: PRINCIPAL_INVESTIGATOR

NIO, Hungary

Locations

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Peter Agoston

Budapest, , Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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Peter Agoston, MD PHD

Role: CONTACT

+361 2248600 ext. 3186

Csaba Polgar, MD, PHD

Role: CONTACT

Facility Contacts

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Peter Agoston, MD, PHD

Role: primary

+3612248600 ext. 3186

Csaba Polgar, MD PHD

Role: backup

Other Identifiers

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PROMOBRA-2013

Identifier Type: -

Identifier Source: org_study_id

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