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
31 participants
Study Classification
INTERVENTIONAL
Study Start Date
2012-07-06
Study Completion Date
2018-08-31
Brief Summary
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This clinical study will evaluate side effects, quality of life and cancer control in patients with prostate cancer diagnosed on only one side of the prostate gland.
The diagnosis of unilateral prostate cancer will be made by means of a prostate transperineal template biopsy (TTB) and multiparametric magnetic resonance imaging (mpMRI).
Patients will be treated with low dose rate brachytherapy, using permanent iodine seed implants.Treatment will be limited to the side of the gland where the cancer has been diagnosed and is therefore called "focal" brachytherapy.
Prostate brachytherapy is usually applied to the whole prostate gland. After whole gland prostate brachytherapy urinary, bowel and sexual function may be affected. In this focal approach, the side effects will be evaluated by means of patient questionnaires.These will be repeated at various intervals after treatment.The results will be compared to the same questionnaires responded by patients who have undergone whole gland brachytherapy.Therefore an assessment can be made whether focal therapy produces fewer side effects than whole gland brachytherapy.The observation period will last for two years after treatment. A biopsy and mpMRI will be repeated after two years to evaluate prostate cancer control.
The diagnosis of unilateral prostate cancer will be made by means of a prostate transperineal template biopsy (TTB) and multiparametric magnetic resonance imaging (mpMRI).
Patients will be treated with low dose rate brachytherapy, using permanent iodine seed implants.Treatment will be limited to the side of the gland where the cancer has been diagnosed and is therefore called "focal" brachytherapy.
Prostate brachytherapy is usually applied to the whole prostate gland. After whole gland prostate brachytherapy urinary, bowel and sexual function may be affected. In this focal approach, the side effects will be evaluated by means of patient questionnaires.These will be repeated at various intervals after treatment.The results will be compared to the same questionnaires responded by patients who have undergone whole gland brachytherapy.Therefore an assessment can be made whether focal therapy produces fewer side effects than whole gland brachytherapy.The observation period will last for two years after treatment. A biopsy and mpMRI will be repeated after two years to evaluate prostate cancer control.
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Detailed Description
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This is a pilot Stage IIS study to evaluate the feasibility of performing a larger multicentre trial.The HAPpy study is a prospective development study offering hemi ablative LDR brachytherapy to 34 men with histologically proven low or intermediate risk localised prostate adenocarcinoma which affects a single lobe of the prostate.The data obtained from these 34 patients will be compared to matched patients from a retrospective cohort of whole gland brachytherapy patients treated in the same institution.Precise mapping and characterisation of the disease will be established using mp-MRI (T2-weighted and DCE(gadolinium)) imaging and transperineal template biopsy (TTB). Only the lobes with disease (left or right half of the gland) will be treated provided that the contralateral side is free of disease. Patients will be followed for two years post treatment at which time a further mp-MRI and TTB will confirm disease control outcomes.
Focal therapy for prostate cancer is a new idea and is considered an experimental treatment which needs to be evaluated within carefully conducted clinical trials . Rather than investigating focal therapy in a strict sense where only known areas of disease are treated, a more conservative approach needs to be taken until more information can be obtained regarding the outcomes of changing treatment techniques. Hemi-ablative focal therapy is considered to be a low-risk treatment and investigations into the performance of the technique should provide a pathway for future investigations of less conservative methodologies. Hemi-ablative focal therapy treats half of the prostate gland with a treatment margin, effectively treating at least 50% of the whole gland with a prescription dose. In theory, this should lessen the side effects associated with radical treatment while still maintaining disease control.This type of treatment is only suitable for patients with unilateral disease.
An international group of experts was established to form a consensus on how to design and conduct an LDR focal brachytherapy program for clinical trials. The group's findings were published by Langley et al and a dosimetric modelling study by Al Qaisieh et al.
Focal hemi gland brachytherapy will be delivered by means of an adaptation of same real-time planning technique (denominated 4D Brachytherapy) used to deliver whole gland LDR prostate brachytherapy. Stranded iodine 125 sources are implanted on the periphery of the prostate gland and loose iodine 125 sources are implanted within the central volume of the gland. Because all planning and dosimetry are done in real-time, radiotherapy physics will be able to adhere to the strict planning protocols required for this study.
Treatment planning: For standard whole-gland treatment, the whole prostate gland is delineated to form the Planning Target Volume (PTV) and the V100 is planned such that it covers the entire PTV plus a 0.5cm margin. For hemi-ablative focal treatments, the prostate will be divided into half and a new HTV (called the HemiTreatment Volume) is outlined on the side of the prostate determined to have clinically significant disease. A treatment margin of 0.5cm is considered around the HTV, which is similar when planning whole-gland treatment. In this way, \>95% of the HTV is aimed to receive 100% of the prescription dose (V100). The V150 is situated in a semi-horseshoe shape in order to spare the urethra from high doses of radiation.
Dose parameters to critical organs are as follows:-
HEMI PROSTATE:
Prescription Dose 145Gy V100 = \>95% V150 = 50-60% D90 = 140 - 160 Gy
URETHRA:
V150 \<15%
RECTUM:
D0.1cc \<200 Gy
The trial design follows recommendations published by the Balliol Collaboration under the Idea, Development, Exploration, Assessment, Long-term follow-up (IDEAL) model for a surgical study.
Data Collection and Statistics
1. Sample Size- Pilot Study There are no published results available and this technique has not been trialed to determine its effectiveness in disease control and quality of life outcomes. As such, a preliminary study is necessary to determine efficacy and feasibility before a large, multi-centre trial can be performed where a significant number of patients can be recruited for appropriate statistical analysis.
The trial site currently treats \~300 patients per year for whole-gland brachytherapy. Of these 300 patients, \~25% present with unilateral disease that is low and intermediate risk. Recruitment will be over 18 months, in which time 100 patients should be eligible for the HAPpy trial. We anticipate a 25% drop-out rate after mp- MRI and template prostate mapping (TPM) biopsy results and a further 25% drop-out due to refusal to participate. This means that \~50 patients should be available for recruitment into the study over an 18 month period. In order to assess a decrease in side-effects (based on quality of life (QoL)) data of at least 10%, 34 patients will be required for the study. This is comparing two independent groups (prospective hemi group versus retrospective whole-gland group) when using α = 5%, β = 10%, and σ = 20%.
2. Data collection The main research co-ordinator is a qualified and experienced data manager. Data will be collected in both paper and electronic form and the data will be stored in one place and backed up twice on two different servers. Data will be held according to the Data Protection Act 1998 and pseudo anonymised as necessary. Each participant will be given a study number and this will be used on all of their study records. The patient number will be known to the chief investigator, the research co-ordinator, and the research radiographer or nurse assigned to the study. Data will be kept in a secure manner in the research offices with access to named individuals from the study group only. The paper records will be kept for a minimum of 10 years after the end of the study. A research radiographer or nurse will be appointed at the time of trial commencement to ensure that the Quality of Life (QOL) questionnaires are completed at each follow-up visit as required by the trial protocol. The research radiographer or nurse is also responsible for ensuring that each patient in the trial has appropriate appointments set up for each treatment, scanning (mp-MRI, biopsy), and follow-up visit and the necessary information is collected at each visit under the protocol. All clinic visit information including questionnaires, scans, biopsy results, and blood results will be kept in study records.
3. Analysis Thirty-four patients will be examined in the HAPpy trial and with this small sample number, non-parametric analysis of the data will be the most suitable. Patients will be paired or matched according to their tumour staging and pathology, age, and baseline scores. The Mann-Whitney U test, the Wilcoxon test, as well as tests for normality (if appropriate) of the data will be performed to determine if there are differences in the trial groups. Analysis of variance will be performed if the data is appropriate to use in this manner.
Data to be collected:- IPSS + QoL questionnaire = Numerical scores, time-points IIEF-5 QoL questionnaire = Numerical scores, time-points EORTC-QLQ-PR25 bowel symptoms questionnaire = Numerical scores, time-points Dosimetry Values for PTV and HTV = Numerical V100, V150, D90 = Numerical Dose to the Urethra (V150) = Numerical Dose to the Rectum (D0.1cc) = Numerical Pathology review of biopsies (all) Standard reporting, qualitative, ranked mm of core invaded = Numerical Biopsy % core invaded = Numerical Prostate-specific antigen (PSA) = Numerical, time-points EN2 = Numerical, time-points Gleason Score= Numerical Staging = Standard reporting, qualitative, ranked
Outcomes will be reported as estimates with 95% confidence intervals using appropriate methods based on the type of data. For patient reported outcomes with available baseline measurements, a comparison will be made with baseline values using paired analyses. Logistic regression will be used to investigate associations with potential risk factors for histological failure, considering PSA and EN2, Gleason score, cancer core length involvement (mm and %), number and % of positive biopsies for any cancer on TTB, stage and risk group. Sensitivity and specificity (with 95% confidence intervals) will be estimated in considering the use of standard PSA kinetics and thresholds for identifying clinically significant cancer. Scores from the quality of life questionnaires will be used in multivariable cross-sectional and longitudinal regression analysis comparing the treatment groups.
Dosimetric evaluation to the PTV, HTV, and structures (urethra, rectum,bladder) will be performed (ultrasound real-time planning and post-operative CT). The dosimetry will be correlated with QoL information and disease control outcomes.
Results from the TTB will be compared with the mp-MRI scans to evaluate the efficacy of using mp-MRI for diagnosis of disease. Disease modelling in three dimensions may be performed if a suitable physicist can be found to perform such an analysis.
EN2 and PSA evaluation over time will be examined using regression analysis and compared between the two trial arms.
Biopsy and mp-MRI results at 2-years (disease control outcomes) will be compared with pre-treatment biopsy and mp-MRI data and correlated with QoL information and dosimetry.
Thirty-four patients will be examined in the HAPpy trial and with this small sample number, non-parametric analysis of the data will be the most suitable. Patients will be paired or matched according to their tumour staging and pathology, age, and baseline scores. The Mann-Whitney U test, the Wilcoxon test, as well as tests for normality (if appropriate) of the data will be performed on the data to determine if there are differences in the trial groups. Analysis of variance will be performed if the data is appropriate to use in this manner.
4. Reporting of Results The data will be analysed and submitted for peer reviewed journals for publication as full manuscripts. Abstracts to conferences will also be submitted for poster or oral presentation. An interim analysis at 12 months using histological and imaging data will be performed once sufficient data are available.
Data collection and reporting of results will follow the guidelines outlined in CONSORT and STROBE for clinical trials.
Focal therapy for prostate cancer is a new idea and is considered an experimental treatment which needs to be evaluated within carefully conducted clinical trials . Rather than investigating focal therapy in a strict sense where only known areas of disease are treated, a more conservative approach needs to be taken until more information can be obtained regarding the outcomes of changing treatment techniques. Hemi-ablative focal therapy is considered to be a low-risk treatment and investigations into the performance of the technique should provide a pathway for future investigations of less conservative methodologies. Hemi-ablative focal therapy treats half of the prostate gland with a treatment margin, effectively treating at least 50% of the whole gland with a prescription dose. In theory, this should lessen the side effects associated with radical treatment while still maintaining disease control.This type of treatment is only suitable for patients with unilateral disease.
An international group of experts was established to form a consensus on how to design and conduct an LDR focal brachytherapy program for clinical trials. The group's findings were published by Langley et al and a dosimetric modelling study by Al Qaisieh et al.
Focal hemi gland brachytherapy will be delivered by means of an adaptation of same real-time planning technique (denominated 4D Brachytherapy) used to deliver whole gland LDR prostate brachytherapy. Stranded iodine 125 sources are implanted on the periphery of the prostate gland and loose iodine 125 sources are implanted within the central volume of the gland. Because all planning and dosimetry are done in real-time, radiotherapy physics will be able to adhere to the strict planning protocols required for this study.
Treatment planning: For standard whole-gland treatment, the whole prostate gland is delineated to form the Planning Target Volume (PTV) and the V100 is planned such that it covers the entire PTV plus a 0.5cm margin. For hemi-ablative focal treatments, the prostate will be divided into half and a new HTV (called the HemiTreatment Volume) is outlined on the side of the prostate determined to have clinically significant disease. A treatment margin of 0.5cm is considered around the HTV, which is similar when planning whole-gland treatment. In this way, \>95% of the HTV is aimed to receive 100% of the prescription dose (V100). The V150 is situated in a semi-horseshoe shape in order to spare the urethra from high doses of radiation.
Dose parameters to critical organs are as follows:-
HEMI PROSTATE:
Prescription Dose 145Gy V100 = \>95% V150 = 50-60% D90 = 140 - 160 Gy
URETHRA:
V150 \<15%
RECTUM:
D0.1cc \<200 Gy
The trial design follows recommendations published by the Balliol Collaboration under the Idea, Development, Exploration, Assessment, Long-term follow-up (IDEAL) model for a surgical study.
Data Collection and Statistics
1. Sample Size- Pilot Study There are no published results available and this technique has not been trialed to determine its effectiveness in disease control and quality of life outcomes. As such, a preliminary study is necessary to determine efficacy and feasibility before a large, multi-centre trial can be performed where a significant number of patients can be recruited for appropriate statistical analysis.
The trial site currently treats \~300 patients per year for whole-gland brachytherapy. Of these 300 patients, \~25% present with unilateral disease that is low and intermediate risk. Recruitment will be over 18 months, in which time 100 patients should be eligible for the HAPpy trial. We anticipate a 25% drop-out rate after mp- MRI and template prostate mapping (TPM) biopsy results and a further 25% drop-out due to refusal to participate. This means that \~50 patients should be available for recruitment into the study over an 18 month period. In order to assess a decrease in side-effects (based on quality of life (QoL)) data of at least 10%, 34 patients will be required for the study. This is comparing two independent groups (prospective hemi group versus retrospective whole-gland group) when using α = 5%, β = 10%, and σ = 20%.
2. Data collection The main research co-ordinator is a qualified and experienced data manager. Data will be collected in both paper and electronic form and the data will be stored in one place and backed up twice on two different servers. Data will be held according to the Data Protection Act 1998 and pseudo anonymised as necessary. Each participant will be given a study number and this will be used on all of their study records. The patient number will be known to the chief investigator, the research co-ordinator, and the research radiographer or nurse assigned to the study. Data will be kept in a secure manner in the research offices with access to named individuals from the study group only. The paper records will be kept for a minimum of 10 years after the end of the study. A research radiographer or nurse will be appointed at the time of trial commencement to ensure that the Quality of Life (QOL) questionnaires are completed at each follow-up visit as required by the trial protocol. The research radiographer or nurse is also responsible for ensuring that each patient in the trial has appropriate appointments set up for each treatment, scanning (mp-MRI, biopsy), and follow-up visit and the necessary information is collected at each visit under the protocol. All clinic visit information including questionnaires, scans, biopsy results, and blood results will be kept in study records.
3. Analysis Thirty-four patients will be examined in the HAPpy trial and with this small sample number, non-parametric analysis of the data will be the most suitable. Patients will be paired or matched according to their tumour staging and pathology, age, and baseline scores. The Mann-Whitney U test, the Wilcoxon test, as well as tests for normality (if appropriate) of the data will be performed to determine if there are differences in the trial groups. Analysis of variance will be performed if the data is appropriate to use in this manner.
Data to be collected:- IPSS + QoL questionnaire = Numerical scores, time-points IIEF-5 QoL questionnaire = Numerical scores, time-points EORTC-QLQ-PR25 bowel symptoms questionnaire = Numerical scores, time-points Dosimetry Values for PTV and HTV = Numerical V100, V150, D90 = Numerical Dose to the Urethra (V150) = Numerical Dose to the Rectum (D0.1cc) = Numerical Pathology review of biopsies (all) Standard reporting, qualitative, ranked mm of core invaded = Numerical Biopsy % core invaded = Numerical Prostate-specific antigen (PSA) = Numerical, time-points EN2 = Numerical, time-points Gleason Score= Numerical Staging = Standard reporting, qualitative, ranked
Outcomes will be reported as estimates with 95% confidence intervals using appropriate methods based on the type of data. For patient reported outcomes with available baseline measurements, a comparison will be made with baseline values using paired analyses. Logistic regression will be used to investigate associations with potential risk factors for histological failure, considering PSA and EN2, Gleason score, cancer core length involvement (mm and %), number and % of positive biopsies for any cancer on TTB, stage and risk group. Sensitivity and specificity (with 95% confidence intervals) will be estimated in considering the use of standard PSA kinetics and thresholds for identifying clinically significant cancer. Scores from the quality of life questionnaires will be used in multivariable cross-sectional and longitudinal regression analysis comparing the treatment groups.
Dosimetric evaluation to the PTV, HTV, and structures (urethra, rectum,bladder) will be performed (ultrasound real-time planning and post-operative CT). The dosimetry will be correlated with QoL information and disease control outcomes.
Results from the TTB will be compared with the mp-MRI scans to evaluate the efficacy of using mp-MRI for diagnosis of disease. Disease modelling in three dimensions may be performed if a suitable physicist can be found to perform such an analysis.
EN2 and PSA evaluation over time will be examined using regression analysis and compared between the two trial arms.
Biopsy and mp-MRI results at 2-years (disease control outcomes) will be compared with pre-treatment biopsy and mp-MRI data and correlated with QoL information and dosimetry.
Thirty-four patients will be examined in the HAPpy trial and with this small sample number, non-parametric analysis of the data will be the most suitable. Patients will be paired or matched according to their tumour staging and pathology, age, and baseline scores. The Mann-Whitney U test, the Wilcoxon test, as well as tests for normality (if appropriate) of the data will be performed on the data to determine if there are differences in the trial groups. Analysis of variance will be performed if the data is appropriate to use in this manner.
4. Reporting of Results The data will be analysed and submitted for peer reviewed journals for publication as full manuscripts. Abstracts to conferences will also be submitted for poster or oral presentation. An interim analysis at 12 months using histological and imaging data will be performed once sufficient data are available.
Data collection and reporting of results will follow the guidelines outlined in CONSORT and STROBE for clinical trials.
Conditions
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Prostatic Neoplasms
Cancer of the Prostate
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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Hemigland focal LDR brachytherapy
Hemigland focal LDR brachytherapy using permanent iodine 125 seed implantation
Group Type
EXPERIMENTAL
Hemigland focal LDR brachytherapy
Intervention Type
RADIATION
The treatment is limited to the hemigland that has been diagnosed with unilateral low to intermediate risk prostate cancer by means of pre-treatment staging with mpMRI and transperineal template biopsy. The affected hemigland will be treated with iodine-125 to a prescription dose of 145Gy. Patients will be assessed at baseline and subsequently at 6 weeks, 3, 6, 9, 12,18, 24 months after treatment with PSA and EN2 measurements and validated questionnaires relating to erectile, urinary, and bowel function and general health related quality of life. mpMRI and transperineal template biopsy will be performed 24 months after treatment.
Interventions
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Hemigland focal LDR brachytherapy
The treatment is limited to the hemigland that has been diagnosed with unilateral low to intermediate risk prostate cancer by means of pre-treatment staging with mpMRI and transperineal template biopsy. The affected hemigland will be treated with iodine-125 to a prescription dose of 145Gy. Patients will be assessed at baseline and subsequently at 6 weeks, 3, 6, 9, 12,18, 24 months after treatment with PSA and EN2 measurements and validated questionnaires relating to erectile, urinary, and bowel function and general health related quality of life. mpMRI and transperineal template biopsy will be performed 24 months after treatment.
Intervention Type
RADIATION
Eligibility Criteria
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Inclusion Criteria
1. TRUS biopsy (if taken):
unilateral disease only
2. Template biopsy (TTB):
unilateral disease only, AND Gleason \< 7 (either 3+4 or 4+3)
3. mp-MRI results: Disease must present as unilateral (left or right) only
4. Stage T1-T2bN0M0 disease, as determined by local guidelines \*
5. Serum PSA \< 15
6. Prostate volume \< 50cc
7. Eligible for brachytherapy as outlined in local guidelines\*
8. Life expectancy \> 10 years
unilateral disease only
2. Template biopsy (TTB):
unilateral disease only, AND Gleason \< 7 (either 3+4 or 4+3)
3. mp-MRI results: Disease must present as unilateral (left or right) only
4. Stage T1-T2bN0M0 disease, as determined by local guidelines \*
5. Serum PSA \< 15
6. Prostate volume \< 50cc
7. Eligible for brachytherapy as outlined in local guidelines\*
8. Life expectancy \> 10 years
Exclusion Criteria
1. Men who have had previous radiation therapy
2. Men who have had androgen suppression/hormone treatment within the previous 12 months for their prostate cancer
3. Men with evidence of metastatic disease or nodal disease outside the prostate on bone scan or cross-sectional imaging.
* https://www.rcr.ac.uk/quality-assurance-practice-guidelines-transperineal-ldr-permanent-seed-brachytherapy-prostate-cancer
2. Men who have had androgen suppression/hormone treatment within the previous 12 months for their prostate cancer
3. Men with evidence of metastatic disease or nodal disease outside the prostate on bone scan or cross-sectional imaging.
* https://www.rcr.ac.uk/quality-assurance-practice-guidelines-transperineal-ldr-permanent-seed-brachytherapy-prostate-cancer
Eligible Sex
MALE
Accepts Healthy Volunteers
No
Sponsors
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Royal Surrey County Hospital NHS Foundation Trust
OTHER
Sponsor Role
lead
Responsible Party
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Stephen Langley
Professor of Urology & Clinical Director Royal Surrey & St Luke's Cancer Centre
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Stephen Langley, MD
Role: PRINCIPAL_INVESTIGATOR
Royal Surrey NHS Foundation Trust
Locations
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Royal Surrey NHS Foundation Trust
Guildford, , United Kingdom
Site Status
Countries
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United Kingdom
References
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Ahmed HU, Pendse D, Illing R, Allen C, van der Meulen JH, Emberton M. Will focal therapy become a standard of care for men with localized prostate cancer? Nat Clin Pract Oncol. 2007 Nov;4(11):632-42. doi: 10.1038/ncponc0959.
Reference Type
BACKGROUND
Eggener SE, Scardino PT, Carroll PR, Zelefsky MJ, Sartor O, Hricak H, Wheeler TM, Fine SW, Trachtenberg J, Rubin MA, Ohori M, Kuroiwa K, Rossignol M, Abenhaim L; International Task Force on Prostate Cancer and the Focal Lesion Paradigm. Focal therapy for localized prostate cancer: a critical appraisal of rationale and modalities. J Urol. 2007 Dec;178(6):2260-7. doi: 10.1016/j.juro.2007.08.072. Epub 2007 Oct 15.
Reference Type
BACKGROUND
Langley S, Ahmed HU, Al-Qaisieh B, Bostwick D, Dickinson L, Veiga FG, Grimm P, Machtens S, Guedea F, Emberton M. Report of a consensus meeting on focal low dose rate brachytherapy for prostate cancer. BJU Int. 2012 Feb;109 Suppl 1:7-16. doi: 10.1111/j.1464-410X.2011.10825.x.
Reference Type
BACKGROUND
Al-Qaisieh B, Mason J, Bownes P, Henry A, Dickinson L, Ahmed HU, Emberton M, Langley S. Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy. Int J Radiat Oncol Biol Phys. 2015 Jul 15;92(4):787-93. doi: 10.1016/j.ijrobp.2015.02.043. Epub 2015 Apr 28.
Reference Type
BACKGROUND
Langley SE, Laing RW. 4D Brachytherapy, a novel real-time prostate brachytherapy technique using stranded and loose seeds. BJU Int. 2012 Feb;109 Suppl 1:1-6. doi: 10.1111/j.1464-410X.2011.10824.x.
Reference Type
BACKGROUND
McCulloch P, Altman DG, Campbell WB, Flum DR, Glasziou P, Marshall JC, Nicholl J; Balliol Collaboration; Aronson JK, Barkun JS, Blazeby JM, Boutron IC, Campbell WB, Clavien PA, Cook JA, Ergina PL, Feldman LS, Flum DR, Maddern GJ, Nicholl J, Reeves BC, Seiler CM, Strasberg SM, Meakins JL, Ashby D, Black N, Bunker J, Burton M, Campbell M, Chalkidou K, Chalmers I, de Leval M, Deeks J, Ergina PL, Grant A, Gray M, Greenhalgh R, Jenicek M, Kehoe S, Lilford R, Littlejohns P, Loke Y, Madhock R, McPherson K, Meakins J, Rothwell P, Summerskill B, Taggart D, Tekkis P, Thompson M, Treasure T, Trohler U, Vandenbroucke J. No surgical innovation without evaluation: the IDEAL recommendations. Lancet. 2009 Sep 26;374(9695):1105-12. doi: 10.1016/S0140-6736(09)61116-8.
Reference Type
BACKGROUND
Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med. 2010 Mar 24;7(3):e1000251. doi: 10.1371/journal.pmed.1000251.
Reference Type
BACKGROUND
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495-9. doi: 10.1016/j.ijsu.2014.07.013. Epub 2014 Jul 18.
Reference Type
BACKGROUND
Barentsz JO, Weinreb JC, Verma S, Thoeny HC, Tempany CM, Shtern F, Padhani AR, Margolis D, Macura KJ, Haider MA, Cornud F, Choyke PL. Synopsis of the PI-RADS v2 Guidelines for Multiparametric Prostate Magnetic Resonance Imaging and Recommendations for Use. Eur Urol. 2016 Jan;69(1):41-9. doi: 10.1016/j.eururo.2015.08.038. Epub 2015 Sep 8. No abstract available.
Reference Type
BACKGROUND
Laing R, Franklin A, Uribe J, Horton A, Uribe-Lewis S, Langley S. Hemi-gland focal low dose rate prostate brachytherapy: An analysis of dosimetric outcomes. Radiother Oncol. 2016 Nov;121(2):310-315. doi: 10.1016/j.radonc.2016.09.014. Epub 2016 Nov 1.
Reference Type
RESULT
Langley S, Uribe J, Uribe-Lewis S, Franklin A, Perna C, Horton A, Cunningham M, Higgins D, Deering C, Khaksar S, Laing R. Hemi-ablative low-dose-rate prostate brachytherapy for unilateral localised prostate cancer. BJU Int. 2020 Mar;125(3):383-390. doi: 10.1111/bju.14948. Epub 2019 Dec 23.
Reference Type
RESULT
Other Identifiers
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R&D12oncn0015
Identifier Type: -
Identifier Source: org_study_id
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EBRT and HDR Brachytherapy for Unfavorable-intermediate, High, and Very High-risk Prostate Cancer
NCT04465500
RECRUITING
PHASE2
HDR Brachytherapy vs SABR in Early-intermediate Prostate Cancer
NCT04870567
UNKNOWN
NA
Assessing the Potential for Reduced Toxicity Using Focal Brachytherapy in Early Stage, Low Volume Prostate Cancer
NCT01354951
TERMINATED
PHASE2
High-Intensity Focused Ultrasound Ablation in Treating Patients With Localized Prostate Cancer
NCT00561314
COMPLETED
PHASE2
CyberKnife Radiosurgery For Low & Intermediate Risk Prostate Cancer: Emulating HDR Brachytherapy Dosimetry
NCT00643617
COMPLETED
NA
Radical Radiotherapy by External Beam Radiation Versus Radical Radiotherapy With Temporary Iridium Implant Plus External Beam Radiation in Carcinoma of the Prostate
NCT00548600
COMPLETED
PHASE3
Feasibility of MR-Informed Adaptive Marker-less SBRT in Patients With Bilateral Hip Prostheses Undergoing SBRT for Localized Prostate Cancer
NCT07042256
NOT_YET_RECRUITING
NA
Fairly Brief Androgen Suppression and Stereotactic Radiotherapy for High Risk Prostate Cancer - Protocol 2
NCT02229734
COMPLETED
PHASE2
Percutaneous High-dose Radiotherapy in Patients With Oligometastases of Prostate Carcinoma
NCT02264379
COMPLETED
Single Fraction HDR Brachytherapy Plus Hypofractionated EBRT for Low-risk Prostate Cancer: Phase II Trial
NCT02283346
UNKNOWN
PHASE2
Combined LDR Boost and HDR Whole Gland
NCT03323879
TERMINATED
PHASE1/PHASE2
Implant Radiation Therapy or Surgery in Treating Patients With Prostate Cancer
NCT01098331
TERMINATED
NA
Pilot Study of Whole Gland Salvage HDR Prostate Brachytherapy for Locally Recurrent Prostate Cancer
NCT02560181
ACTIVE_NOT_RECRUITING
NA
Two-Fraction Ultrahypofractionated Radiotherapy With Focal Boost for Intermediate Risk, Localized Prostate Cancer
NCT06518226
RECRUITING
NA
HDR Focal: Feasibility Study
NCT02918253
RECRUITING
NA
Internal Radiation Therapy in Treating Patients With Low-Risk Prostate Cancer
NCT01859689
WITHDRAWN
PHASE2