A Trial Assessing Post-Operative Use of ProSpare, a Rectal Obturator in Prostate Cancer Radiotherapy
NCT ID: NCT02978014
Last Updated: 2021-04-19
Study Results
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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UNKNOWN
PHASE2
245 participants
INTERVENTIONAL
2017-02-08
2024-12-31
Brief Summary
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Detailed Description
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Radiotherapy alone is also a standard treatment for prostate cancer. At the Royal Marsden Hospital and Institute of Cancer Research the investigators have designed and patented a device called ProSpare to improve the accuracy of radiotherapy. The device has already been developed and tested in over 80 patients having prostate radiotherapy and was well tolerated. Treatment accuracy was improved and the radiation dose to the rectum was reduced. Patients have given very valuable feedback and comments about ProSpare's design and use, which the investigators have incorporated in the final design. It is now important to test ProSpare in a multi-centre randomised controlled trial. The investigators aim to determine whether ProSpare will reduce the side effects reported by patients having radiotherapy after prostatectomy.
The ProSpare device is inserted by the patient into the rectum for each daily radiotherapy treatment. The disposable device stays in place for about 15 minutes each day. The curve in the device is designed to follow the shape of the rectum and it stays in the correct place by securely locating in the anal sphincter. ProSpare contains small "markers" - steel ball bearings - which can be "seen" on the standard scans taken before a radiotherapy treatment. Treatment is adjusted before each daily treatment to account for patient movement and radiotherapy set-up variation. As a result, treatment is more accurate than using the standard methods of radiotherapy localisation. This means the radiotherapy "safety margins" which are placed around the prostate bed can be reduced. The dose to the rectum and bladder as well as the structures that are associated with erectile function will be reduced. This may lead to an improvement in the side effects caused by radiotherapy.
Other ways to identify the treatment target area for such image guided radiotherapy (IGRT) includes the insertion of fiducial markers - usually in the form of gold seeds into the prostate or prostate bed. This has become standard practice in some radiotherapy centres for prostate radiotherapy but is technically complex for prostate bed radiotherapy and not routinely used. ProSpare has the additional advantage of being non-invasive and without the risk of infection associated with fiducial insertion.
Patients will be randomly selected to either have standard treatment or use ProSpare daily with adjusted set-up margins. During and after treatment, patients will be asked questions and given questionnaires to complete, asking about bowel, urinary and sexual function. The investigators will look at the results in each group and see if treatment with ProSpare has a benefit in improving the side effects from radiotherapy. If a benefit is seen, the aim will be for ProSpare guided radiotherapy to become part of the standard treatment for prostate bed radiotherapy nationally and internationally.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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ProSpare Arm
ProSpare (obturator) image guided IMRT (i.e. radiotherapy administered to patients with the ProSpare device inserted in the rectum)
ProSpare
A novel rectal obturator (ProSpare) acting as a non-invasive daily on-line image guided tool, a rectal spacer and a prostate bed stabiliser
Non-ProSpare Arm
Standard of Care (non-obturator) image guided IMRT (i.e. radiotherapy administered to patients without the ProSpare device inserted in the rectum)
No interventions assigned to this group
Interventions
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ProSpare
A novel rectal obturator (ProSpare) acting as a non-invasive daily on-line image guided tool, a rectal spacer and a prostate bed stabiliser
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Histologically confirmed prostatic cancer
3. Patient due to receive post-operative prostate bed radiotherapy either in the adjuvant or salvage\* setting
4. WHO performance status 0-1 at randomization
5. Age \> 18 years
6. Written informed consent
7. Able to independently complete patient questionnaires
Exclusion Criteria
2. Prior pelvic radiotherapy
3. Previous invasive cancer in the past 3 years, with the exception of non-melanoma skin cancer
4. Symptomatic haemorrhoids or other anal conditions which affect adequate insertion and retention of the rectal obturator
5. Planned chemotherapy within 2 months of completion of adjuvant or salvage radiotherapy
6. Musculoskeletal conditions which limit flexibility or mobility and will make patient self insertion of ProSpare™ difficult
7. Comorbid conditions likely to impact on advisability of prostate bed radiotherapy (e.g. inflammatory bowel disease, previous colorectal surgery, significant bladder instability or urinary incontinence)
18 Years
MALE
No
Sponsors
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Institute of Cancer Research, United Kingdom
OTHER
Royal Marsden NHS Foundation Trust
OTHER
Responsible Party
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Principal Investigators
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Dr Julia Murray
Role: PRINCIPAL_INVESTIGATOR
Royal Marsden Hospital / Institute of Cancer Research
Locations
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Beacon Centre, Musgrove Park Hospital
Taunton, Somerset, United Kingdom
The Royal Marsden NHS Foundation Trust
Sutton, Surrey, United Kingdom
Cambridge University Hospitals
Cambridge, , United Kingdom
Royal Surrey County Hospital NHS Foundation Trust
Guildford, , United Kingdom
East Suffolk and North Essex NHS Trust
Ipswich, , United Kingdom
University College London Hospitals NHS Foundation Trust
London, , United Kingdom
Royal Free Hampstead NHS Trust
London, , United Kingdom
The Royal Marsden NHSFT
London, , United Kingdom
East and North Hertfordshire NHS Trust, Mount Vernon Cancer Centre
Middlesex, , United Kingdom
Norfolk and Norwich University Hospital NHSFT
Norwich, , United Kingdom
Countries
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Central Contacts
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Facility Contacts
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Dr Emma Gray
Role: primary
Dr Yvonne Rimmer
Role: primary
Dr Chee Goh
Role: primary
Dr Christopher Scrase
Role: primary
Dr Reena Davda
Role: primary
Dr Sarah Needleman
Role: primary
Prof Peter Hoskin
Role: primary
Dr Jenny Nobes
Role: primary
Other Identifiers
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CCR 4359
Identifier Type: -
Identifier Source: org_study_id
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