SBRT With Focal Dose Escalation on DIL in Localized Prostate Cancer

NCT ID: NCT05919524

Last Updated: 2023-09-26

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

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-01

Study Completion Date

2025-06-30

Brief Summary

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Stereotactic ablative Body Radiotherapy (SBRT) is an advanced radiation technique that allows for precise delivery of higher radiation doses in fewer treatment sessions, resulting in a shorter overall treatment duration. The available clinical evidence suggests that SBRT is highly effective in controlling localized prostate cancer (PCa) with acceptable side effects.

On the other side, dose escalation is a commonly employed strategy in radiotherapy for prostate cancer. Recent studies have confirmed a dose-response relationship, demonstrating improved biochemical control with focal dose escalation to the identified dominant intraprostatic lesion (DIL) on multiparametric magnetic resonance imaging (mpMRI) of the prostate.

The hypothesis of this study is that the combination prostate SBRT with focal dose intensification on the DIL with preservation of the prostatic urethra, would lead to a higher probability of local control without a significant increase in toxicity compared to standard clinical practice.

This is a prospective single-arm phase II study designed to evaluate the effectiveness, safety and impact on quality of life of focal dose intensification using SBRT technology and extreme hypofractionated radiotherapy.

Detailed Description

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Conditions

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Prostate Adenocarcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single group assignment
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SBRT with mpMRI guided focal boost

SBRT 36.25 Gy in 5 sessions of 7.25 Gy to the entire prostate (including seminal vesicles) with a DIL simultaneous integrated focal boost (SIB) up to 50 Gy in 5 sessions, with partial protection of the prostatic urethra and bladder trigone.

Group Type EXPERIMENTAL

Prostate SBRT (stereotactic body radiation therapy) with focal boost

Intervention Type RADIATION

* Prostate SBRT delivered to a dose of 36.25 Gy in 5 fractions of 7.25 Gy to the entire prostate (including seminal vesicles) using VMAT
* mpMRI defined DIL was simultaneously boosted up to 50 Gy in 5 sessions to the mpMRI identified DIL.
* Additional urethra and bladder trigone sparing constrains
* Daily IGRT with cone beam CT and intrafraction gold-seeds fiducial tracking

Interventions

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Prostate SBRT (stereotactic body radiation therapy) with focal boost

* Prostate SBRT delivered to a dose of 36.25 Gy in 5 fractions of 7.25 Gy to the entire prostate (including seminal vesicles) using VMAT
* mpMRI defined DIL was simultaneously boosted up to 50 Gy in 5 sessions to the mpMRI identified DIL.
* Additional urethra and bladder trigone sparing constrains
* Daily IGRT with cone beam CT and intrafraction gold-seeds fiducial tracking

Intervention Type RADIATION

Other Intervention Names

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SABR with SIB SBRT focal intensification

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed adenocarcinoma of the prostate
* Primary localized PCa, cN0 and cM0, intermediate or high-risk disease according to NCCN 2023
* Signed written informed consent for this study
* T2-T3a clinical stage with visible DIL on mpMRI
* ECOG 0-1
* Desirable prostate volume (not mandatory) \< 80 cc or \> 80 cc if urinary function is preserved and dosimetrically feasible
* IPSS ≤ 18 (International Prostate Symptom Score)

Exclusion Criteria

* Unresolved previous prostatitis, symptomatic urethral stenosis
* Bilateral hip prosthesis
* T3b-4 clinical stage or N1
* M1 (presence of distant metastases)
* Previous surgery at the prostate level (Transurethral Resection of the Prostate) within the last 6 months
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Almudena Zapatero

OTHER

Sponsor Role lead

Responsible Party

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Almudena Zapatero

Principal Investigator and Sponsor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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La Princesa University Hospital, Health Research Institute, Madrid

Madrid, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Almudena Zapatero, PhD

Role: CONTACT

+34915202315

Facility Contacts

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Almudena Zapatero, PhD

Role: primary

+34915202315

References

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Zapatero A, Castro P, Roch M, Carnero PR, Carroceda S, Rosciupchin AES, Hernandez SH, Cogorno L, Iturriaga AG, Garcia DB. Functional imaging guided stereotactic ablative body radiotherapy (SABR) with focal dose escalation and bladder trigone sparing for intermediate and high-risk prostate cancer: study protocol for phase II safo trial. Radiat Oncol. 2024 May 3;19(1):54. doi: 10.1186/s13014-024-02440-7.

Reference Type DERIVED
PMID: 38702761 (View on PubMed)

Other Identifiers

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SBRT Focal SAFO

Identifier Type: -

Identifier Source: org_study_id

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