Focal Versus Whole Gland High Dose-Rate Brachytherapy (HDR-BT) Boost to External Beam Radiotherapy in Localized Prostate Cancer: A Phase 2 Randomized Trial

NCT ID: NCT07300566

Last Updated: 2025-12-24

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

NOT_YET_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-28

Study Completion Date

2033-03-31

Brief Summary

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This project aims to compare the changes in the urinary quality of life (QoL) following focal high dose-rate brachytherapy (HDR-BT) boost to stereotactic ablative radiotherapy (SABR), compared to standard whole gland HDR-BT boost, in the treatment of men diagnosed with intermediate- and high-risk prostate cancer, with have an identifiable DIL on mpMRI.

Detailed Description

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Conditions

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Prostate Cancer

Keywords

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Focal high dose rate brachytherapy Whole gland high dose rate brachytherapy External beam radiotherapy Intermediate risk prostate cancer High risk prostate cancer

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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Whole Gland High Dose Rate Brachytherapy Boost Arm

Group Type ACTIVE_COMPARATOR

Standard Arm: Whole Gland High Dose Rate Brachytherapy Boost

Intervention Type RADIATION

Whole gland high dose rate brachytherapy (15 Gray/1 fraction) plus stereotactic ablative radiotherapy to the prostate +/- pelvis (25 Gray/5 fractions). Androgen deprivation therapy 6 to 24 months (physician discretion).

Focal High Dose Rate Brachytherapy Boost Arm

Group Type EXPERIMENTAL

Experimental Arm: Focal High Dose Rate Brachytherapy Boost

Intervention Type RADIATION

Focal high dose rate brachytherapy boost to the dominant intraprostatic lesion (15 Gray/1 fraction) plus stereotactic ablative radiotherapy to the prostate (30 Gray/5 fractions) +/- the pelvis (25 Gray/5 fractions). Androgen deprivation therapy 6 to 24 months (physician discretion).

Interventions

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Standard Arm: Whole Gland High Dose Rate Brachytherapy Boost

Whole gland high dose rate brachytherapy (15 Gray/1 fraction) plus stereotactic ablative radiotherapy to the prostate +/- pelvis (25 Gray/5 fractions). Androgen deprivation therapy 6 to 24 months (physician discretion).

Intervention Type RADIATION

Experimental Arm: Focal High Dose Rate Brachytherapy Boost

Focal high dose rate brachytherapy boost to the dominant intraprostatic lesion (15 Gray/1 fraction) plus stereotactic ablative radiotherapy to the prostate (30 Gray/5 fractions) +/- the pelvis (25 Gray/5 fractions). Androgen deprivation therapy 6 to 24 months (physician discretion).

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed diagnosis of adenocarcinoma of the prostate
* Eastern Co-Operative Oncology Group (ECOG) 0-2
* Intermediate and high-risk disease with localized unfavorable features:

* defined as clinical stage tumor cT1 or cT2a, International Society of Urological Pathology (ISUP) grade group 2-4 in less than or equal to 50% of the cores, unilateral extracapsular extension (ECE), prostate specific antigen (PSA) less than or equal to 20 ng/mL
* corresponding to an Identified dominant intraprostatic lesion (DIL) on multiparametric magnetic resonance imaging (mpMRI) Prostate Imaging Reporting and Data System score (PI-RADs 3-5)
* Prostate volume less than or equal to 60 cc is recommended. Transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) are accepted to assess prostate volume. Patients with a prostate volume between 60 and 80 cc can be included if the International Prostate Symptom Score (IPSS) is less than 15 and brachytherapy is deemed feasible by the treating physician.

Exclusion Criteria

* Contraindications to mpMRI
* Documented nodal or distant metastases
* Previous pelvic radiotherapy
* Recent transurethral resection of prostate (less than or equal to 6 months), previous prostatectomy or high-intensity focused ultrasound (HIFU)
* Poor baseline urinary function: International Prostate Symptom Score (IPSS) greater than 19
* Connective tissue disease or inflammatory bowel disease
* Patients deemed unsuitable for general anaesthetic by the Anaesthesia Department
* Patient is unable to lie flat long enough for the Radiation Therapy (RT) Simulation and Treatment
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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London Health Sciences Centre

OTHER

Sponsor Role collaborator

Joelle Helou

OTHER

Sponsor Role lead

Responsible Party

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Joelle Helou

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Joelle Helou, MD

Role: PRINCIPAL_INVESTIGATOR

London Health Sciences Centre Research Institute, London Health Sciences Centre

Locations

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London Health Sciences Centre, Verspeeten Family Cancer Centre

London, Ontario, Canada

Site Status

Countries

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Canada

Central Contacts

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Joelle Helou, MD

Role: CONTACT

Phone: 519-685-8650

Email: [email protected]

Facility Contacts

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Joelle Helou, MD

Role: primary

Other Identifiers

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FORWARD - ReDA 16623

Identifier Type: -

Identifier Source: org_study_id