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NCT Number: NCT01288534

Hypofractionated Stereotactic Body Radiation Therapy (SBRT)

The purpose of this study is to evaluate the safety and tolerability of using radiation therapy with 5 fractions of radiation to treat prostate cancer with guidance of radiation using the Calypso 4D Treatment System (Calypso).A number of recent studies have used 5 radiation fraction to treat prostate cancer over 2-3 weeks as compared to the typical treatment which would involve 40-42 smaller radiation fractions over 8-9 weeks. This type of radiation using a smaller number of treatments has been called hypofractionated radiation therapy.

The Calypso is a new technique which uses beacons implanted into the prostate which using radio signals are able to localize and track the position of the prostate continuously during radiation therapy. The Calypso system has been approved by the United States Food and Drug Administration (FDA) for guidance of radiation therapy during the treatment of prostate cancer and is being utilized all across the United States. However, it has not been tested for hypofractionated radiation therapy.

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Key information

Conditions

Prostate Cancer Genital Diseases Genital Diseases, Male Genital Neoplasms, Male Male Urogenital Diseases Neoplasms Neoplasms by Site Prostatic Diseases Prostatic Neoplasms Urogenital Diseases Urogenital Neoplasms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

The Radiological Associates of Sacremento, Sacramento, California, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18 years of age or older
  • Histologically confirmed diagnosis of adenocarcinoma of the prostate within 180 days of enrollment
  • Signed informed consent
  • Gleason score ≤ 7
  • If Gleason 7 (3+4=7 or 4+3=7) then <50% of biopsy cores must be positive for any pathologic grade of prostate cancer
  • If Gleason score <7 then there is no limit on the percentage of biopsy cores involved by prostate cancer
  • PSA (within 90 days prior to enrollment)
  • ≤ 15 ng/ml prior to start of therapy if Gleason ≤ 6 and
  • ≤ 10 ng/ml prior to start of therapy if Gleason 7
  • No plan to use hormone therapy prior to evidence of biochemical failure(ie: No neoadjuvant or adjuvant ADT)
  • Tumor stage: T1a, T1b, T1c, T2a, T2b
  • ECOG Performance Status 0-1

Exclusion criteria

  • A history of other malignancy diagnosed within the previous 60 months except for non-melanoma skin cancer.
  • Any patients who have received other investigational therapy within the last 60 days
  • Individuals that have previously been implanted with permanent Beacon transponders
  • Patients that have any prosthetic implants in the pelvic region that contain metal or conductive materials (e.g., an artificial hip)
  • Patients with implanted pacemaker or defibrillators
  • Patients who are felt to have body habitus not conducive to tracking with Calypso beacons
  • Positive lymph nodes or metastatic disease from prostate cancer
  • Tumor stage: T2c, T3, or T4
  • Previous pelvic radiation therapy
  • Previous surgery or chemotherapy for prostate cancer
  • Previous transuretheral resection of the prostate (TURP) or cryotherapy to the prostate
  • Prior hormone therapy or plans for concurrent or post treatment adjuvant hormonal therapy or chemotherapy
  • Hormone therapy to include LHRH agonist or oral anti-androgen
  • Finasteride and Dutasteride use not excluded
  • Concomitant antineoplastic therapy (including surgery, cryotherapy, conventionally fractionated radiation therapy, and chemotherapy) while on this protocol
  • History of Crohn's Disease or Ulcerative Colitis

Treatment and study plan

radiation therapy

Radiation

Patients will receive 5 fractions of radiation (you will not receive radiation therapy on two consecutive days). Each fraction size will be 7.4 Gy. The total dose will be 37 Gy. The 5 treatments will be scheduled to be delivered 2 fractions per business week (Monday through Friday). The total duration of treatment will be no shorter than 15 days and no longer than 19 days.

Primary outcomes

  1. Percentage of Patients With a Minimally Detected Decline (MDD) in Quality of Life (QOL)

    Time frame: 24 months

    To evaluate the safety of the proposed hyperfractionation regimen of 5 fractions of radiation to treat prostate cancer with guidance of radiation using the Calypso 4D Treatment System (Calypso, and to compare it to that expected from conventional treatment, which would involve 40-42 smaller radiation fractions over 8-9 weeks.

    Percentage of patients with a MDD in Quality of Life (QOL) surveys for urinary incontinence (UI), urinary obstructive (UO), bowel (BS), and sexual (SS) domains were reviewed at 6 months and 24 months.

Secondary outcomes

  1. Percentage of Patients With a PSA Nadir of <3.35 ng/ml at 12 Months

    Time frame: 1 Year

    To estimate one year prostate specific antigen (PSA)control of prostate cancer when treated with stereotactic body radiotherapy (SBRT) using continuous real-time evaluation of prostate motion.

  2. Relation Between Dose Distribution and Toxicities.

    Time frame: 5 years

    To look at the relation between dose distribution and toxicities and to determine if reconstructed delivered doses are more predictive of toxicity than planned doses.

  3. Relation Between Reconstructed Delivered Dose Distributions.

    Time frame: 5 years

    To determine the relation between reconstructed delivered dose distributions, accounting for prostate translation and rotation, and tumor control probabilities.

  4. Frequency of Required Interventions.

    Time frame: 5 years

    To assess the frequency of required interventions (interruptions) based on real-time prostate translations and rotations to verify that the proposed planning target volume(PTV) margins and action level are appropriate and practical. This will be assessed by the percentage of patients with no interventions for any fraction, the percentage of patients with 1-2 fractions interrupted and the percentage of patients with more than two fractions interrupted and the percentage of patients that had an interruption of the beam at least once for all 5 fractions.

Sponsors and collaborators

Lead sponsor

University of Michigan Rogel Cancer Center

Other

Collaborators

  • Cedars-Sinai Medical Center
  • Fox Chase Cancer Center
  • Washington University School of Medicine

Registry information

Official study title

A Study of Hypofractionated Stereotactic Body Radiation Therapy (SBRT) Using Continuous Real-time Evaluation of Prostate Motion

Important dates

Study start
2011
Primary completion
2016
Study completion
2016
First posted
Feb 2, 2011
Registry last updated
Oct 24, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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