Two different types of radiotherapy, and hormone therapy for treatment of prostate cancer

SBRT boost (high doses of radiation to tumor ), IMRT (low radiation to normal tissues, optimal radiation to cancer cells), hormone therapy

a study on Prostate Cancer

Summary

Eligibility
for males ages 18 years and up (full criteria)
Location
at UC Davis
Dates
study started
estimated completion
Principal Investigator
by Richard Valicenti, MD (ucdavis)

Description

Summary

We hypothesize that Stereotactic Body Radiotherapy Boost (SBRT) as a boost to the prostate following whole pelvic intensity modulated radiotherapy (IMRT) can be delivered effectively and safely in a population of men with unfavorable intermediate and high risk localized prostate cancer. Our primary objective is to assess the feasibility and safety of a treatment strategy incorporating whole pelvic IMRT followed by an SBRT boost to the prostate with neoadjuvant, concurrent, and adjuvant androgen deprivation for a total of 28 months for men with unfavorable intermediate or high risk localized prostate cancer.

Official Title

Whole-Pelvic Radiotherapy With a Stereotactic Body Radiotherapy Boost and Long-Term Androgen Deprivation for Unfavorable-Intermediate and High Risk Localized Adenocarcinoma of the Prostate.

Details

The primary objective of this study is to assess the feasibility and safety of a treatment strategy incorporating whole pelvic IMRT followed by an SBRT boost to the prostate with neoadjuvant, concurrent, and adjuvant androgen deprivation for a total of 28 months for men with unfavorable intermediate or high risk localized prostate cancer. The secondary objective is to assess biochemical control at 24 months following the experimental treatment strategy by the "Phoenix definition". Patients not meeting these prostate-specific antigen (PSA) criteria (Phoenix Definition) for failure who undergo salvage therapies (such as androgen deprivation therapy (ADT), radical prostatectomy or brachytherapy, or Cryosurgery) should also be declared as failures at the time a positive biopsy is obtained or salvage therapy is administered, whichever comes first. Another secondary objective is to assess toxicity of the experimental treatment approach as scored by the Common Terminology Criteria for Adverse Events The third secondary objective is to assess prostate organ motion during hypofractionated radiotherapy. To assess motion of the prostate during the protracted delivery of hypofractionated radiotherapy as assessed by implanted electromagnetic transponder beacons.

Keywords

Adenocarcinoma of the Prostate Prostate Cancer Radiotherapy Androgen Deprivation Adenocarcinoma Prostatic Neoplasms Leuprolide Goserelin Bicalutamide Stereotactic Radiosurgical Boost Casodex

Eligibility

You can join if…

Open to males ages 18 years and up

  1. Pathologically (histologically or cytologically) proven diagnosis of prostatic adenocarcinoma within 180 days of registration at moderate to high risk for recurrence
  2. History/physical examination (to include at a minimum digital rectal examination of the prostate and examination of the skeletal system and abdomen) within 90 days prior to registration.
  3. Clinically negative lymph nodes as established by imaging (pelvic ± abdominal CT or MRI), (but not by nodal sampling, or dissection) within 90 days prior to registration.
  4. Patients with lymph nodes equivocal or questionable by imaging are eligible if the nodes are ≤ 2.0 cm.
  5. No evidence of bone metastases (M0) on bone scan within 90 days prior to registration.
  6. Equivocal bone scan findings are allowed if plain films (or CT or MRI) are negative for metastasis.
  7. Baseline serum PSA value performed with an FDA-approved assay (e.g., Abbott, Hybritech) within 12 weeks (90 days) prior to registration.
  8. Study entry PSA should not be obtained during the following time frames: (1) 10-day period following prostate biopsy; (2) following initiation of hormonal therapy; (3) within 30 days after discontinuation of finasteride; (4) within 90 days after discontinuation of dutasteride.
  9. Zubrod Performance Status 0-2
  10. . Complete blood count (CBC)/differential obtained within 2 weeks (14 days) prior to registration on study, with adequate bone marrow function
  11. . Patient must be able to provide study specific informed consent prior to study entry.

You CAN'T join if...

  1. Prior invasive (except non-melanoma skin cancer) malignancy unless disease-free for a minimum of 2 years.
  2. Previous radical surgery (prostatectomy) or cryosurgery for prostate cancer
  3. Previous pelvic irradiation, prostate brachytherapy, or bilateral orchiectomy
  4. Previous hormonal therapy
  5. Prior pharmacologic androgen ablation for prostate cancer is allowed only if the onset of androgen ablation is ≤ 60 days prior to the date of registration.
  6. Use of finasteride within 30 days prior to registration
  7. Use of dutasteride or dutasteride/tamsulosin (Jalyn) within 90 days prior to registration
  8. Previous or concurrent cytotoxic chemotherapy for prostate cancer; note that prior chemotherapy for a different cancer is allowable. See Section 3.2.1.
  9. Prior radiotherapy, including brachytherapy, to the region of the study cancer that would result in overlap of radiation therapy fields
  10. . Severe, active co-morbidity including heart issues, infection and liver problems
  11. . Patients who are sexually active and not willing/able to use medically acceptable forms of contraception
  12. . Prior allergic reaction to the hormones involved in this protocol
  13. . Patients status-post a negative lymph node dissection are not eligible

Location

  • UC Davis Sacramento Cancer Center Dept of Radiation Oncology accepting new patients
    Sacramento California 95817 United States

Lead Scientist at UC Cancer

  • Richard Valicenti, MD (ucdavis)
    Professor, Radiation Oncology. Authored (or co-authored) 100 research publications.

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, Davis
ID
NCT02064036
Study Type
Interventional
Last Updated