Radiotherapy for Prostate Cancer
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests two methods of delivering radiation therapy to men with prostate cancer to determine which causes fewer urinary and digestive side effects. One group receives a radiation boost to the entire prostate (prostate stereotactic body radiotherapy with whole gland boost), while the other group receives a boost to just the main tumor area (prostate stereotactic body radiotherapy with DIL boost). The trial seeks men with prostate adenocarcinoma who have not yet received treatment and have a specific type of lesion visible on an MRI scan. The primary goal is to identify the safer and more effective method. As a Phase 2, Phase 3 trial, this research measures treatment efficacy in an initial, smaller group and represents the final step before FDA approval, offering participants a chance to contribute to advancements in prostate cancer treatment.
Do I have to stop taking my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
In a previous study, patients who received a focused type of radiation therapy called prostate SBRT, with extra attention to the main tumor area, demonstrated that this treatment was feasible for most people. Research indicates that this method did not cause significant side effects for many patients, suggesting it is generally well-tolerated. Similarly, studies on SBRT targeting the entire prostate gland found the treatment safe and well-received by patients. Overall, both SBRT treatment methods have shown promising safety, with few reports of serious side effects.12345
Why are researchers excited about this trial's treatments?
Researchers are excited about these radiotherapy treatments for prostate cancer because they offer targeted approaches that could enhance effectiveness. Unlike traditional radiotherapy, which often treats the entire prostate gland uniformly, these methods use stereotactic body radiotherapy (SBRT) to deliver high-dose radiation precisely. Arm A focuses on boosting radiation directly to the prostate without a margin, while Arm B targets the dominant intra-prostatic lesion (DIL) with an even higher dose. This precision could potentially reduce side effects and improve outcomes, making these approaches promising advancements over existing treatments.
What evidence suggests that this trial's treatments could be effective for prostate cancer?
Research has shown that prostate stereotactic body radiotherapy (SBRT) is highly effective for treating prostate cancer. In this trial, participants will receive either a boost to the prostate alone or a boost to the dominant intra-prostatic lesion (DIL). For patients receiving extra radiation to the main tumor area within the prostate, one study found a 98.6% cure rate. This area often sees cancer recurrence, so targeting it can be crucial. For the entire prostate gland treatment with SBRT, studies have shown that about 95% of men remain cancer-free for at least five years post-treatment. Both methods have demonstrated promising results in improving survival rates and maintaining quality of life.23467
Who Is on the Research Team?
Michael Baine, MD, PhD
Principal Investigator
University of Nebraska medicine
Are You a Good Fit for This Trial?
This trial is for men age 19 or older with prostate cancer, specifically those who have a high-risk lesion seen on MRI (PI-RADS 4 or 5), a prostate gland smaller than 100 cc, and mild urinary symptoms. They must be eligible for stereotactic body radiotherapy (SBRT).Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive stereotactic body radiotherapy (SBRT) with dose escalation over 5 fractions
Follow-up
Participants are monitored for chronic genitourinary and gastrointestinal toxicities and biochemical progression-free survival
What Are the Treatments Tested in This Trial?
Interventions
- Prostate stereotactic body radiotherapy with DIL boost
- Prostate stereotactic body radiotherapy with whole gland boost
Trial Overview
The study compares two types of targeted radiation therapy: one boosts the entire prostate gland, while the other focuses extra radiation only on the main tumor area within the prostate during SBRT. Participants are randomly assigned to either group.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Participants assigned to Arm B will receive external beam radiation therapy consisting of 3625 cGy to the planning target volume (PTV), plus a boost of 4500 cGy to the dominant intra-prostatic lesion (DIL). Treatment will be delivered over 5 fractions with at least 36 hours between fractions via simultaneous integrated boost (SIB).
Participants assigned to Arm A will receive external beam radiation therapy consisting of 3625 cGy to the planning target volume (PTV), plus a boost of 4000 cGy to the clinical target volume (CTV), consisting of the prostate alone without a margin. Treatment will be delivered over 5 fractions with at least 36 hours between fractions via simultaneous integrated boost (SIB).
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Nebraska
Lead Sponsor
Citations
a dosimetric planning study | Scientific Reports
Consequently, the DIL boost with SBRT was possible in 73% of patients with DIL_40 plans, and 60% of patients with DIL_45 plans without any ...
Narrative review of focal boost to intraprostatic dominant ...
In this review, we describe and summarize clinical outcomes of previous studies, including the technological background, current status, and ...
3.
appliedradiationoncology.com
appliedradiationoncology.com/articles/stereotactic-body-radiation-therapy-with-integrated-boost-to-the-dominant-intraprostatic-nodule-initial-dosimetric-and-clinical-outcomesSBRT With Integrated Boost to the Dominant Intraprostatic ...
The motivation for a boost to the DIL has been established, as several studies have shown the DIL to be the main site of tumor recurrence in 90% ...
Toxicity and Patient-Reported Quality-of-Life Outcomes ...
In this prospective phase 2 trial, we investigated the toxicity and patient-reported quality-of-life outcomes in patients treated with stereotactic body ...
Dose Intensification to the Dominant Intraprostatic Lesion ...
A total of 50 consecutive patients were treated with prostate stereotactic body radiation therapy (SBRT), via a simultaneous integrated boost to the DIL, on a ...
Simultaneous integrated boost with stereotactic radiotherapy ...
Consequently, the DIL boost with SBRT was possible in 73% of patients with DIL_40 plans, and 60% of patients with DIL_45 plans without any ...
Stereotactic Body Radiation Therapy for High-Risk Prostate ...
Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat. Oncol. 2014, 9, 52. [Google ...
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