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Adenocarcinoma of ProstateNCT01913717

Short-term High Precision Radiotherapy for Early Prostate Cancer With Concomitant Boost on the Dominant Lesion

A study testing External beam radiotherapy in people with Adenocarcinoma of Prostate, run by European Institute of Oncology at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The present research project aims to improve the current treatment for prostate-confined tumor, evaluating the safety and feasibility of a very short hypofractionated radiotherapy schedule administered with one of the best available dose delivery systems. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Adenocarcinoma of Prostate
What is being tested?
External beam radiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
65 participants
Where
1 siteItaly
Study dates
Jan 2014to 1 Jul 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed adenocarcinoma of prostate, including the following 2011 National Comprehensive Cancer Network (NCCN) risk categories: very low (T1c PSA <10 ng/ml, Gleason score <7, fewer than 3 positive biopsy cores, <50% cancer in each core, PSA density <0.15 ng/ml) or low (T1-T2a, PSA <10 ng/ml, Gleason score <7) or intermediate (T2b or T2c, PSA between 10 and 20 ng/ml, Gleason score of 7)
  • cN0 and cM0 stage
  • Age > 18 years
  • Good performance status (ECOG< 2),
  • No previous pelvic radiotherapy
  • No previous prostatectomy
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  • No hormonal treatment (neoadjuvant or concomitant)
  • No concomitant bowel inflammatory disease or other serious comorbidities
  • Good urinary flow (peak flow > 10 ml/s)
  • No previous invasive cancer (within 5 years before the prostate cancer diagnosis) apart from non-melanoma skin malignancies.

Who cannot join

  • Extraprostatic tumor extension (T3) or locally advanced disease (T4)
  • Pelvic lymph node metastasis (N1)
  • Distant metastasis (M1)
  • Urinary obstructive symptoms (IPSS > 20)
  • Previous pelvic radiotherapy
  • Severe systemic disorders
Show all 10Show fewer
  • Concomitant disorders including: chronic urinary or intestinal inflammatory conditions (for example, ulcerous recto-colitis, Crohn disease), anti-coagulant treatment (warfarin, heparin)
  • Previous malignancy except for skin non-melanoma cancer or 3-year disease free interval from previous malignancy like in situ cervix cancer or non muscle invasive bladder cancer
  • Non conformity of the radiotherapy dose distribution when compared to the dose constraints
  • Psychiatric disorders or any other condition that can can make unreliable the informed consent

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • European Institute of Oncology

    Milan

Other trials in Italy

About this study

The present research project aims to improve the current treatment for prostate-confined tumor, evaluating the safety and feasibility of a very short hypofractionated radiotherapy schedule administered with one of the best available dose delivery systems. The study will include 2 sub-studies (in-silica and clinical study) and 4 tasks.

Read the detailed description

Approximately 70% of men with newly diagnosed prostate cancer feature organ-confined disease. Conventional treatment options for prostate-confined cancer include radical prostatectomy, external beam radiation therapy, brachytherapy and active surveillance. All currently available treatments have comparable toxicity risk and high social and economic impact, hence the best treatment option has not been defined yet. In the radiation oncology field the gold standard for prostate cancer management is 7-8 weeks intensity modulated radiotherapy (IMRT), which can be delivered with the latest generation of accelerators providing modulated arc delivery (eg. RapidArc™, Varian) or with newly developed machines such as the Vero system (BrainLab AG - Mitsubishi Heavy Industries Ltd). The present research project aims to improve the current treatment for prostate confined tumor, evaluating the best strategy to deliver a very-short hypofractionated radiotherapy scheme. In the first part of this AIRC grant an in-silica study will be performed on 10 test prostate cancer patients, with comparative competitive treatment plans with the state of the art treatment options for prostate cancer: the Vero system, the RapidArc system, the Cyberknife (all available at the European Institute of Oncology IEO, Milan, Italy), and protontherapy (available at the Centre of Adrotherapy, in Pavia, Italy). This dosimetric comparison will be performed in order to define the technique that provides the maximum target coverage with the minimum dose to the surrounding organs at risk (OARs) to be used to perform the clinical trial that will follow within this AIRC grant. After performing the in-silica study, 65 newly diagnosed prostate cancer patients with 2011 National Comprehensive Cancer Network (NCCN) risk category ranging from very low to intermediate but not undergoing hormonal treatment, will be consecutively enrolled in a prospective phase II trial. The patients will be treated at the Division of Radiation Oncology of the IEO, with the dose delivery system that will result most fit at the in-silica study. Simultaneous Integrated Boost (SIB) technique will be applied to deliver a total dose of 36.25 Gy in 5 fractions (over 10 days) to the whole prostate (7.25 Gy/fraction) and 37.5 Gy to the dominant intraprostatic lesion DIL (7.5 Gy/fraction), profiting of the high sensibility of prostate cancer to high dose/fraction. Several strategies will be applied in order to reduce the dose to the surrounding OARs. In order to define the localization of the DIL, multiparametic magnetic resonance imaging (MRI) of the pelvis will be performed (with spectroscopy, diffusion weighted and perfusion acquisitions), and fused with computed tomography (CT) scan. In-room image-guidance will be applied at each treatment section, in order to minimize uncertainties in intra and inter-fraction prostate localization. At the end of the radiotherapy course, each patient will be followed-up, in order to assess the treatment safety and effectiveness in terms of early and late toxicity, and tumor control. A sampling from the prostate tumor tissue for biological study will be taken for microarray analysis. The expression of specific markers of radiosensitivity and radioresistance will be investigated.

Being tested
External beam radiotherapy
Keywords
Prostate cancer, Radiotherapy, hypofractionated radiotherapy
Medical subject headings
Prostatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • External beam radiotherapyRadiation

    Also called hypofractionated radiotherapy

    The patients will be treated with extreme hypofractionated radiotherapy with the dose delivery system that will result most fit at the in-silica study. Simultaneous Integrated Boost (SIB) technique will be applied to deliver a total dose of 36.25 Gy in 5 fractions (over 10 days) to the whole prostate (7.25 Gy/fraction) and 37.5 Gy to the dominant intraprostatic lesion DIL (7.5 Gy/fraction), profiting of the high sensibility of prostate cancer to high dose/fraction. Several strategies will be applied in order to reduce the dose to the surrounding organs at risk.

Study groups in NCT01913717
Study groupRoleWhat they receive
External beam radiotherapyExperimentalExternal beam radiotherapy
Receives: Radiation: External beam radiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Acute toxicity

    The primary outcome is the acute toxicity according to the validated scale Radiotherapy Oncology Group / European Organization for Research and Treatment of Cancer (RTOG / EORTC). It will measure the proportion of patients who experience at least one event of acute toxicity of grade 3 or 4 according to the scale RTOG / EORTC) as the maximum value of toxicity during radiation treatment or within one month after the completion of radiotherapy.

    Measured: one month after radiotherapy

Secondary outcomes (2)
  1. late toxicity

    late toxicity according to Scala CTCAE v4.0 toxicity criteria and scale RTOG / EORTC

    Measured: 2 years

  2. efficacy of treatment

    assessed in terms of

    • biochemical progression free survival (biochemical relapse, i.e. rising PSA)
    • pattern of relapse
    • clinical progression free survival (including local or distant recurrence)
    • overall survival

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Aug 2013 (estimated)
  2. Study startJan 2014
  3. Primary completion1 Jul 2017
  4. Study completion1 Jul 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
65 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01913717
Sponsor's protocol ID
IEO S768/113
Other IDs
2012-IG133218
Status last verified
Jun 2023
First submitted
30 Jul 2013
Last updated
28 Jun 2023
Results posted
No
Data monitoring committee
No

Publications

  • Corrao G, Marvaso G, Zaffaroni M, Volpe S, Augugliaro M, Fodor CI, Zerini D, Vingiani A, Mistretta FA, Luzzago S, Alessi S, Pricolo P, Musi G, De Cobelli O, Renne G, Manzoni M, Petralia G, Orecchia R, Jereczek-Fossa BA. Correlation between radiological and biological features and clinical outcomes in early prostate cancer: an exploratory subgroup analysis. Neoplasma. 2022 Mar;69(2):404-411. doi: 10.4149/neo_2021_210622N828. Epub 2022 Jan 12.

    PubMed 35014537
  • Marvaso G, Ciardo D, Gandini S, Riva G, Frigo E, Volpe S, Fodor C, Zerini D, Rojas DP, Comi S, Cambria R, Cattani F, Musi G, De Cobelli O, Orecchia R, Jereczek-Fossa BA. Comparison of Outcomes and Toxicity Between Extreme and Moderate Radiation Therapy Hypofractionation in Localized Prostate Cancer: A Propensity Score Analysis. Int J Radiat Oncol Biol Phys. 2019 Nov 15;105(4):735-744. doi: 10.1016/j.ijrobp.2019.07.027. Epub 2019 Aug 1.

    PubMed 31377161
  • Cremonesi M, Garibaldi C, Timmerman R, Ferrari M, Ronchi S, Grana CM, Travaini L, Gilardi L, Starzynska A, Ciardo D, Orecchia R, Jereczek-Fossa BA, Leonardi MC. Interim 18F-FDG-PET/CT during chemo-radiotherapy in the management of oesophageal cancer patients. A systematic review. Radiother Oncol. 2017 Nov;125(2):200-212. doi: 10.1016/j.radonc.2017.09.022. Epub 2017 Oct 10.

    PubMed 29029833
  • Garibaldi C, Ronchi S, Cremonesi M, Gilardi L, Travaini L, Ferrari M, Alterio D, Kaanders JHAM, Ciardo D, Orecchia R, Jereczek-Fossa BA, Grana CM. Interim 18F-FDG PET/CT During Chemoradiation Therapy in the Management of Head and Neck Cancer Patients: A Systematic Review. Int J Radiat Oncol Biol Phys. 2017 Jul 1;98(3):555-573. doi: 10.1016/j.ijrobp.2017.02.217. Epub 2017 Mar 4.

    PubMed 28581396
  • Jereczek-Fossa BA, Fanetti G, Fodor C, Ciardo D, Santoro L, Francia CM, Muto M, Surgo A, Zerini D, Marvaso G, Timon G, Romanelli P, Rondi E, Comi S, Cattani F, Golino F, Mazza S, Matei DV, Ferro M, Musi G, Nole F, de Cobelli O, Ost P, Orecchia R. Salvage Stereotactic Body Radiotherapy for Isolated Lymph Node Recurrent Prostate Cancer: Single Institution Series of 94 Consecutive Patients and 124 Lymph Nodes. Clin Genitourin Cancer. 2017 Aug;15(4):e623-e632. doi: 10.1016/j.clgc.2017.01.004. Epub 2017 Jan 11.

    PubMed 28185875
  • Timon G, Ciardo D, Bazani A, Garioni M, Maestri D, De Lorenzo D, Pansini F, Cambria R, Rondi E, Cattani F, Marvaso G, Zerini D, Vischioni B, Ciocca M, Russo S, Molinelli S, Golino F, Scroffi V, Rojas DP, Fodor C, Petralia G, Santoro L, De Cobelli O, Orecchia R, Jereczek-Fossa BA. Rationale and protocol of AIRC IG-13218, short-term radiotherapy for early prostate cancer with concomitant boost to the dominant lesion. Tumori. 2016 Oct 13;102(5):536-540. doi: 10.5301/tj.5000547. Epub 2016 Aug 5.

    PubMed 27514314

Questions about this trial

What is this clinical trial studying?

A study testing External beam radiotherapy in people with Adenocarcinoma of Prostate, run by European Institute of Oncology at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acute toxicity (time frame: one month after radiotherapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01913717, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2023.

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