Phase II study of extreme hypofractionated radiotherapy for localized prostate cancer
ISRCTN | ISRCTN19419439 |
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DOI | https://doi.org/10.1186/ISRCTN19419439 |
Secondary identifying numbers | GRS 903/A/14 |
- Submission date
- 11/07/2018
- Registration date
- 23/07/2018
- Last edited
- 06/08/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Cancer
Plain English summary of protocol
Background and study aims
Radiotherapy is a treatment where radiation is used to kill cancer cells and can be used to treat prostate cancer. The effectiveness of radiotherapy for the treatment of prostate cancer improves when high doses are delivered to the prostate, especially in aggressive, localised prostate cancer. The standard method of radiotherapy is to deliver small daily doses over the course of 8 weeks; however, as the dose increases over this time, so do the side effects.
Recent evidence shows that, instead of small doses over a longer time period, higher daily doses over a few weeks, mean that higher doses of radiotherapy can be given without increasing the side effects of the treatment, along with improving rates of curing the cancer. This has been shown in patients with low-risk and some patients with intermediate-risk prostate cancer.
We aim to look at whether similar results can be achieved for patients with intermediate-risk and high-risk prostate cancer through 8 days of high dose radiotherapy.
Who can participate?
Localised prostate cancer patients
What does the study involve?
All participants receive high dose radiotherapy on 8 days across 3 weeks, along with traditional androgen deprivation therapy. Additionally, patients will be regularly tested for toxicity, PSA levels and metastasis for 10 years following the study.
What are the possible benefits and risks of participating?
The benefits to participants of taking part include potential curing of their cancer with reduced side effects, along with an improved quality of life. Additionally, the treatment scheme is short, which is more convenient for patients. A possible risk of taking part is unexpected toxicity/side effects.
Where is the study run from?
Salamanca University Hospital, Spain
When is the study starting and how long is it expected to run for?
January 2012 to December 2022
Who is funding the study?
Castille-Leon Autonomous Community public health system (Spain)
Who is the main contact?
Dr Victor Macias-Hernandez (radiation oncologist/clinical oncologist)
victormaciash@gmail.com
Contact information
Scientific
Paseo de San Vicente
Salamanca
37007
Spain
0000-0003-2904-5715 | |
Phone | +34687481166 |
victormaciash@gmail.com |
Study information
Study design | Interventional prospective single-centre non-randomised study |
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Primary study design | Interventional |
Secondary study design | Non randomised study |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
Scientific title | Phase II single-centre trial of Extreme Hypofractionated RAdiotherapy for low, intermediate and high-risk localised Prostate cancer |
Study acronym | EHRAP |
Study objectives | Late toxicity, quality of life and biochemical-free survival outcomes after extreme hypofractionated radiotherapy for localized prostate cancer are not inferior to normofractionated or moderate hypofractionated radiotherapy |
Ethics approval(s) | The Spanish Agency of Medicines and Medical Devices (AEMPS) , 29/01/2013, PI 120413 |
Health condition(s) or problem(s) studied | Low, intermediate and highrisk prostate cancer |
Intervention | Participants with low, intermediate and high risk prostate cancer received extreme hypofractionated radiotherapy using helical tomotherapy, with online guided MVCT and an endorectal balloon. This radiotherapy delivered 8 fractions of 5.65 Gy radiation over 3 weeks. Additionally, participants received androgen deprivation therapy as usually prescribed in normal standard - for those with intermediate-risk prostate cancer, this consisted of one 6 month LHRH analogue and 1 month bicalutamide; for those with high-risk prostate cancer, this consisted of 2-3 years of 6 month LHRH analogue and 1 month bicalutamide. Patients will be interviewed at least 2, 6, 12, 18, 24, 30, 36, 48 and 60 months after radiotherapy and every year afterwards up to 10 years, and will be asked about symptoms, along with undergoing urine and blood tests and quality of life questionnaires. At each visit, the following will be tested: 1. Urinary and intestinal toxicity, if any, according to CTCAE scale 2. Health-related quality of life 3. PSA levels (from blood tests performed a few weeks before each visit). If a PSA relapse is found, a rectal examination will be performed to detect a local clinical relapse. 4. Metastases (examined through CT scans and bone scans) |
Intervention type | Procedure/Surgery |
Primary outcome measure | The following are measured at the baseline and 2, 6, 12, 18, 24, 30, 36, 48 and 60 months after radiotherapy and every year afterwards: 1. Urinal and intestinal toxicities measured using CTCAE (Common Toxicity Criteria Adverse Effects) scale 2. Health-related quality of life measured using EPIC-26 (Expanded Prostate Cancer Index Composite short form) |
Secondary outcome measures | 1. PSA relapse free survival (nadir+2 ng/ml) is measured using total PSA levels (determined through blood test performed a few weeks before visit) measured at the baseline and 2, 6, 12, 18, 24, 30, 36, 48 and 60 months after radiotherapy and every year afterwards 2. Metastases-free survival is measured using a CT scan and bone scan, evaluated at the baseline and every 6 months only after a biochemical relapse is diagnosed (PSA > 2 ng + nadir, ASTRO definition) |
Overall study start date | 01/01/2012 |
Completion date | 31/07/2023 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Male |
Target number of participants | 120 |
Key inclusion criteria | 1. cT1-T3 N0 M0 prostate cancer 2. International Prostate Symptoms Score < 21 3. No acute urinary retention or urethral surgery in the last 6 months 4. Aged 18 years or older 5. Signed specific informant consent form |
Key exclusion criteria | 1. Hip prosthesis 2. Contraindication for radical radiotherapy such as active inflamatory bowel disease, previous pelvic radiotherapy 3. Intense low urinary tract symptoms, IPSS > 20 4. Inability to understand and appreciate the nature and consequences of health decisions |
Date of first enrolment | 01/06/2013 |
Date of final enrolment | 31/12/2017 |
Locations
Countries of recruitment
- Spain
Study participating centre
Salamanca
37007
Spain
Sponsor information
Hospital/treatment centre
Paseo de San Vicente
Salamanca
37007
Spain
Phone | +34923291200 |
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vamacias@saludcastillayleon.es | |
Website | https://www.saludcastillayleon.es/CASalamanca/es |
https://ror.org/0131vfw26 |
Funders
Funder type
Not defined
No information available
No information available
Results and Publications
Intention to publish date | 01/06/2019 |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Data sharing statement to be made available at a later date |
Publication and dissemination plan | Accepted oral communication at American Society of Radiation Oncology annual meeting on october 2018. To send to a peer-review journal in 2019. Updated results with longer follow-up to be published in 2021. |
IPD sharing plan | The datasets generated and/or analysed during the current study during this study will be included in the subsequent results publication |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
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Results article | early toxicity results | 26/11/2014 | Yes | No | |
Results article | results | 01/11/2018 | Yes | No | |
Results article | 15/10/2019 | 06/08/2024 | Yes | No |
Editorial Notes
06/08/2024: Publication reference added.
05/12/2018: Publication reference added.