POst-Prostatectomy Ablative Radiation Therapy

NCT04831970 | Recruiting DMC

• 1 other identifier: POPART
• Study Type: observational
• Target: 30
• Locations: 1 country
• Sites: 2

Brief Summary

The use of hypofractionated radiotherapy for prostate cancer has matured to a point that in current guidelines extremely hypofractionated image-guided IMRT regimens (6 Gy per fraction or greater) can be considered an alternative to conventionally fractionated regimens at clinics with appropriate technology, physics and clinical expertise. The delivery of fewer and larger fractions with hypofractionation compared to conventional radiotherapy might effectively improve the therapeutic ratio while maintaining isoeffective tumour doses, thus, shortening overall treatment time. In the present study, patients will undergo postoperative image-guided SBRT by means of volumetric intensity-modulated arc radiotherapy (IGRT-VMAT) with state-of-the-art treatment-planning and quality assurance procedures. Normal tissue sparing and delivery accuracy are accomplished by the use of devices that ensure stability and beam location reproducibility. The primary endpoint is to evaluate the cumulative incidence of treatment related toxicities and adverse events in the acute (\< 90 days from the end of treatment) and late (\> 90 days) setting.

Conditions

Radiation Toxicity

Keywords

SBRT; adjuvant RT; salvage RT; prostatectomy; prostatic bed

Outcome Measures

Primary Outcomes (1)

• Number of participants with treatment-related adverse events as assessed by CTCAE v.5.0

  To assess treatment related acute (\< 90 days from the end of treatment) and late (\> 90 days) gastrointestinal (GI) and genitourinary (GU) toxicity in patients who undergo postoperative SBRT using CTCAE v.5.0

  60 months

Secondary Outcomes (4)

• QUALITY OF LIFE (QOL) assessed by Expanded Prostate Cancer Index Composite (EPIC-26) Questionnaire. For each domain minimum symptom score (=0) means best QOL and maximum symptom score (=12) means worst QOL

  60 months

• Number of participants with urinary incontinence assessed by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), ranging from 0 (best) to 21 (worst)

  60 months

• Number of participants with erectile dysfunction assessed by International Index of Erectile Function Questionnaire ranging from 5 (worst ) to 25 (best)

  60 months

• Number of participants with biochemical relapse assessed by PSA (cut off 0.20 ng/mL)

  60 months

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with adverse pathological features or biochemical and clinical relapse following radical prostatectomy

You may qualify if:

• Adenocarcinoma of the prostate treated with radical prostatectomy (any type of radical prostatectomy is permitted including retropubic, perineal, laparoscopic or robotically assisted; there is no time limit for the date of radical prostatectomy).
• Pathologic T3N0/Nx disease or pathologic T2N0/Nx disease, with or without a positive prostatectomy surgical margin
• Post-radical prostatectomy PSA of ≥ 0.1 - \< 2.0 ng/mL.
• Clinical local relapse assessed by Magnetic Resonance Imaging (MRI) of the pelvis
• ECOG performance status of 0-1
• No distant metastases at restaging (in case of biochemical failure), within 60 days prior to registration
• Patients can be on androgen deprivation therapy
• Ability to understand and willingness to sign a study-specific informed consent prior to study entry

You may not qualify if:

• N1 and or M1 patients
• Prior radiation of any kind to the prostate gland or pelvis
• Prior brachytherapy is not allowed
• History of inflammatory colitis or other active severe comorbidities
• Patients who are on immunosuppressant medication

Sponsors & Collaborators

• University of Milano Bicocca: lead

Study Sites (2)

Radiation Oncology, Humanitas Cancer Center (Humanitas University)

Rozzano, MI, 20089, Italy

ACTIVE NOT RECRUITING

Radiation Oncology, ASST Monza (University of Milan Bicocca)

Monza, 20900, Italy

RECRUITING

Related Publications (10)

• Morgan SC, Hoffman K, Loblaw DA, Buyyounouski MK, Patton C, Barocas D, Bentzen S, Chang M, Efstathiou J, Greany P, Halvorsen P, Koontz BF, Lawton C, Leyrer CM, Lin D, Ray M, Sandler H. Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline. J Clin Oncol. 2018 Oct 11;36(34):JCO1801097. doi: 10.1200/JCO.18.01097. Online ahead of print. No abstract available.

  PMID: 30307776 RESULT

• Kruser TJ, Jarrard DF, Graf AK, Hedican SP, Paolone DR, Wegenke JD, Liu G, Geye HM, Ritter MA. Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence. Cancer. 2011 Jun 15;117(12):2629-36. doi: 10.1002/cncr.25824. Epub 2010 Dec 14.

  PMID: 21656740 RESULT

• Bell LJ, Eade T, Hruby G, Bromley R, Kneebone A. Intra-fraction displacement of the prostate bed during post-prostatectomy radiotherapy. Radiat Oncol. 2021 Jan 22;16(1):20. doi: 10.1186/s13014-020-01743-9.

  PMID: 33482863 RESULT

• Wong GW, Palazzi-Churas KL, Jarrard DF, Paolone DR, Graf AK, Hedican SP, Wegenke JD, Ritter MA. Salvage hypofractionated radiotherapy for biochemically recurrent prostate cancer after radical prostatectomy. Int J Radiat Oncol Biol Phys. 2008 Feb 1;70(2):449-55. doi: 10.1016/j.ijrobp.2007.06.042. Epub 2007 Sep 14.

  PMID: 17869014 RESULT

• Wages NA, Sanders JC, Smith A, Wood S, Anscher MS, Varhegyi N, Krupski TL, Harris TJ, Showalter TN. Hypofractionated Postprostatectomy Radiation Therapy for Prostate Cancer to Reduce Toxicity and Improve Patient Convenience: A Phase 1/2 Trial. Int J Radiat Oncol Biol Phys. 2021 Apr 1;109(5):1254-1262. doi: 10.1016/j.ijrobp.2020.11.009. Epub 2020 Nov 21.

  PMID: 33227441 RESULT

• Ballas LK, Luo C, Chung E, Kishan AU, Shuryak I, Quinn DI, Dorff T, Jhimlee S, Chiu R, Abreu A, Jennelle R, Aron M, Groshen S. Phase 1 Trial of SBRT to the Prostate Fossa After Prostatectomy. Int J Radiat Oncol Biol Phys. 2019 May 1;104(1):50-60. doi: 10.1016/j.ijrobp.2018.12.047. Epub 2018 Dec 31.

  PMID: 30605751 RESULT

• Cuccia F, Mortellaro G, Serretta V, Valenti V, Tripoli A, Gueci M, Luca N, Lo Casto A, Ferrera G. Hypofractionated postoperative helical tomotherapy in prostate cancer: a mono-institutional report of toxicity and clinical outcomes. Cancer Manag Res. 2018 Oct 29;10:5053-5060. doi: 10.2147/CMAR.S182016. eCollection 2018.

  PMID: 30464605 RESULT

• Lewis SL, Patel P, Song H, Freedland SJ, Bynum S, Oh D, Palta M, Yoo D, Oleson J, Salama JK. Image Guided Hypofractionated Postprostatectomy Intensity Modulated Radiation Therapy for Prostate Cancer. Int J Radiat Oncol Biol Phys. 2016 Mar 1;94(3):605-11. doi: 10.1016/j.ijrobp.2015.11.025. Epub 2015 Dec 2.

  PMID: 26867889 RESULT

• Koerber SA, Katayama S, Sander A, Jaekel C, Haefner MF, Debus J, Herfarth K. Prostate bed irradiation with alternative radio-oncological approaches (PAROS) - a prospective, multicenter and randomized phase III trial. Radiat Oncol. 2019 Jul 10;14(1):122. doi: 10.1186/s13014-019-1325-x.

  PMID: 31291969 RESULT

• Lucchini R, Franzese C, Vukcaj S, Purrello G, Panizza D, Faccenda V, Andreoli S, Poli GL, Baldaccini D, Lo Faro L, Tomatis S, Cazzaniga LF, Scorsetti M, Arcangeli S. Acute Toxicity and Quality of Life in a Post-Prostatectomy Ablative Radiation Therapy (POPART) Multicentric Trial. Curr Oncol. 2022 Nov 30;29(12):9349-9356. doi: 10.3390/curroncol29120733.

  PMID: 36547147 DERIVED

MeSH Terms

Conditions

Radiation Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Officials

• Stefano Arcangeli, MD

  University of Milan Bicocca

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Stefano Arcangeli, MD

CONTACT

+39-0392333663; stefano.arcangeli@unimib.it

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: March 30, 2021
• First Posted: April 5, 2021
• Study Start: April 15, 2021
• Primary Completion: April 30, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: October 25, 2022

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: 5 years

Locations

IT (2)