Hypo-fractionated Postoperative IMRT in Prostate Cancer
Primary Purpose
Prostate Cancer
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Hypo-fractionated postoperative IMRT-SIB
Sponsored by

About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring adjuvant, hypofractionation, IMRT, phase I-II, prostate neoplasms, radiotherapy
Eligibility Criteria
Inclusion Criteria:
- > 18 years
- prior radical prostatectomy with or without lymphadenectomy
- high-risk patients (positive surgical margins, and/or extracapsular extension, and/or seminal vescicle invasion, and/or probability of nodal metastasis > 7% calculated by the Roach formula after pelvic lymph node dissection with ≤ 13 nodes removed, and/or presence of any positive pelvic nodes) or patients with biochemical relapse (initial post-surgery serum PSA equal or above 0.2 ng/mL with a second confirmatory PSA of the same value)
- ECOG performance status 0-1
- adequate bone marrow function (hemoglobin concentration > 8 g/dl, white blood cell count > 3,000/ mm³, platelet count > 75,000/ mm³)
- pre-treatment computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen and pelvis
- bone scan
- informed consent
Exclusion Criteria:
- prior pelvic radiotherapy
- distant metastases
- macroscopic residual tumor
- pelvic or para-aortic nodes at re-evaluation imaging after surgery
- secondary malignancies
- genetic syndromes of hyper-radio-sensitivity
- chronic inflammatory bowel disease
- previously treated with androgen deprivation therapy
- previously treated with chemotherapy for prostate cancer
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Hypo-fractionated postoperative IMRT-SIB
Arm Description
All patients underwent combined, intensified and modulated radiotherapy for five days a week with the following doses: 62.5 Gy to the prostate bed and 45 Gy to pelvis nodes in 25 fractions.
Outcomes
Primary Outcome Measures
incidence of early treatment-emergent adverse events
adverse events after radiotherapy. Acute side effets were scored according to the Radiation Therapy Oncology Group (RTOG) scale.
Secondary Outcome Measures
Biochemical relapse free survival
Survival free from increase of PSA livel exceeding 0.2 ng/mL for those with post surgical PSA livel of 0.2 ng/mL or lower, and as two consecutive PSA increases for patients with a postsurgical PSA livel of > 0.2 ng/mL
incidence of late treatment-emergent adverse events were assessed with Radiation
Late complications were assessed with delete Radiation Morbidity Scoring Scheme of the RTOG/European Organization for Research and Treatment of Cancer (EORTC)
Full Information
NCT ID
NCT03233672
First Posted
July 26, 2017
Last Updated
March 5, 2018
Sponsor
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Collaborators
Catholic University of the Sacred Heart, University of Bologna, Howard University
1. Study Identification
Unique Protocol Identification Number
NCT03233672
Brief Title
Hypo-fractionated Postoperative IMRT in Prostate Cancer
Official Title
Hypofractionated Post-operative IMRT in Prostate Carcinoma: a Phase I/II Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
September 18, 2007 (Actual)
Primary Completion Date
September 18, 2010 (Actual)
Study Completion Date
September 18, 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Collaborators
Catholic University of the Sacred Heart, University of Bologna, Howard University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
To report the outcome of hypo-fractionated radiotherapy after radical prostatectomy (RP) for prostate cancer (PCa) using IMRT-SIB. 124 patients with PCa at high risk of relapse after RP or diagnosis of biochemical relapse were included. Patients received 62.5 Gy to the prostate bed (PB) and 45 Gy to pelvis nodes in 25 fractions. Androgen suppressive therapy was prescribed based on NCCN risk categories. Median follow-up was 30 months.
Detailed Description
To report the outcome of hypo-fractionated radiation therapy after radical prostatectomy (RP) for prostate cancer (PCa) using intensity-modulated radiation treatment with simultaneous integrated boost (IMRT-SIB).
One hundred and twenty-four patients with PCa at high risk of relapse after RP or diagnosis of biochemical relapse were included in this phase II study (adjuvant: 106 patients, salvage: 18 patients). All patients received 62.5 Gy to the prostate bed (PB) and 45 Gy to pelvis nodes in 25 fractions. Androgen suppressive therapy was prescribed based on NCCN risk categories. Acute and late toxicities were recorded and evaluated according to RTOG (Radiation Therapy Oncology Group) criteria and RTOG-EORTC (European Organization for Research and Treatment of Cancer) scale, respectively.
Median follow-up was 30 months (13-92).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
adjuvant, hypofractionation, IMRT, phase I-II, prostate neoplasms, radiotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
124 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Hypo-fractionated postoperative IMRT-SIB
Arm Type
Other
Arm Description
All patients underwent combined, intensified and modulated radiotherapy for five days a week with the following doses: 62.5 Gy to the prostate bed and 45 Gy to pelvis nodes in 25 fractions.
Intervention Type
Radiation
Intervention Name(s)
Hypo-fractionated postoperative IMRT-SIB
Intervention Description
intensity-modulated radiation treatment with simultaneous integrated boost
Primary Outcome Measure Information:
Title
incidence of early treatment-emergent adverse events
Description
adverse events after radiotherapy. Acute side effets were scored according to the Radiation Therapy Oncology Group (RTOG) scale.
Time Frame
< 90 days
Secondary Outcome Measure Information:
Title
Biochemical relapse free survival
Description
Survival free from increase of PSA livel exceeding 0.2 ng/mL for those with post surgical PSA livel of 0.2 ng/mL or lower, and as two consecutive PSA increases for patients with a postsurgical PSA livel of > 0.2 ng/mL
Time Frame
5 years
Title
incidence of late treatment-emergent adverse events were assessed with Radiation
Description
Late complications were assessed with delete Radiation Morbidity Scoring Scheme of the RTOG/European Organization for Research and Treatment of Cancer (EORTC)
Time Frame
5 years
Other Pre-specified Outcome Measures:
Title
First evidence of any pelvic recurrence
Description
First evidence of any pelvic recurrence
Time Frame
5 years
Title
Metastasis-free survival
Description
The first evidence of any extrapelvic recurrence of disease
Time Frame
5 years
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
> 18 years
prior radical prostatectomy with or without lymphadenectomy
high-risk patients (positive surgical margins, and/or extracapsular extension, and/or seminal vescicle invasion, and/or probability of nodal metastasis > 7% calculated by the Roach formula after pelvic lymph node dissection with ≤ 13 nodes removed, and/or presence of any positive pelvic nodes) or patients with biochemical relapse (initial post-surgery serum PSA equal or above 0.2 ng/mL with a second confirmatory PSA of the same value)
ECOG performance status 0-1
adequate bone marrow function (hemoglobin concentration > 8 g/dl, white blood cell count > 3,000/ mm³, platelet count > 75,000/ mm³)
pre-treatment computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen and pelvis
bone scan
informed consent
Exclusion Criteria:
prior pelvic radiotherapy
distant metastases
macroscopic residual tumor
pelvic or para-aortic nodes at re-evaluation imaging after surgery
secondary malignancies
genetic syndromes of hyper-radio-sensitivity
chronic inflammatory bowel disease
previously treated with androgen deprivation therapy
previously treated with chemotherapy for prostate cancer
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alessio G Morganti, MD
Organizational Affiliation
Radiation Oncology Center, Department of Experimental, Diagnostic and Speciality Medicine-DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
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Hypo-fractionated Postoperative IMRT in Prostate Cancer
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