A Randomized Phase II Trial of Prostate Boost Irradiation With Stereotactic Body Radiotherapy (SBRT) or Conventional Fractionation (CF) External Beam Radiotherapy (EBRT) in Locally Advanced Prostate Cancer: The PBS Trial (NCT03380806).


Journal

Clinical genitourinary cancer
ISSN: 1938-0682
Titre abrégé: Clin Genitourin Cancer
Pays: United States
ID NLM: 101260955

Informations de publication

Date de publication:
08 2020
Historique:
received: 22 10 2019
revised: 25 12 2019
accepted: 26 12 2019
pubmed: 9 4 2020
medline: 16 6 2021
entrez: 9 4 2020
Statut: ppublish

Résumé

Standard therapy for high-risk (HR) prostate cancer (PrCa) involves androgen deprivation therapy (ADT) and pelvic conventional fractionation (CF) external beam radiotherapy (EBRT) followed by boost CF-EBRT treatment to prostate for a total of 78 to 80 Gy in 39 to 40 fractions. This is a long and inconvenient treatment for patients. Brachytherapy boost treatment studies indicate that escalation of biological dose of radiotherapy (RT) can improve outcomes in HR-PrCa. However, brachytherapy is an invasive treatment associated with increased toxicity and requires specialized resources. Stereotactic body radiotherapy (SBRT) is a promising, non-invasive alternative to brachytherapy. However, its impact on patient quality of life (QoL) and RT-associated toxicity has not been investigated in a randomized setting. In this study, we investigate SBRT as a boost treatment, following pelvic CF-EBRT, in patients with HR-PrCa treated with ADT. One hundred patients with locally advanced PrCa will be randomized to receive daily CF-EBRT of 45 to 46 Gy in 23 to 25 fractions followed by either daily CF-EBRT of 32 to 33 Gy in 15 to 16 fractions (control arm) or SBRT boost treatment of 19.5 to 21 Gy in 3 fractions (1 fraction per week) (experimental arm). The primary objective of the PBS trial is early bowel and urinary QoL (expanded prostate index composite [EPIC], up to 6 months after RT). This phase II randomized study (PBS) provides an appropriate setting to investigate effectively the impact of SBRT boost on QoL and toxicity in patients with HR-PrCa, before this modality can be compared against the current standard of care in larger phase III protocols.

Identifiants

pubmed: 32265129
pii: S1558-7673(19)30393-3
doi: 10.1016/j.clgc.2019.12.020
pii:
doi:

Types de publication

Clinical Trial, Phase II Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e410-e415

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Naghmeh Isfahanian (N)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Himanshu Lukka (H)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Ian Dayes (I)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Kimmen Quan (K)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Kara Lynne Schnarr (KL)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Georgia Douvi (G)

Department of Oncology, McMaster University, Hamilton, ON, Canada.

Mira Goldberg (M)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada.

Jim Wright (J)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Anand Swaminath (A)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada.

Tom Chow (T)

Medical Physics, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada.

Kevin Diamond (K)

Medical Physics, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada.

Jean Claude Cutz (JC)

Departments of Oncology, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.

Peter Kavsak (P)

Departments of Oncology, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.

Lehana Thabane (L)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, St Joseph's Healthcare, Hamilton, ON, Canada.

Theodoros Tsakiridis (T)

Radiation Oncology, Department of Oncology, Juravinski Cancer Center, McMaster University, Hamilton, ON, Canada; Department of Oncology, McMaster University, Hamilton, ON, Canada; Departments of Oncology, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: theos.tsakiridis@hhsc.ca.

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