Phase II Study to Evaluate the Efficacy of Intensity Modulated Radiation Therapy With Hypofractionated Radiosurgical Boosts in the Treatment of Clinically Localized Prostate Cancer
This is a phase II study designed to prospectively evaluate the efficacy and morbidity of
IMRT with CyberKnife radiosurgical boosts for clinically localized prostate cancer. Patients
with clinically localized prostate cancer will be treated with three radiosurgical
treatments (6.5 Gy per fraction to the PTV) followed by IMRT (45 Gy in 25 fractions).
Treatment will be completed over a 6-7 week period.
The hypothesis is that for patients with clinically localized adenocarcinoma of the
prostate, CyberKnife Radiosurgery delivered to the prostate is efficacious with acceptable
toxicity in combination with IMRT.
Subjects will have toxicity evaluation and AUA score on the last day of treatment. At 1
month following treatment, subjects will be assessed for acute toxicity and will fill out
AUA form, SF-12, EPIC-26, SHIM and Utilization of Sexual Rx/Devices. At 3, 6, 12, 18 and 24
month intervals (and every 6 months thereafter, through year 5, and annually through year
10, if investigators opt to continue past year 5), subjects will be seen and evaluated,
including a history, physical exam, performance status, PSA, toxicity evaluation, and AUA
score. In addition, at 6 months, 12 months and annually thereafter, the SF-12, EPIC-26, SHIM
and Utilization of Sexual Medications/Devices will be administered. A prostate biopsy will
be performed at time of biochemical or local clinical failure, and is encouraged at 2 years
following treatment and at time of distant failure. A bone scan will be performed at the
time of biochemical failure, or when the subject develops signs of symptoms suggesting
Acute side effects (≤ 90 days of treatment start) will be assessed using the NCI Toxicity
Criteria version 3.0.
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
To estimate the rate of local failure as assessed by 2 year post-radiotherapy prostate biopsies. (Studies with the CyberKnife radiosurgery would be worthwhile for prostate cancer patients if the rate of local control was > 70%)
2 years after radiotherapy.
Sean P Collins, MD,PhD
Georgetown University Hospital
United States: Institutional Review Board
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