Internal Radiation Therapy in Treating Patients With Prostate Cancer

Prostate Cancer Clinical Trial

Official title:

A Pilot Study of High Dose Rate Brachytherapy as Definitive Management for Intermediate Risk Prostate Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00573833
• Other study ID #: 07-120
• Secondary ID: MSKCC-07120
• Status: Completed
• Phase: N/A
• First received: December 13, 2007
• Last updated: September 19, 2017
• Start date: November 2007
• Est. completion date: September 2014

Study information

• Verified date: September 2017
• Source: Memorial Sloan Kettering Cancer Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

RATIONALE: Internal radiation therapy uses radioactive material placed directly into or near a tumor to kill tumor cells.

PURPOSE: This clinical trial is studying the side effects and how well internal radiation therapy works in treating patients with prostate cancer.

Description:

OBJECTIVES:

Primary

• To assess the feasibility of high-dose rate (HDR) brachytherapy (without the use of external-beam radiotherapy) as definitive treatment for patients with intermediate-risk prostate cancer.

• To assess acceptable toxicity, defined as treatment related toxicity (urinary and rectal), no worse than that seen by patients treated with conventional therapy (grade 3 urinary toxicity < 10% and grade 3 rectal toxicity < 10%).

Secondary

• To achieve adequate dosimetric coverage of the prostate comparable to current standards.

• To assess the effect of treatment on sexual function.

OUTLINE: Patients undergo 4 high-dose rate brachytherapy treatments over 2 days.

Patients complete bladder, bowel, sexual function, and quality of life questionnaires, including the International Index of Erectile Function (IIEF) questionnaire, the International Prostate Symptom Score Index (IPSS), and the MSKCC Prostate Quality of Life questionnaire at baseline and then at every follow-up visit.

After completion of study treatment, patients are followed every 3 months for 1 year.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 23
• Est. completion date: September 2014
• Est. primary completion date: September 2014
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years to 120 Years

Eligibility

DISEASE CHARACTERISTICS:

Inclusion criteria:

• Intermediate-risk adenocarcinoma of the prostate, defined by 1of the following criteria:

• PSA 10-20 ng/mL

• Gleason score = 7

• Stage = T2b AND < T3

• Less than 20% risk of seminal vesicle involvement or lymph node involved based upon the Kattan nomogram (pre-treatment risk with IMRT)

• Prostate size < 60 cc by MRI or CT imaging

• International Prostate Symptom Score Index = 15

Exclusion criteria:

• Evidence of definitive extracapsular extension/seminal vesicle invasion or pelvic adenopathy by MRI (endorectal coil) and DRE (digital rectal examination)

• Suspected extracapsular disease will not be considered an exclusion criteria

• PSA > 20 ng/mL

• Presence of distant metastases

PATIENT CHARACTERISTICS:

• WBC = 3,500/mm³

• Platelet count = 75,000/mm³

• Hemoglobin = 10 g/dL

• Creatinine = 1.5 mg/dL

• Liver function tests = 1.5 times normal

• INR = 2.5

• Able to complete quality of life questionnaires

• Able to give informed consent

• No active perineal infections

• No history of urethral stricture

• No prior history of pelvic malignancy

• No prior history of lymphoma disease, ulcerative colitis, or anal fissures

• No contraindications to general anesthesia

• No pacemaker

PRIOR CONCURRENT THERAPY:

• No prior transurethral resection of the prostate

• No prior pelvic radiotherapy

• No prior treatment for prostate cancer except for hormone therapy

Related Conditions & MeSH terms

• Prostate Cancer
• Prostatic Neoplasms

Intervention

Other:
• questionnaire administration

Procedure:
• quality-of-life assessment

Radiation:
• brachytherapy

Locations

Country	Name	City	State
United States	Memorial Sloan-Kettering Cancer Center	New York	New York

Sponsors (2)

Lead Sponsor	Collaborator
Memorial Sloan Kettering Cancer Center	National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Number of Participants Having an International Index of Erectile Function - Erectile Function (IIEF-EF) Domain Score Greater Than or Equal to 26 Through 12-Week Endpoint	Self-reported erectile function over the past 4 weeks. IIEF- EF is the sum of Questions 1-5 and 15 of the IIEF. Questions 1-5 are scored 0 (low/no erectile function) to 5 (high erectile function) and Question 15 is scored 1 (very low confidence) to 5 (very high confidence), for a total score ranging from 1 to 30. Higher scores represent better erectile function. Data presented are the number of participants who return to normal erectile function (IIEF-EF domain score =26)	week 12 reported
Other	Median International Prostate Symptom Total Score	Quality of life will be assessed with the MSKCC prostate quality of life instrument. International prostate symptom score index (IPSS). The IPSS index is a seven item questionnaire designed to assess urinary functioning, specifically urinary frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying, and urgency. Questions are rated on a six point Likert scale with higher scores indicating more difficulty in urinary functioning. This measure demonstrated a high internal consistency (Cronbach's alpha = 0.84) with excellent test-retest reliability (r = 0.92).	week 12 reported
Primary	Number of Patients With an Acceptable Level of Severe Toxicity as Defined at < Grade 3 CTC Toxicity	Feasibility will be defined as an acceptable level of severe toxicity (both acute and late effects), and adequate dosimetric coverage. Severe toxicity will be defined as > or = grade 3 NCI CTC toxicity	At scheduled 3 month intervals for one year
Primary	Number of Patients With an Acceptable Level of Treatment Related Urinary and Rectal Toxicity as Defined at < Grade 3 CTC Toxicity	urinary and rectal toxicity-see the adverse event tables	Within 90 days of treatment (early toxicities) or after 90 days (late toxicities)

External Links

•   Memorial Sloan Kettering Cancer Center