Trial Details

Brief Summary

This study is a single centre feasibility trial. The trial will recruit men with intermediate risk localised prostate cancer who will all receive targeted dose (escalated/de-escalated dose directed by MRI) 5 fraction SBRT to the prostate. Trial Objectives are: Primary To develop a 5 fraction de-escalated dose SBRT protocol capable of reducing side effects Secondary To assess levels of acute GU and GI toxicity (CTCAE) To assess levels of late GU and GI toxicity (CTCAE) To assess late sexual quality of life (expanded EPIC, IIEF-5) To assess biochemical relapse-free survival at 2

Official Title

A Pilot Study of Dose dE-eScalaTion IN prostATe radIOtherapy usiNg the MRL

Selection Criteria

Eligibility Inclusion Criteria

- Men aged ≥18 years
- Histological confirmation of prostate adenocarcinoma requiring radical radiotherapy
- Gleason score 3+3, 3+4 or 4+3 (Grade groups 1, 2 or 3)
- MRI stage T2 or less (as staged by AJCC TNM 2018)
- MRI-visible tumour(s) of PIRADS v2 grade 3 or higher on T2 and diffusion-weighted imaging and/or dynamic contrast-enhanced imaging (multiparametric MRI or mpMRI) with concordant pathology
- Tumour nodule visible on MRI occupying <50% of prostate on any axial slice and <50% prostate volume
- PSA <20 ng/ml prior to starting ADT (if applicable)
- Short course (< 6 months) concurrent androgen deprivation therapy (antiandrogens or LHRH analogues) allowed though not mandated as per the discretion of the treating physician.
- WHO Performance status 0-2
- Ability of the participant understand and the willingness to sign a written informed consent form.
- Ability/willingness to comply with the patient reported outcome questionnaires schedule throughout the study.

Eligibility Exclusion Criteria

- Contraindications to MRI (e.g. pacemaker, potentially mobile metal implant, claustrophobia)
IPSS 19 or higher
- High grade disease (GG3) occult to MRI-defined lesion
- Post-void residual >100 mls, where known
- Prostate volume >90cc
- Comorbidities which predispose to significant toxicity (e.g. inflammatory bowel disease) or preclude long term follow up
- Unilateral or bilateral total hip replacement, or other pelvic metalwork which causes artefact on diffusion-weighted imaging
- Previous pelvic radiotherapy
- Patients needing >6 months of ADT due to disease parameters as per the discretion of the treating physician
- Previous invasive malignancy within the last 2 years excluding basal or squamous cell carcinomas of the skin, low risk non-muscle invasive bladder cancer (assuming cystoscopic follow up now negative) or small renal masses on surveillance.