RecruitingNCT06834152

Online Adaptive Stereotactic Body Radiotherapy for Localized Prostate Cancer (X-SMILE)

Online Adaptive Stereotactic Body Radiotherapy for Localized Prostate Cancer in Patients With Lower Urinary Tract Symptoms and/or Prostate Hyperplasia (X-SMILE)


Sponsor

University of Zurich

Enrollment

75 participants

Start Date

Mar 1, 2024

Study Type

OBSERVATIONAL

Conditions

Summary

The aim of this phase II international multicenter study is to evaluate the safety, feasibility, and efficacy of CT or MRI-adaptive SBRT, delivered in five weekly fractions, in patients with newly diagnosed localized prostate cancer who have lower urinary tract symptoms and/or prostatic hyperplasia.


Eligibility

Sex: MALEMin Age: 18 Years

Inclusion Criteria4

  • histologically confirmed localized prostate cancer
  • planned treatment is SBRT according to standard of care and consists of definitive CT or MRI online adaptive SBRT of the prostate according to the PACE trial which includes a total dose to clinical target volume 1 (CTV1, i.e. prostate and proximal 1 cm of the seminal vesicle) of 40.0 Gy in 5 weekly fractions (single dose of 8.0 Gy) and total dose to planning target volume 1 (PTV1) of 37.5 Gy in 5 weekly fractions (single dose of 7.5 Gy) with a compromise for bowel sparing allowed. For patients with unfavorable intermediate to very high-risk disease (according to NCCN guidelines) a total dose to the planning target volume 2 (PTV2, i.e. proximal 1-2 cm of the seminal vesicle) of 32.5 Gy in 5 weekly fractions (single dose of 6.5 Gy) will be delivered.
  • intermediate to (very) high risk localized prostate cancer (≤ cT3a and Gleason score ≤ 9 and/or PSA ≤ 20 ng/ml)
  • prostate volume \> 60 cc and/or IPSS \> 12;

Exclusion Criteria6

  • Very high risk localized prostate cancer with indication for ADT and ARPI (i.e. Gleason ≥ 8 and cT3a)
  • Involvement of seminal vesicles (cT3b)
  • Contraindications against definitive CT or MRI-adaptive radiotherapy of the prostate, e.g. inflammatory bowel disease (IBD); previous radiotherapy in the pelvis, previous local radiotherapy of the prostate, contraindication for MRI or CT;
  • Patients with severe genitourinary symptoms (e.g. recent urinary retention ≥ grade 3 according CTCAE v.5.0);
  • Lymph node metastases or distant metastases (i.e. no localised prostate cancer);
  • Participation in a clinical trial which might influence the results of this project.

Interventions

RADIATIONradiotherapy

Patients with prostate cancer in the medium or high risk range who are planned to receive definitive CT or MRI-adaptive SBRT.


Locations(3)

Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Heidelberg

Heidelberg, Baden-Wurttemberg, Germany

Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum LMU

Munich, Bavaria, Germany

University Hospital Zurich, Department of Radio-Oncology

Zurich, Canton of Zurich, Switzerland

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NCT06834152


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