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NCT00214097

Phase I/II Hypofractionated Radiotherapy for Prostate Cancer

Completed Phase 1, PHASE2 Results posted Last updated 25 November 2019
What this trial tests

Phase 1, PHASE2 trial testing Radiotherapy in Prostate Cancer in 347 participants. Completed in 21 August 2017.

Timeline
14 October 2002
Primary endpoint
21 August 2017
21 August 2017

Quick facts

Lead sponsorUniversity of Wisconsin, Madison
PhasePhase 1, PHASE2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment347
Start date14 October 2002
Primary completion21 August 2017
Estimated completion21 August 2017
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Wisconsin, Madison

Who can join

18 and older, male only, with Prostate Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants Who Experience Grade 3 or Higher Acute Toxicities Primary · 90 days post radiation treatment

To evaluate acute tolerances to dose-per-fraction escalation in the treatment of prostate cancer using optimized treatment of Intensity-modulated radiation therapy (IMRT), daily rectal balloon displacement, and transabdominal ultrasound localization of the prostate. For toxicities observed within the first 10 patients at each hypofractionation level, ≥20% acute grade 3 or higher GI or genitourinary (GU) toxicity will constitute a threshold toxicity level and will dictate a decrease in frequency of treatment by one treatment per week. Maximum tolerated dose is reached if 20% of participants exp

GroupValue95% CI
Level 11
Level 21
Level 30
Number of Subjects Experiencing Grade 2 or Higher Late Rectal Toxicities at Any Time During Follow Up Primary · from 90 days post XRT through last follow-up visit (up to 3 years)

To evaluate late radiation toxicities to dose-per fraction escalation in the treatment of prostate

GroupValue95% CI
Level I14
Level II26
Level III29
Biochemical Progression-free Survival Based on PSA Surveillance Secondary · up to 15 years from enrollment

Patients will be considered to be without biochemical recurrence if either the Prostate-specific antigen (PSA) is still declining or the PSA nadir has been reached and is below 1.0ng/ml

GroupValue95% CI
Level I91.588.2 – 94.8
Level II92.790 – 95.4
Level III94.191.9 – 96.3
Fox Chase Bowel Survey at Baseline and 3 Years Secondary · Baseline and 3 years

The Fox Chase Bowel/Bladder survey was divided into two sections: Bowel (questions 1 to 14, N=14) and Bladder (questions 19, and 21 to 30, N=11). To facilitate analysis, Bowel and Bladder scores for each section were rescaled to a total score of between 0 - 100, where higher scores indicated better Quality of Life (QoL). Results for the Bowel Section are reported here.

Baseline
GroupValue95% CI
Level I90.0± 10.7
Level II88.0± 14.6
Level III86.2± 14.6
Year 3
GroupValue95% CI
Level I86.3± 11.1
Level II87.7± 11.6
Level III85.4± 14.7
Fox Chase Bladder Survey at Baseline and 3 Years Secondary · Baseline and 3 years

The Fox Chase Bowel/Bladder survey was divided into two sections: Bowel (questions 1 to 14, N=14) and Bladder (questions 19, and 21 to 30, N=11). To facilitate analysis, Bowel and Bladder scores for each section were rescaled to a total score of between 0 - 100, where higher scores indicated better Quality of Life. Results for the Bladder Section are reported here.

Baseline
GroupValue95% CI
Level I84.2± 9.4
Level II84.7± 10.1
Level III82.7± 11.3
3 years
GroupValue95% CI
Level I79.5± 13.5
Level II82.5± 10.1
Level III81.1± 12.2
International Index of Erectile Function (IIEF) Score at Baseline and 3 Years Secondary · Baseline and 3 years

The IIEF is a 15-item survey where 9-items are scored 0-5 and 6-items are scored 1-5 with a total range of 6-75. The standard scoring mechanism was used for IIEF, where the QoL items corresponded to the following domains: erectile function (score range 1-30), orgasmic function (score range 1-10), sexual desire (score range 2-10), intercourse satisfaction (score range 0-15), and overall satisfaction (score range 2-10). Higher numbers indicate increased QoL.

Baseline
GroupValue95% CI
Level I15.6± 11.7
Level II17.6± 11.7
Level III15.1± 11.1
3 years
GroupValue95% CI
Level I10.4± 10.6
Level II13.6± 11.7
Level III9.6± 8.9
Spritzer Quality of Life Index (SQLI) at Baseline and 3 Years Secondary · Baseline and 3 years

The SQLI is composed of five items (activity, daily living, health, support, outlook) scored utilizing a numerical scale of 0-2. Standard scoring was also used for the SQLI survey (total score range 0-10) where higher score indicate increased QoL.

Baseline
GroupValue95% CI
Level I9.7± 0.7
Level II9.4± 1.2
Level III9.5± 1.4
Year 3
GroupValue95% CI
Level I9.5± 1.4
Level II9.8± 0.4
Level III9.5± 1.4

Adverse events — posted to ClinicalTrials.gov

Time frame: Acute GI and GU toxicities and Late GI and GU toxicities were recorded for the duration of the study. For level 1 patients, median followup was 100 months, for level 2 patients median follow up was 85.5 months and for level 3 it was 61.7 months. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Level 1
Serious: 0/101 (0%)
Deaths: 22/101
Level 2
Serious: 0/111 (0%)
Deaths: 18/111
Level 3
Serious: 0/135 (0%)
Deaths: 20/135
Other adverse events (3 terms — click to expand)

ReactionSystemLevel 1Level 2Level 3
Late GI and GU toxicitiesRenal and urinary disorders
Acute GURenal and urinary disorders
Acute GIGastrointestinal disorders

Data from ClinicalTrials.gov NCT00214097 adverse events section.

Sponsor's own description

The purpose of this study is to examine the clinical feasibility of using Intensity-modulated radiation therapy (IMRT) combined with daily pretreatment prostate localization to deliver increasingly hypofractionated treatment courses. Progressively larger fraction sizes will be delivered in a phase I design based on both acute and long-term tolerances to the treatment. The dose-per-fraction escalation design utilizes schemas that maintain an isoeffective dose for late effects, while predicting that tumor control will actually improve. The delivery of fewer, larger fractions of radiation, if proven effective and safe, would result in significant cost saving and more efficient use of resources. Phase II will commence with Maximum Tolerated Dose (MTD) finding with up to 200 additional patients being enrolled during this phase of the study.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Quality of life outcomes from a dose-per-fraction escalation trial of hypofractionation in prostate cancer.
    Brower JV, Forman JD, Kupelian PA, Petereit DG, et al · · 2016 · cited 9× · PMID 26755165 · DOI 10.1016/j.radonc.2015.12.018
  2. A Prospective Multi-Institutional Phase I/II Trial of Step-Wise Dose-per-Fraction Escalation in Low and Intermediate Risk Prostate Cancer.
    Ritter MA, Kupelian PA, Petereit DG, Lawton CA, et al · · 2020 · cited 3× · PMID 32169590 · DOI 10.1016/j.prro.2020.02.013

Verify or expand the search:

Other trials of Radiotherapy

Trials testing the same drug.

Other recruiting trials for Prostate Cancer

Currently open trials in the same condition.

Other University of Wisconsin, Madison trials

Trials by the same sponsor.

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