Extended-Field Lymph Node Proton Irradiation for High Risk Prostate Cancer
Emory University
Summary
This phase II trial investigates whether proton radiation therapy directed to the prostate tumor, pelvic, and para-aortic lymph nodes, is an effective way to treat patients with high-risk or lymph node positive prostate cancer who are receiving radiation therapy, and if it will result in fewer gastrointestinal and genitourinary side effects. Proton beam therapy is a new type of radiotherapy that directs multiple beams of protons (positively charged subatomic particles) at the tumor target, where they deposit the bulk of their energy with essentially no residual radiation beyond the tumor. By reducing the exposure of the healthy tissues and organs to radiation in the treatment of prostate cancer, proton therapy has the potential to better spare healthy tissue and reduce the side effects of radiation therapy.
Description
PRIMARY OBJECTIVE: I. To determine the rate of acute grade 2+ gastrointestinal toxicity compared to historical photon treatments. SECONDARY OBJECTIVES: I. To determine the rate of acute grade 2+ genitourinary toxicity compared to historical photon treatments. II. To assess the feasibility of extended-field proton irradiation of high-risk prostate. III. To demonstrate safety of proton therapy followed by high dose rate (HDR) boost. IV. To determine patient-reported outcomes (PROs) of toxicity. OUTLINE: Patients undergo conventionally fractionated proton beam therapy daily on Monday-Frid…
Eligibility
- Age range
- 18+ years
- Sex
- Male
- Healthy volunteers
- No
Inclusion Criteria: * Pathologically confirmed high-risk prostate cancer fulfilling any one of the following criteria: * Gleason grade 8 or higher * cT3b (seminal vesicle involvement) or cT4 * Prostate specific antigen \[PSA\] \> 20 (or PSA \>10 if on finasteride) * Clinically or pathologically positive regional lymph nodes within the inguinal, external iliac, internal iliac, obturator, peri-rectal, pre-sacral, common iliac, or lower para-oaortc (inferior to the L2-L3 interspace) basins * Zubrod performance status 0-2 * Complete blood cell (CBC)/differential obtained within 90 days p…
Interventions
- RadiationHigh-Dose Rate Brachytherapy
Receive high-dose rate brachytherapy boost
- RadiationProton Beam Radiation Therapy
Undergo proton beam therapy
- OtherQuality-of-Life Assessment
Ancillary studies
- OtherSurvey Administration
Ancillary studies
Location
- Emory University Hospital/Winship Cancer InstituteAtlanta, Georgia