Reduction of Gastrointestinal Toxicity in Prostate Cancer by Proton Spot Placement
Covenant Health Cancer Center
Summary
This purpose of this study is to examine the placement of proton spots during pencil beam scanning proton therapy for low and intermediate risk prostate cancer. The researchers will test a unique technique called "Spot Delete" to control the placement of spots during treatment planning. They will also use a special computer model to study how the energy of the proton beam (linear energy transfer) is related to rectal and bladder side effects. The study involves creating a treatment plan based on a CT scan, which helps guide the proton beam in the body. The clinical team uses this CT scan to find the best placement for the protons. The "Spot Delete" method prevents protons from stopping in the rectum, sigmoid, and small bowel, which is thought to be related to acute or late toxicities, such as tenesmus, diarrhea, fecal incontinence, proctitis, and rectal hemorrhage.
Description
Patients will be randomized into two groups of spot placement. In the experimental arm, "Spot Delete" will be used to prohibit proton spots from being placed in the rectum, sigmoid, and small bowel. In the control arm, proton spots are placed by the treatment planning system are not modified. Medical staff will document gastrointestinal toxicities (diarrhea, fecal incontinence, proctitis, and rectal hemorrhage) and genitourinary toxicities (hematuria, urinary incontinence, urinary retention, urinary obstruction, urinary pain, urinary frequency, and urinary urgency) in the electronic medical re…
Eligibility
- Age range
- 18+ years
- Sex
- Male
- Healthy volunteers
- No
Inclusion Criteria: * Pathological proven diagnosis of prostatic adenocarcinoma * History and physical exam to establish clinical staging * Clinical stage T1-T2c (AJCC 7th edition) * Prostate specific antigen (PSA) \< 20 ng/mL * Gleason Score ≤ 7 * Eastern Cooperative Oncology Group (ECOG) Performance status 0-1 * Patients must be 18 years of age or older * Willingness and ability to complete the International Prostate Symptom Score (IPSS) survey and Expanded Prostate Cancer Index Composite (EPIC) questionnaire Exclusion Criteria: * Prior radiotherapy to the pelvic area * Prior prostate can…
Interventions
- RadiationSpot Delete planning for proton therapy
The method of adjusting the placement of proton spots or targets that are placed by the treatment planning system during pencil beam scanning for proton therapy
- RadiationTraditional proton treatment planning system
In the control arm, the proton spots placed by the treatment planning system are not modified.
Location
- Thompson Proton CenterKnoxville, Tennessee