Partial Prostate Salvage High Dose Rate Brachytherapy
High Dose Rate Partial Prostate Brachytherapy as Salvage Treatment for Local Failures After Previous External Beam Radiotherapy
About This Trial
- This clinical trial is studying a targeted internal radiation treatment for men whose prostate cancer has returned after earlier radiation therapy.
- It is designed for men aged 45 and older whose cancer has come back in only one specific area of the prostate at least three years after their original treatment, with no signs of spread to other parts of the body.
- Instead of treating the entire prostate again, doctors use detailed scans to deliver high doses of radiation directly to just the area where the cancer returned.
- Before considering this study, patients should know that the treatment involves a procedure performed under anesthesia to place the temporary radiation inside the body, with the goal of controlling the cancer while sparing surrounding healthy tissue.
More Information
- A dose-response relationship for radiation in the management of prostate cancer is well established.
- Local recurrence of prostate cancer after external beam radiotherapy occurs in at least 40% of patients treated because of inability to deliver sufficient dose through external beam techniques.
- These patients respond well to re-irradiation using brachytherapy with about 50% of selected patients remaining free of recurrence 5 years after salvage.
- Advanced imaging using multiparametric Magnetic Resonance Imaging (mpMRI) allows identification of the site of recurrence, permitting partial prostate salvage brachytherapy.
- There is extensive literature on Low Dose Rate salvage brachytherapy but less on High Dose Rate.
Who Can Enroll
- Age Range: 45 years and older
- Gender: Male
- Who This Trial is For: This clinical trial is studying a targeted internal radiation treatment for men whose prostate cancer has returned after earlier radiation therapy.
Study Details
- Start Date: January 1, 2018
- Lead Sponsor: British Columbia Cancer Agency
Full Eligibility Criteria
Inclusion Criteria
- Age >45 and Life expectancy >10 years
- Previous External Beam Radiotherapy (EBRT) or LDR brachytherapy w
- > 3 year interval since EBRT or LDR Brachytherapy
- No late toxicity from prior EBRT ≥ grade 2
- PSA > nadir + 2 ng/ml and 6 months
- Radiographic evidence corresponding with site of recurrence in an under-dosed or untreated site. The recurrence should correspond to the site of original disease or be located in the seminal vesical +/- adjacent prostate as only area of recurrence (i.e. unifocal recurrence).
- Per Investigator, recurrence is suitable for implant with HDR brachytherapy and patient is suitable for procedure under anesthesia, spinal or general.
- Negative staging of the abdomen/pelvis and bones.
- Willing to provide informed consent
Exclusion Criteria
- Not compliant with criteria above
- Unable to give informed consent
Treatments
- Radiation: HDR partial prostate brachytherapy