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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06547398
Registration number
NCT06547398
Ethics application status
Date submitted
25/07/2024
Date registered
9/08/2024
Date last updated
3/10/2024
Titles & IDs
Public title
Prostate Adaptive Radiation Therapy
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Scientific title
Prostate Adaptive Radiation Therapy
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Secondary ID [1]
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Prostate ART
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prostatic Neoplasms
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Condition category
Condition code
Cancer
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Adaptive radiotherapy +/- Margin Reduction
Treatment: Other - Image guided radiotherapy
Active comparator: Adaptive radiotherapy +/- margin reduction - Phase 1 and 2: Treating Radiation Therapists (RTs) on the treatment machine will review the treatment target and organs at risk contours that are automatically generated on the plan of the day. They will modify these safely, as required, and then also approve the computer generated re-plan of the day, within the bounds of departmental protocols and decision guides (RT led).
Phase 2 only: Margin reduction facilitated by adaptive radiotherapy.
Active comparator: Standard radiotherapy - Patients will receive standard image guided radiotherapy
Treatment: Other: Adaptive radiotherapy +/- Margin Reduction
Radiotherapy using adaptive technology to recontour and replan daily as required. Reductions in the PTV margin will also be introduced in the second phase of this study.
Treatment: Other: Image guided radiotherapy
Standard radiation treatment used in the department of radiation oncology for prostate cancer
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Safety of Adaptive Radiation Therapy via Radiation Therapists-led* treatment delivery (CTV coverage)
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Assessment method [1]
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A comparison of Clinical Target Volume (CTV) dose coverage will be performed. The CTV dose coverage must be equal or better in 90% of fractions for 90% of patients compared with the virtual image guided radiotherapy (IGRT) fraction. Dose coverage will be calculated as the percent of CTV receiving at least 95% of the prescribed dose (TD).
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Timepoint [1]
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12 months
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Primary outcome [2]
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Safety of Adaptive Radiation Therapy via Radiation Therapists-led* treatment delivery (OAR DVH constraints)
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Assessment method [2]
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A comparison of organ at risk (OAR) dose-volume histogram (DVH) constraints will be performed. The OAR DVH dose constraints must be equal or better in 90% of fractions for 90% of patients compared with the virtual image guided radiotherapy (IGRT) fraction.
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Timepoint [2]
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12 months
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Primary outcome [3]
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Feasibility of ART via RT-led* treatment delivery
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Assessment method [3]
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At least 90% of patients must have 90% of planned adaptive treatments successfully delivered in phase 1 of the study.
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Timepoint [3]
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12 months
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Primary outcome [4]
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Acute patient reported toxicity
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Assessment method [4]
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The study will measure the difference in patient reported combined maximum GU and GI toxicity (Grade 2 or higher) as per PRO-CTCAE between the two treatment arms.
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Timepoint [4]
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Within 90 days of patients completing treatment
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Secondary outcome [1]
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Acute clinician reported toxicity
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Assessment method [1]
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The study will measure the difference in acute combined maximum GU and GI toxicity (Grade 2 or higher) grading between the two treatment arms as reported by clinicians using CTCAE v5.0
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Timepoint [1]
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Within 90 days of patients completing treatment
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Secondary outcome [2]
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Late clinician reported toxicity
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Assessment method [2]
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The study will measure the difference in late GU and GI toxicity (Grade 2 or higher) between the two treatment arms as reported by clinicians using CTCAE v5.0
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Timepoint [2]
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5 years
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Secondary outcome [3]
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Late patient reported toxicity
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Assessment method [3]
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The study will measure the difference in patient reported late GU and GI toxicity (Grade 2 or higher) between the two treatment arms as per PRO-CTCAE.
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Timepoint [3]
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5 years
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Secondary outcome [4]
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Biochemical progression Free Survival
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Assessment method [4]
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The rate of biochemical failure as defined as Nadir+2.0, commencement of ADT for relapse or evidence of disease recurrence on imaging
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Timepoint [4]
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3 and 5 years
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Secondary outcome [5]
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Time differences between treatment arms
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Assessment method [5]
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The study will assess the average absolute treatment time difference per fraction for adaptive radiation therapy compared to prostate IGRT.
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Timepoint [5]
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1 and 5 years
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Secondary outcome [6]
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Radiation dosimetric differences between treatment arms
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Assessment method [6]
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The study will evaluate the radiation dosimetric differences between treatment using ART and treatment using standard prostate IGRT
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Timepoint [6]
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1 and 5 years
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Secondary outcome [7]
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Patient reported attitudes and perceptions
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Assessment method [7]
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The study will assess the patient experience with radiotherapy on a five item questionnaire that uses a five-point Likert-scale (ranging from strongly disagree to strongly agree). Differences in responses for each question between the arms will be reported.
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Timepoint [7]
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1 and 5 years
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Eligibility
Key inclusion criteria
1. - Age > 18
2. Biopsy proven prostate malignancy
3. Definitive treatment is radiotherapy to the prostate alone
4. ECOG performance status 0-2
5. Ability to understand and the willingness to sign an informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Hip prosthesis
2. Patient separation from prostate centre to skin edge > 24cm, measured on diagnostic scan-
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
31/10/2024
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/10/2031
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Actual
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Sample size
Target
130
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Northern Sydney Cancer Centre, Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
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2065 - St Leonards
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Funding & Sponsors
Primary sponsor type
Other
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Name
Royal North Shore Hospital
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Northern Sydney and Central Coast Area Health Service
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Prostate ART is a two phase study looking at using adaptive radiotherapy to help reduce toxicity for prostate cancer patients. Adaptive radiotherapy is a new technology that provides the ability to account for daily changes in anatomy. Adaptive radiotherapy also provides a foundation for which radiotherapy margins might be safely reduced. Phase 1 of this study is looking to see if a radiation therapist centred adaptive workflow can be implemented. If phase 1 of this study is safe and feasible, the study will proceed to phase 2. Part 2 of the study looks at using adaptive technology to reduce radiation treatment margins. The primary aim of this study is to see whether margin reduced treatment using adaptive radiotherapy can reduce side effects for prostate cancer patients.
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Trial website
https://clinicaltrials.gov/study/NCT06547398
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Andrew Prof Kneebone, MBBS
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Address
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Northern Sydney Local Health District
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Carol Kwong
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Address
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Country
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Phone
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+61294631339
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Fax
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Email
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carolyn.kwong@health.nsw.gov.au
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Contact person for scientific queries
Data sharing statement
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT06547398
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