Focal Versus Whole Gland High Dose-Rate Brachytherapy (HDR-BT) Boost to External Beam Radiotherapy in Localized Prostate Cancer: A Phase 2 Randomized Trial

Korábbi kezelés

• Previous pelvic radiotherapy
• Recent transurethral resection of prostate (less than or equal to 6 months), previous prostatectomy or high-intensity focused ultrasound (HIFU)
• Patient is unable to lie flat long enough for the Radiation Therapy (RT) Simulation and Treatment

Más betegség

• Connective tissue disease or inflammatory bowel disease

Egyéb

• Contraindications to mpMRI
• Documented nodal or distant metastases
• Poor baseline urinary function: International Prostate Symptom Score (IPSS) greater than 19
• Patients deemed unsuitable for general anaesthetic by the Anaesthesia Department

• Histologically confirmed diagnosis of adenocarcinoma of the prostate
• Eastern Co-Operative Oncology Group (ECOG) 0-2
• Intermediate and high-risk disease with localized unfavorable features:
  • defined as clinical stage tumor cT1 or cT2a, International Society of Urological Pathology (ISUP) grade group 2-4 in less than or equal to 50% of the cores, unilateral extracapsular extension (ECE), prostate specific antigen (PSA) less than or equal to 20 ng/mL
  • corresponding to an Identified dominant intraprostatic lesion (DIL) on multiparametric magnetic resonance imaging (mpMRI) Prostate Imaging Reporting and Data System score (PI-RADs 3-5)
• Prostate volume less than or equal to 60 cc is recommended. Transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) are accepted to assess prostate volume. Patients with a prostate volume between 60 and 80 cc can be included if the International Prostate Symptom Score (IPSS) is less than 15 and brachytherapy is deemed feasible by the treating physician.