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A trial using stereotactic radiotherapy to treat prostate cancer (SPORT)
Coronavirus and cancer
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This trial is looking at whether a new targeted type of radiotherapy called SABR is a useful treatment for prostate cancer.
Some of the men taking part will have their
More about this trial
Radiotherapy, either with surgery or hormone therapy or on its own is the usual treatment for locally advanced prostate cancer. But there is still a risk of the cancer coming back or getting worse after treatment.
Doctors want to see if it is better and safer to treat the prostate gland and lymph nodes with SABR. They also want to see if this will improve the way the radiotherapy is given.
The prostate organ moves with breathing. Doctors will place markers into the prostate so that the radiotherapy can target the prostate precisely.
A type of gel called a spacer placement will also be put in at the same time above the back passage (rectum). This creates a space between the rectum and prostate to help reduce side effects.
The aims of the trial are to find out
- if it is practical to give SABR radiotherapy to treat prostate cancer
- if it is effective to treat lymph nodes with the prostate gland
- what the side effects are
Who can enter
The following bullet points list the entry conditions for this trial. Talk to your doctor or the trial team if you are unsure about any of these. They will be able to advise you.
You may be able to join this trial if all of the following apply. You
- Have a stage 3a locally advanced prostate cancer that has not spread to any lymph nodes or elsewhere in your body
- Have a PSA level of above 20ng/ml
- Have a Gleason score of 7 (4+3) or above
- Are well enough to be up and about for at least half the day (performance status 0, 1 or 2)
- Are at least 18 years old
- Are to have 1 to 3 years of hormone therapy as part of your treatment
You cannot join this trial if any of these apply. You
- Have a prostate bigger than a volume of 90cc
- Have prostate cancer that is stage T3b or higher
- Might not respond to hormone therapy (castrate resistant)
- Have any severe lower urinary tract symptoms, such as a feeling of incomplete bladder emptying, having to pass urine very often, having to pass urine suddenly, having to strain to pass urine, having to pass urine a lot at night
- Are having chemotherapy or drugs as part of a clinical trial
- Are having any surgery, or taking any drugs or treatment which may cause a problem with the hormone therapy or radiotherapy
- Have had radiotherapy to your pelvis
- Have had previous major surgery to your
- Have been diagnosed with any cancer in the last 5 years, apart from basal cell carcinoma
- Have an
- Have had both hips replaced
- Have excessive bleeding and your blood is unable to form clots
- Take medicine to help your blood clot
- Have any inflammatory bowel disease or any other long term bowel problem
- Have had any scarring in your bowel (bowel adhesions)
- Have any other serious uncontrollable disease
- Are allergic to gold
In this part the people are put into 1 of 2 treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in.
• One group have SABR radiotherapy to their prostate gland only
• The other group have SABR radiotherapy to their prostate gland and lymph nodes
You have treatment once a week for 5 weeks.
In this part everyone has SABR radiotherapy to their prostate gland and lymph nodes. You have treatment every other day (alternate days) for 2 weeks.
You have hormone therapy alongside the radiotherapy. This is usually an injection every 3 months but your doctor will discuss treatment choices with you.
You will see the doctors and have some tests before you start treatment. The tests include:
- a clinical examination of your chest and
- blood tests
- a CT scan of the area between your hip bones (pelvis)
Before you start your treatment the doctors plan your radiotherapy.
You also have fiducial markers put into your prostate and a spacer placement put above your rectum. A spacer placement is a gel which is placed above the rectum. It reduces the side effects from the radiotherapy. At the same time you have a prostate biopsy.
You have your 5 radiotherapy treatments at the hospital.
For people in the randomised part you have them once a week over a total of 29 days.
For people in the non randomised part you have your radiotherapy treatments every other day over 2 weeks.
During the treatment you:
- have a blood test before each treatment
- have a blood test the day after the first treatment
- give a urine sample after every treatment (for those in the randomised part only)
- complete a questionnaire about your symptoms at every treatment
After your radiotherapy has finished you:
- have a blood test at your follow up appointments
- give a urine sample at your follow up appointments for the first 2 years after finishing radiotherapy (for those in the randomised part only)
- complete short questionnaires about your symptoms at every visit
- consider having a second prostate biopsy after you have finished the hormone therapy
People in the non randomised part see the doctor or get a phone from the team 2 weeks after finishing treatment. This is to see how you are and if there are any side effects.
The risks from fiducial markers, spacer placement and prostate biopsy include
- blood in your urine and poo
- blood in your semen
Feelings of pain and discomfort do not last long and you should feel better after taking simple painkillers. You should stop having blood in your urine and poo after a week. You will be given 2 antibiotic tablets straight after the procedure. You carry on taking these twice a day for 5 days.
The most common side effects from radiotherapy to your prostate and pelvis include
- bladder problems which include having to pass urine more frequently and urgently, passing more urine overnight and finding blood in your urine
- bowel problems which include changes in bowel habits and bleeding from the back passage
- tiredness (fatigue)
- inability to have an erection
- skin reddening and itchiness
- swollen legs
- pubic hair loss
We have more information about side effects of radiotherapy to the prostate.
How to join a clinical trial
Dr Suneil Jain
Experimental Cancer Medicine Centre (ECMC)
Belfast Health & Social Care Trust
Friends of the Cancer Centre