DESTINATION Dose dE-eScalaTion IN prostATe radIOtherapy usiNg the MRL
Research type
Research Study
Full title
DESTINATION-MRL A phase II study of Dose dE-eScalaTion IN prostATe radIOtherapy usiNg the MRL
IRAS ID
317448
Contact name
Alison Tree
Contact email
Sponsor organisation
The Royal Marsden NHSFT
Clinicaltrials.gov Identifier
Duration of Study in the UK
4 years, 0 months, 3 days
Research summary
Radiotherapy can cure men with prostate cancer confined to the prostate. Due to the improvements in radiotherapy delivery higher doses of radiotherapy can be given in a single treatment. Prostate radiotherapy is now given over 20 doses of treatment as standard, previously given over 37 doses.
Ongoing advances in technology allow delivery of radiotherapy with much greater precision than was previously seen and iin some countries it is now standard to give 5 treatments over 1-2 weeks using Stereotactic body radiotherapy (SBRT). This mode of treatment is being adopted in more and more centers worldwide. The MR-Linac combines detailed MR imaging with a radiotherapy delivery machine, which results in precise alignment of the patient and allows the radiotherapy to be adapted to the exact position of the prostate and the adjacent organs on each treatment day.
Despite these advances, patients continue to experience side effects from radiotherapy which can affect their quality of life. These are inevitable with current techniques due to the radiotherapy which is received by the surrounding organs (bladder, bowel, urethra and nerves). Unless the dose to the prostate is reduced it is impossible to significantly reduce the dose to the adjacent organs and thereby reduce effects on the healthy tissue.
In a bid to reduce side effects, this study will look at giving a high dose to the visible cancer (as seen on MRI scan and proven on prostate biopsy) and reducing the dose delivered to the normal prostate. It is possible that the normal looking prostate contains some non-visible cancerous cells and therefore the whole prostate will still receive a moderate dose of radiotherapy.
The ability to deliver a lower dose of radiotherapy to the normal prostate with a high dose to the area of cancerous cells as seen on the MRI scan will be tested. Information on toxicity and cancer control will also be collected
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
22/EM/0253
Date of REC Opinion
7 Dec 2022
REC opinion
Further Information Favourable Opinion