DESTINATION2
Research type
Research Study
Full title
Dose dE-eScalaTion IN prostATe radIOtherapy usiNg the MRL in 2 fractions - a randomised trial
IRAS ID
338368
Contact name
Alison Tree
Contact email
Sponsor organisation
The Royal Marsden NHSFT
Clinicaltrials.gov Identifier
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Radiotherapy usually cures prostate cancer confined to the prostate. Ongoing advances in technology allows for greater precision of radiotherapy delivery such that higher doses of radiotherapy can now be safely delivered in fewer fractions. Prostate radiotherapy is standardly given over 20 doses of treatment, previously given over 37 doses.
Treatment over 5 doses has now been shown to be as good as 20 doses of radiotherapy for early prostate cancer. The MR-Linac combines MRI imaging with a radiotherapy delivery machine, resulting in precise alignment of the patient and allows radiotherapy to be adapted to the exact position of the prostate and the adjacent organs on each day.
Despite these advances, patients continue to experience side effects using current radiotherapy techniques which can be troublesome for some patients and affect their quality of life. These are due to the radiotherapy 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 these organs and the impact on healthy tissue.
In a bid to reduce side effects, this study will look at maintaining a high dose to the visible cancer (as seen on MRI scan and proven on biopsy) whilst reducing the dose delivered to the normal-looking 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, which we believe is adequate to eradicate microscopic disease.
The ability to deliver a lower dose of radiotherapy to the normal prostate with a high dose to the area of cancerous cells seen on MRI scan will be tested in this randomised trial, compared to giving a uniform dose to the whole prostate. Information on toxicity and cancer control will be collected.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
24/EE/0163
Date of REC Opinion
29 Aug 2024
REC opinion
Further Information Favourable Opinion