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CompletedNCT03253744Updated Oct 8, 2025Results posted

Prostate SBRT for Locally Recurrent Prostate Cancer After Prior Radiotherapy

A Phase 1 interventional study of 18F-DCFPyL and Tumor Irradiation in Prostate Cancer and Prostatic Neoplasm, sponsored by National Cancer Institute (NCI). Completed at 1 site in United States. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-10-08.

Sponsored by National Cancer Institute (NCI) · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
17
Allocation
Non-randomized
Ages
18 Years and older
Sex
Male
01

Study summary

Background:

Prostate cancer is the second leading cause of cancer death in United States (U.S.) men. Radiation is an effective treatment for most patients with localized prostate cancer, but sometimes the tumor returns. Researchers want to see if a highly focused type of radiation can help. It is given in only 5 treatments. It is called stereotactic body radiation therapy (SBRT).

Objective:

To study the maximum tolerated dose and side effects of stereotactic body radiation therapy in people with a local recurrence of prostate cancer after radiation.

Eligibility:

Men at least 18 years old who have recurrent prostate cancer after radiation therapy and no evidence of distant metastatic disease.

Design:

Participants will be screened with blood tests, physical exam, and medical history. They may also have:

Magnetic resonance imaging (MRI) scan of the prostate.

Positron emission tomography (PET)/computed tomography (CT) scan. Participants will get an injection of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) for the PET scan. They will lie very still on their back on the scanner table.

Small samples of prostate tumor tissue will be taken by a needle through the skin or rectum to see if the cancer is in the prostate. Small metal seeds will be placed into the prostate at the same time to help guide the radiation.

About 2 weeks later, participants will have a radiation treatment planning CT scan.

Participants will answer questions about their urine function, bowel function, erectile function, and mood.

Participants will receive SBRT. They will have 5 radiation treatments over 2 weeks.

Participants will have follow-up visits. They will have a physical exam, blood tests, and questionnaires.

Six months after ending SBRT, the 18F-DCFPyL PET/CT will be repeated.

Participants will continue to have routine visits until two years after treatment is completed....

Read the detailed description

Background:

  • Prostate cancer that recurs after prior radiation treatment can be challenging to cure due to the side effects of available treatments such as surgery and cryoablation.
  • Re-irradiation with brachytherapy or stereotactic approaches has shown excellent rates of prostate cancer disease control with tolerable side effects.
  • Using image guidance to allow highly conformal focal re-irradiation may potentially increase the efficacy of re-irradiation.

Objectives:

-Define the maximum tolerated dose (MTD) of image guided, focally dose escalated prostate radiation with stereotactic body radiation therapy (SBRT) in patients with a local recurrence of prostate cancer after prior radiotherapy.

Eligibility:

  • Histological confirmation of recurrent prostate cancer after prior irradiation (external beam or brachytherapy)
  • No evidence of distant metastases of prostate cancer
  • No prior prostatectomy
  • Subject is greater than or equal to18 years old
  • Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2 (Karnofsky greater than or equal to 60%).

Design:

  • This is a Phase I trial of focal dose escalation with SBRT using image and pathologic guidance.
  • Areas in the prostate shown to have tumor on biopsy or with advanced imaging studies will be treated with highly conformal SBRT over a period of two to three weeks. Treatment will be guided and gated by fiducials implanted in the prostate.
  • Patients will be treated to escalating doses based on tolerability of the treatment.
  • Quality of life and functional outcomes such as urine, bowel, and erectile function will be assessed with questionnaires.
  • Up to 52 patients will be enrolled.
02

Conditions studied

  • Prostate Cancer
  • Prostatic Neoplasm

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Keywords

  • Image Guidance
  • Dose Escalation
  • Radiotherapy
  • Re-irradiation
  • Quality of Life
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • Patients must have histologically confirmed locally recurrent adenocarcinoma of the prostate after prior radiation (external beam radiation therapy (EBRT) or brachytherapy).
  • Prostate-specific antigen (PSA) failure after definitive radiation as defined by the Phoenix criteria (PSA elevation at least 2 nanograms (ng) per deciliter (dL) above post-radiotherapy nadir)
  • Age greater than or equal to 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2 (Karnofsky greater than or equal to 60%).
  • Ability of subject to understand and the willingness to sign a written informed consent document.

Exclusion criteria

EXCLUSION CRITERIA:

  • Patients who are receiving any other investigational agents.
  • PSA greater than or equal to 20 ng/dL if no prior 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) scan obtained (If PSA > 20 and 18F-DCFPyL obtained within 3 months prior to enrollment shows no evidence of metastatic disease, subjects may be included in the study)
  • Biochemical recurrence within one year of completion of radiotherapy
  • Need for chronic anticoagulation therapy (chronic low dose aspirin is not an exclusion)
  • Pre-existing and ongoing radiation-related grade 3 bowel or bladder toxicity
  • Inflammatory bowel disease
  • Active Lupus or Active scleroderma
  • Patients with distant metastatic disease (prostate adjacent adenopathy is not an exclusion)
  • Prior prostatectomy
  • Subjects with any coexisting medical or psychiatric condition that is likely to interfere with study procedures and/or results.
  • Subjects with severe claustrophobia that is unresponsive to oral anxiolytics
  • Other medical conditions deemed by the Principal Investigator (or associates) to make the subject unsafe or ineligible for protocol procedures
  • Subjects weighing > 350 lbs. (weight limit for scanner table), or unable to fit within the imaging gantry
  • Serum creatinine > 2 times the upper limit of normal
  • Total bilirubin > 2 times the upper limit of normal OR in patients with Gilbert's syndrome, a total bilirubin > 3.0.
  • Liver transaminases (alanine aminotransferase (ALT), aspartate aminotransferase (AST) greater than 3 times the upper limit of normal
  • Patients with positive Human Immunodeficiency Virus (HIV) status and currently requiring treatment with agents known to sensitize to irradiation, such as protease inhibitors.
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    Cohort 1, Level 1, Arm 1: Tumor Irradiation

    Arm 1: Tumor irradiation. Cohort 1, Level 1, Arm 1 - 40 gray (Gy) to Tumor planning target volume (PTV) Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy. External beam radiation therapy (EBRT): Participants with locally recurrent prostate cancer after treatment with EBRT. These participants cannot have had permanent brachytherapy as part of their treatment.

    Drug: 18F-DCFPyL · Radiation: Tumor Irradiation

  • Experimental
    Cohort 1, Level 2, Arm 1 - Tumor Irradiation

    Arm 1: Tumor irradiation. Cohort 1, Level 2, Arm 1 - 42.5 gray (Gy) to Tumor planning target volume (PTV) Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy; and a reduced dose will be delivered to the entire prostate. External beam radiation therapy (EBRT): Participants with locally recurrent prostate cancer after treatment with EBRT. These participants cannot have had permanent brachytherapy as part of their treatment.

    Drug: 18F-DCFPyL · Radiation: Tumor Irradiation

  • Experimental
    Cohort 2, Level 1, Arm 2 - Prostate and Tumor Irradiation

    Arm 2: Prostate and tumor irradiation Cohort 2, Level 1, Arm 2 - 30 gray (Gy) PTV to Prostate and 40 Gy to Tumor planning target volume (PTV) Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy; and a reduced dose will be delivered to the entire prostate. Brachytherapy: Participants with locally recurrent prostate cancer after treatment with brachytherapy +/- external beam radiation therapy (EBRT). These participants must have had brachytherapy as part of their treatment.

    Drug: 18F-DCFPyL · Radiation: Prostate + tumor irradiation · Radiation: Tumor Irradiation

  • Experimental
    Cohort 2, Level 2, Arm 2 - Prostate and Tumor Irradiation

    Arm 2: Prostate and tumor irradiation Arm 2 - 30 gray (Gy) planning target volume (PTV) to Prostate and 42.5 Gy to Tumor PTV Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy; and a reduced dose will be delivered to the entire prostate. Brachytherapy: Participants with locally recurrent prostate cancer after treatment with brachytherapy +/- external beam radiation therapy (EBRT). These participants must have had brachytherapy as part of their treatment.

    Drug: 18F-DCFPyL · Radiation: Prostate + tumor irradiation · Radiation: Tumor Irradiation

Interventions

  • Drug18F-DCFPyL

    Participants will receive 2-(3-{1-carboxy-5-\[(6-18F-fluoro-pyridine-3-carbonyl)-amino\]-pentyl}-ureido)-pentanedioic acid at baseline and 6 months after radiation. The maximum amount of injected active drug will be less than 4.02 micrograms. The target administered activity will be 6-6.5 mCi.

    Also known as: 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid

  • RadiationTumor Irradiation

    Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy.

    Also known as: SBRT

  • RadiationProstate + tumor irradiation

    Stereotactic body radiation therapy (SBRT) will be delivered to areas of recurrent prostate cancer identified on imaging and biopsy; and a reduced dose will be delivered to the entire prostate.

    Also known as: SBRT

  • RadiationTumor Irradiation

    External beam radiation therapy (EBRT): Participants with locally recurrent prostate cancer after treatment with EBRT. These participants cannot have had permanent brachytherapy as part of their treatment.

    Also known as: EBRT

05

What researchers measure

Primary outcomes

  1. Maximum Tolerated Dose (MTD)

    The MTD of image-guided, focally dose escalated prostate stereotactic body radiation therapy (SBRT) in participants with a local recurrence of prostate cancer after prior radiotherapy. The MTD is the dose level at which no more than 1 of up to 6 participants experience dose-limiting toxicity (DLT) during treatment and up to 3 weeks following completion of treatment, and the dose below that at which at least 2 (of .6) participants have DLT as a result of treatment. A DLT is a Grade 3 rectal, small bowel, or urinary toxicity that does not resolve to Grade 2 or less within 4 days, other Grade 3 in-field toxicities attributable to Stereotactic body radiation therapy (SBRT) that do not resolve to a Grade 2 or less within 4 days, and delays of more than one week in completing radiation treatment due to toxicity.

    Time frame: 3 weeks post-treatment

Secondary outcomes

  1. Sensitivity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer

    The sensitivity of DCF-PyL for detecting locally recurrent prostate cancer (at baseline) will be reported using biopsy as the gold standard to evaluate 18F-DCFPyL imaging as a method to detect locally recurrent prostate cancer after radiation. Sensitivity is the number of true positives divided by the sum of the number of true positives and false negatives. Lesions detected on DCF-PyL that are biopsy confirmed are considered true positives. Lesions that are not detected on DCFPyL and are biopsy positive are considered false negatives.

    Time frame: 6 months after radiation

  2. Specificity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer

    The specificity of DCF-PyL for detecting locally recurrent prostate cancer (at baseline) will be reported using biopsy as the gold standard to evaluate 18F-DCFPyL imaging as a method to detect locally recurrent prostate cancer after radiation. Specificity is the number of true negatives divided by the sum of the number of true negatives and the number of false positives. Lesions that are not detected on DCF-PyL that are biopsy confirmed to have no tumor are considered true negatives. Lesions that are detected on DCF-PyL and are biopsy negative are considered false positives.

    Time frame: 6 months after radiation

  3. Changes of Sexual Health Inventory for Men (SHIM) Quality of Life (QOL) Scores During and After Treatment

    Changes of QOL scores during and after treatment of focally dose escalated prostate stereotactic body radiation therapy (SBRT) on participant reported outcomes (Sexual Health Inventory for Men (SHIM), in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model quality of life scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The SHIM is a 5-question quiz used to identify erectile dysfunction and assess its severity. The composite score is generated by adding the score for each question. The total score can range from 1-25. Higer values represent better erectile function.

    Time frame: Baseline compared to 24 months after treatment

  4. Changes of American Urologic Association (AUA) Symptom Index Quality of Life (QOL) Scores During and After Treatment

    Changes of QOL scores during and after treatment of focally dose escalated prostate stereotactic body radiation therapy (SBRT) on participant reported outcomes, American Urologic Association (AUA) Symptom Index, in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model quality of life scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The AUA Symptom Index is a 7-question quiz used to identify urinary symptoms and assess severity. Each question is scored based on the frequency of a different urinary symptoms. The composite score is generated by adding the score for each question. The total score can range from 0-35. Lower values represent less symptoms.

    Time frame: Baseline compared to 24 months after treatment

  5. Changes of Expanded Prostate Cancer Index Composite (EPIC-26) Quality of Life (QOL) Scores During and After Treatment

    Changes of QOL scores during and after treatment on participant reported outcomes, EPIC-26 in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model QOL scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The EPIC-26 is a shortened, validated questionnaire used to assess health related QOL in individuals with prostate cancer. The EPIC-26 measures sexual function, bowel function, hormone therapy side effects, urinary incontinence, and urinary irritative symptoms. The survey has 26 individual items that have 4 to 5 response options that reflect a range of function from poor to excellent. The EPIC-26 uses a Likert scale for each item, and scores are transformed to a 0-100 scale, with higher scores indicating better Health-Related Quality of Life.

    Time frame: Baseline compared to 24 months after treatment

  6. Biochemical Progression Free Survival (bPFS)

    bPFS, prostate-specific antigen (PSA) \< 2 ng/dL above post stereotactic body radiation therapy (SBRT) nadir) at 1 and 2 years after treatment with focally dose escalated SBRT for locally recurrent prostate cancer after irradiation: bPFS will be estimated by the Kaplan-Meier survival analysis and effects of clinical variables on bPFS will be assessed by the Cox proportional hazards model. bPFS is defined as the duration of time from start of treatment to time of PSA progression or death, whichever occurs first. PSA progression (also known as biochemical failure) is defined based on elevation of PSA 2 ng/dL beyond the post-treatment nadir PSA, using the Phoenix criteria.

    Time frame: 1 and 2 years after treatment

  7. Dose Limiting Toxicities (DLT)

    DLT's of image-guided, focally dose escalated prostate Stereotactic body radiation therapy (SBRT) in participants previously treated with radiotherapy. A DLT (during treatment and within the first three weeks after treatment) is defined as a Grade 3 rectal, small bowel, or urinary toxicity that does not resolve to Grade 2 or less within 4 days with appropriate medical management. Other grade 3 in-field toxicities attributable to SBRT that do not resolve to Grade 2 or less within 4 days with appropriate medical management. Delays of more than one week in completing radiation treatment due to toxicity. Toxicities were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Grade 2 is moderate. Grade 3 is severe. Define the dose-limiting toxicities and toxicity profile of image-guided, focally dose escalated prostate SBRT in patients previously treated with radiotherapy: DLTs will be reported descriptively.

    Time frame: 3 weeks after end of treatment

Other outcomes

  1. Number of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)

    Here is the number of participants with serious and/or non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

    Time frame: Date treatment consent signed to date off study, approximately 38 months (mos) & 26 days (d) for Cohort 1, Level 1, Arm 1, 29 mos & 9 d for Cohort 1, Level 2, Arm 1, 43 mos & 12 d for Cohort 2, Level 1, Arm 1, & 26 mos & 9 d for Cohort 2, Level 2, Arm 1.

06

Results

Posted Nov 14, 2023

Participant flow

SBRT Treatment
Participant flow — SBRT Treatment
MilestoneCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
Started6236
Completed6236
Not completed0000
Completed Dose-Limiting Toxicity Assess.
Participant flow — Completed Dose-Limiting Toxicity Assess.
MilestoneCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
Started6236
Completed6236
Not completed0000
Completion of Follow-Up
Participant flow — Completion of Follow-Up
MilestoneCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
Started6236
Completed4232
Not completed2004
Withdrew: Continuing follow-up.2004

Outcome measures

PrimaryMaximum Tolerated Dose (MTD)

The MTD of image-guided, focally dose escalated prostate stereotactic body radiation therapy (SBRT) in participants with a local recurrence of prostate cancer after prior radiotherapy. The MTD is the dose level at which no more than 1 of up to 6 participants experience dose-limiting toxicity (DLT) during treatment and up to 3 weeks following completion of treatment, and the dose below that at which at least 2 (of .6) participants have DLT as a result of treatment. A DLT is a Grade 3 rectal, small bowel, or urinary toxicity that does not resolve to Grade 2 or less within 4 days, other Grade 3 in-field toxicities attributable to Stereotactic body radiation therapy (SBRT) that do not resolve to a Grade 2 or less within 4 days, and delays of more than one week in completing radiation treatment due to toxicity.

Time frame:
3 weeks post-treatment
Reported as:
Number · gray (Gy)
Maximum Tolerated Dose (MTD)
gray (Gy)All Participants in Arm 1All Participants in Arm 2
Maximum Tolerated Dose (MTD)4042.5
SecondarySensitivity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer

The sensitivity of DCF-PyL for detecting locally recurrent prostate cancer (at baseline) will be reported using biopsy as the gold standard to evaluate 18F-DCFPyL imaging as a method to detect locally recurrent prostate cancer after radiation. Sensitivity is the number of true positives divided by the sum of the number of true positives and false negatives. Lesions detected on DCF-PyL that are biopsy confirmed are considered true positives. Lesions that are not detected on DCFPyL and are biopsy positive are considered false negatives.

Time frame:
6 months after radiation
Reported as:
Number · Percent
Sensitivity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer
PercentAll Participants in Arm 1All Participants in Arm 2
Sensitivity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer95 (82 to 99)100 (88 to 100)
SecondarySpecificity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer

The specificity of DCF-PyL for detecting locally recurrent prostate cancer (at baseline) will be reported using biopsy as the gold standard to evaluate 18F-DCFPyL imaging as a method to detect locally recurrent prostate cancer after radiation. Specificity is the number of true negatives divided by the sum of the number of true negatives and the number of false positives. Lesions that are not detected on DCF-PyL that are biopsy confirmed to have no tumor are considered true negatives. Lesions that are detected on DCF-PyL and are biopsy negative are considered false positives.

Time frame:
6 months after radiation
Reported as:
Number · Percent
Specificity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer
PercentAll Participants in Arm 1All Participants in Arm 2
Specificity of 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-Amino]-Pentyl}-Ureido)-Pentanedioic Acid (18F-DCFPyL) Imaging as Compared to Biopsy in Detecting Locally Recurrent Prostate Cancer100 (96 to 100)100 (96 to 100)
SecondaryChanges of Sexual Health Inventory for Men (SHIM) Quality of Life (QOL) Scores During and After Treatment

Changes of QOL scores during and after treatment of focally dose escalated prostate stereotactic body radiation therapy (SBRT) on participant reported outcomes (Sexual Health Inventory for Men (SHIM), in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model quality of life scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The SHIM is a 5-question quiz used to identify erectile dysfunction and assess its severity. The composite score is generated by adding the score for each question. The total score can range from 1-25. Higer values represent better erectile function.

Time frame:
Baseline compared to 24 months after treatment
Reported as:
Mean · Scores on a scale
Changes of Sexual Health Inventory for Men (SHIM) Quality of Life (QOL) Scores During and After Treatment
Scores on a scaleAll Participants in Arm 1All Participants in Arm 2
Baseline7.25 ± 8.3614.33 ± 10.44
After treatment5.75 ± 7.616.71 ± 9.10
SecondaryChanges of American Urologic Association (AUA) Symptom Index Quality of Life (QOL) Scores During and After Treatment

Changes of QOL scores during and after treatment of focally dose escalated prostate stereotactic body radiation therapy (SBRT) on participant reported outcomes, American Urologic Association (AUA) Symptom Index, in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model quality of life scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The AUA Symptom Index is a 7-question quiz used to identify urinary symptoms and assess severity. Each question is scored based on the frequency of a different urinary symptoms. The composite score is generated by adding the score for each question. The total score can range from 0-35. Lower values represent less symptoms.

Time frame:
Baseline compared to 24 months after treatment
Reported as:
Mean · Scores on a scale
Changes of American Urologic Association (AUA) Symptom Index Quality of Life (QOL) Scores During and After Treatment
Scores on a scaleAll Participants in Arm 1All Participants in Arm 2
Baseline5.75 ± 5.488.77 ± 6.53
After treatment11.86 ± 9.568.14 ± 3.98
SecondaryChanges of Expanded Prostate Cancer Index Composite (EPIC-26) Quality of Life (QOL) Scores During and After Treatment

Changes of QOL scores during and after treatment on participant reported outcomes, EPIC-26 in participants previously treated with radiotherapy. The QOL scores will be summarized at baseline and for each visit. Linear mixed effects model will be used to model QOL scores at baseline and during and after treatment in which random intercept and random slope are used to account for participant-specific trajectory of QOL scores. The EPIC-26 is a shortened, validated questionnaire used to assess health related QOL in individuals with prostate cancer. The EPIC-26 measures sexual function, bowel function, hormone therapy side effects, urinary incontinence, and urinary irritative symptoms. The survey has 26 individual items that have 4 to 5 response options that reflect a range of function from poor to excellent. The EPIC-26 uses a Likert scale for each item, and scores are transformed to a 0-100 scale, with higher scores indicating better Health-Related Quality of Life.

Time frame:
Baseline compared to 24 months after treatment
Reported as:
Mean · Scores on a scale
Changes of Expanded Prostate Cancer Index Composite (EPIC-26) Quality of Life (QOL) Scores During and After Treatment
Scores on a scaleAll Participants in Arm 1All Participants in Arm 2
Baseline93.75 ± 11.5775.00 ± 25.00
After treatment82.14 ± 27.8271.43 ± 22.49
SecondaryBiochemical Progression Free Survival (bPFS)

bPFS, prostate-specific antigen (PSA) \< 2 ng/dL above post stereotactic body radiation therapy (SBRT) nadir) at 1 and 2 years after treatment with focally dose escalated SBRT for locally recurrent prostate cancer after irradiation: bPFS will be estimated by the Kaplan-Meier survival analysis and effects of clinical variables on bPFS will be assessed by the Cox proportional hazards model. bPFS is defined as the duration of time from start of treatment to time of PSA progression or death, whichever occurs first. PSA progression (also known as biochemical failure) is defined based on elevation of PSA 2 ng/dL beyond the post-treatment nadir PSA, using the Phoenix criteria.

Time frame:
1 and 2 years after treatment
Reported as:
Number · percentage of participants
Biochemical Progression Free Survival (bPFS)
percentage of participantsAll Participants in Arm 1All Participants in Arm 2
1 year after treatment100100
2 years after treatment87.5100
SecondaryDose Limiting Toxicities (DLT)

DLT's of image-guided, focally dose escalated prostate Stereotactic body radiation therapy (SBRT) in participants previously treated with radiotherapy. A DLT (during treatment and within the first three weeks after treatment) is defined as a Grade 3 rectal, small bowel, or urinary toxicity that does not resolve to Grade 2 or less within 4 days with appropriate medical management. Other grade 3 in-field toxicities attributable to SBRT that do not resolve to Grade 2 or less within 4 days with appropriate medical management. Delays of more than one week in completing radiation treatment due to toxicity. Toxicities were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Grade 2 is moderate. Grade 3 is severe. Define the dose-limiting toxicities and toxicity profile of image-guided, focally dose escalated prostate SBRT in patients previously treated with radiotherapy: DLTs will be reported descriptively.

Time frame:
3 weeks after end of treatment
Reported as:
Number · toxicities
Dose Limiting Toxicities (DLT)
toxicitiesAll Participants in Arm 1All Participants in Arm 2
Grade 3 Cystitis non-infective10
Grade 3 Urinary incontinence10
Other pre-specifiedNumber of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)

Here is the number of participants with serious and/or non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

Time frame:
Date treatment consent signed to date off study, approximately 38 months (mos) & 26 days (d) for Cohort 1, Level 1, Arm 1, 29 mos & 9 d for Cohort 1, Level 2, Arm 1, 43 mos & 12 d for Cohort 2, Level 1, Arm 1, & 26 mos & 9 d for Cohort 2, Level 2, Arm 1.
Reported as:
Count of participants · Participants
Number of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)
ParticipantsCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
Number of Participants With Serious and/or Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)6236

Adverse events

Collected over Date treatment consent signed to date off study, approximately 38 months and 26 days for Cohort 1, Level 1, Arm 1, 29 months and 9 days for Cohort 1, Level 2, Arm 1, 43 months and 12 days for Cohort 2, Level 1, Arm 1, and 26 months and 9 days for Cohort 2, Level 2, Arm 1.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and Tumor0/6 (0%)0/6 (0%)6/6 (100%)
Cohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor Irradiation0/2 (0%)1/2 (50%)2/2 (100%)
Cohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor Irradiation0/3 (0%)0/3 (0%)3/3 (100%)
Cohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation0/6 (0%)0/6 (0%)6/6 (100%)
Most frequent serious events
Most frequent serious events
EventCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
HematuriaRenal and urinary disorders0/61/20/30/6
Most frequent other events
Showing 10 of 60
Most frequent other events
EventCohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor Irradiation
Urinary incontinenceRenal and urinary disorders0/62/21/33/6
Cystitis noninfectiveRenal and urinary disorders2/61/21/35/6
DiarrheaGastrointestinal disorders0/60/22/33/6
FatigueGeneral disorders3/61/20/34/6
Fecal incontinenceGastrointestinal disorders0/60/22/30/6
Urinary frequencyRenal and urinary disorders1/60/21/34/6
Urinary tract obstructionRenal and urinary disorders0/60/22/31/6
Urinary tract painRenal and urinary disorders2/61/22/31/6
Anal painGastrointestinal disorders1/61/20/30/6
AnemiaBlood and lymphatic system disorders1/61/20/30/6

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
<=18 years00000
Between 18 and 65 years10023
>=65 years523414
Age, Continuous
Age, Continuous(years)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
Mean71.02 ± 5.6578.3 ± 5.6672.7 ± 4.1765.95 ± 4.5170.38 ± 6.07
Sex: Female, Male
Sex: Female, Male(Participants)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
Female00000
Male623617
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
Hispanic or Latino00000
Not Hispanic or Latino623617
Unknown or Not Reported00000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
American Indian or Alaska Native00000
Asian00000
Native Hawaiian or Other Pacific Islander00000
Black or African American40015
White223512
More than one race00000
Unknown or Not Reported00000
Region of Enrollment
Region of Enrollment(participants)Cohort 1, Level 1, Arm 1: 40 Gray (Gy) Tumor Irradiation Prostate and TumorCohort 1, Level 2, Arm 1 - 42.5 Gray (Gy) Tumor IrradiationCohort 2, Level 1, Arm 2 - 30 Gray (Gy) and 40 Gy Prostate and Tumor IrradiationCohort 2, Level 2, Arm 2 - 30 Gray (Gy) and 42.5 Gy Prostate and Tumor IrradiationTotal
United States623617
07

Study locations

1 site
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
08

References and documents

Publications

  • Patel KR, Rydzewski NR, Schott E, Cooley-Zgela T, Ning H, Cheng J, Salerno K, Huang EP, Lindenberg L, Mena E, Choyke P, Turkbey B, Citrin DE. A Phase 1 Trial of Salvage Stereotactic Body Radiation Therapy for Radiorecurrent Prostate Cancer After Brachytherapy. Int J Radiat Oncol Biol Phys. 2024 Aug 1;119(5):1471-1480. doi: 10.1016/j.ijrobp.2024.02.014. Epub 2024 Feb 29. PubMed 38428681 ↗

Study documents

  • Protocol and statistical analysis plan · May 24, 2023
  • Informed consent form · May 26, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — All individual participant data (IPD) recorded in the medical record will be shared with intramural investigators upon request. In addition, all large-scale genomic sequencing data will be shared with subscribers to the database of Genotypes and Phenotypes (dbGaP).

Supporting information: Study protocol, Sap, Icf

09

Registry details

Key details

Study ID
NCT03253744
Lead sponsor
National Cancer Institute (NCI)
Responsible party
Deborah Citrin, M.D. (Principal Investigator, National Cancer Institute (NCI)) — Principal investigator
First posted
Aug 18, 2017
Start date
Jul 5, 2018
Primary completion
May 3, 2023
Completion
Jan 30, 2025
Results posted
Nov 14, 2023
Last update
Oct 8, 2025

Study contacts

Deborah E Citrin, M.D.
principal investigator · National Cancer Institute (NCI)

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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