Proffered Presentations Archive

UK & Ireland Prostate Brachytherapy Conference 2024

Abstract number 20 

Reirradiation Options for Previously Irradiated Prostate cancer (RO-PIP): Feasibility Study Investigating Toxicity Outcomes Following Reirradiation with Stereotactic Body Radiotherapy (SBRT) vs. High Dose-Rate Brachytherapy (HDR-BT)

Jim Zhong, Ann Henry, Pam Shuttleworth, Peter Bownes
Leeds Cancer Centre 

Sarah Brown
University of Leeds 

Maria Serra
The Christie 

Purpose: Radiotherapy is the most common curative treatment for non-metastatic prostate cancer, however up to 13% of patients will develop local recurrence within 10 years. Systematic review shows that high dose rate brachytherapy (HDR-BT) and stereotactic body radiotherapy (SBRT) have the best outcomes in terms of biochemical control and side effects. The RO-PIP trial aims to determine the feasibility of recruitment to a trial randomising patients to salvage HDR-BT or SBRT and provide prospective data on patient recorded toxicity outcomes that will inform a future phase III trial. 

Methods: This study was approved by the Yorkshire and the Humber – Bradford Leeds Research Ethics Committee (Reference: 21/YH/0305) (1). The primary endpoint of the RO-PIP feasibility study is to evaluate the patient recruitment potential over 2 years to a trial randomising to either SBRT or HDR-BT for patients who develop local recurrence of prostate cancer following previous radiation therapy. The aim is to recruit 60 patients across 3 sites over 2 years and randomise 1:1 to SBRT or HDR-BT. Secondary objectives include recording clinician and patient reported outcome measures (PROMs) to evaluate treatment-related toxicity. In addition, the study aims to identify potential imaging, genomic and proteomic biomarkers that are predictive of toxicity and outcome based on hypoxia status, a prognostic marker of prostate cancer. 

Results: To date, out of 16 screened patients 8 patients have been recruited to the trial, 5 randomised to HDR-BT and 3 to SBRT. Out of the patients not recruited, 2 were not suitable for HDR-BT (1 high risk for deep vein thrombosis and 1 unfit for general anaesthetic), 5 awaiting further investigations and one did not meet inclusion criteria for biochemical recurrence. 

Conclusion: The RO-PIP study will provide data on PROMs and toxicity outcomes that will inform a future phase III trial evaluating salvage prostate radiotherapy options. 

References: 

1. Zhong J, Brown S, Serra M, Shuttleworth P, Bownes P, Thompson C, Reed R, Reeves K, Dubec M, McHugh D, Eccles C, Chuter R, Tsang YM, Taylor NJ, West C, Buckley D, Scarsbrook A, Choudhury A, Hoskin P, Henry A. Reirradiation Options for Previously Irradiated Prostate cancer (RO-PIP): Feasibility study investigating toxicity outcomes following reirradiation with stereotactic body radiotherapy (SBRT) versus high-dose-rate brachytherapy (HDR-BT). BMJ Open. 2022 Nov 8;12(11):e068580.