Assessing the Potential for Reduced Toxicity Using Focal Brachytherapy in Early Stage, Low Volume Prostate Cancer

Phase II Study Assessing the Potential for Reduced Toxicity Using Focal Brachytherapy Early Stage, Low Volume in Prostate Cancer

The purpose of this study is to see what side effects a type of radiation treatment called focal brachytherapy has in treating early stage prostate cancer. The study is also looking at how useful focal brachytherapy will be in treating prostate cancer. Additionally, the investigators would like to see how this type of treatment impacts quality of life.

Inclusion Criteria:

• Men ≥ 21 years of age with a life expectancy estimated to be > 10-years.
• Diagnosis of adenocarcinoma of the prostate confirmed by MSKCC or participating site pathology review.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Prostate cancer clinical stage T1c-T2a
• PSA < 10ng/mL (this will be the PSA level prompting the prostate biopsy)
• MRI evidence of one-sided disease performed within 3 months of registration
• Prostate size <60 cc at time of treatment- if the prostate is larger, hormonal therapy is allowed to achieve the required size Screening biopsy parameters:
• Minimum of 10 biopsy cores
• Gleason grade 7 in two cores or less, with no primary Gleason grade 4 or 5 in any cores
• Unilateral cancer (only right-sided or left-sided, not bilateral)
• No more than 50 % cancer in any one biopsy core
• No more than 25 % of cores containing cancer
• Repeat transrectal or transperineal prostate biopsy that must meet the following parameters:
• Minimum of 12 biopsy cores
• Unilateral cancer (only right-sided or left-sided, not bilateral)
• Gleason grade 7 in two cores or less, with no primary Gleason grade 4 or 5 in any cores
• No more than 50 % cancer in any one biopsy core
• No more than 25 % of cores containing cancer

Subject Exclusion Criteria:

• Medically unfit for anesthesia
• Evidence or suspicion of extracapsular extension on MRI
• IPSS score > 18
• Unable to receive MRI
• Prior radiotherapy for the current disease