Dose Escalation With SIB to Intraprostatic/Lymphatic GTV in High Risk Prostate Cancer

Phase 2 Study of High Risk Prostatae Cancer Treated With Dose-escalated Simultaneous Integrated Boost to Prostate and Lymph Node GTV

A single arm phase 2 study to study the outcome of dose-escalation with simultaneous integrated boost to intraprostatic lesion and positive lymph nodes. Prostate cancer patients with high risk of lymph node metastasis or oligo positive nodes in true pelvic area can be included. The boost volumes will be outlined by usin PET-CT and MRI data. Our hypothesis is that we will have fewer relapses in this very high risk patient group compared to matched historical controls with acceptable side effects.

Inclusion Criteria:

• Histologically confirmed high risk prostate cancer with a risk of lymphatic spread >15% according to the MSKCC nomogram (1) http://nomograms.mskcc.org/Prostate/PreTreatment.aspx
• Written informed consent
• > 18 years
• Fiducial gold markers implanted in the prostate (min 3)

Exclusion Criteria:

• • Non MR-safe implants or other contraindication to MRI

  • WHO PS>1
  • Previous pelvic irradiation
  • TURP within 6 months
  • IPSS >19
  • Metastatic disease in skeleton, parenchymal organs or lymph nodes outside the pelvis
  • Creatinin clearance < 30ml/min according to http://www.fass.se/LIF/produktfakta/kreatinin.jsp