Actively Recruiting
Dose De-escalation in Prostate Radiotherapy Using an MR-Linac in Two Fractions
Led by The Netherlands Cancer Institute · Updated on 2026-02-06
54
Participants Needed
1
Research Sites
158 weeks
Total Duration
On this page
Sponsors
T
The Netherlands Cancer Institute
Lead Sponsor
M
MRL Consortium
Collaborating Sponsor
AI-Summary
What this Trial Is About
The goal of this clinical trial is to find out whether lowering the radiation dose to parts of the prostate without visible tumor on MRI can reduce side effects while still effectively treating prostate cancer in men with low or intermediate-risk prostate cancer. The main questions it aims to answer are: * Does reducing the radiation dose to healthy prostate tissue lower the risk of bowel and urinary side effects? * Can we maintain good cancer control by keeping a high dose for MRI-visible tumor areas? Researchers will compare two treatment approaches: * One group receives a uniform high dose to the entire prostate. * The other group receives a lower dose to healthy prostate tissue and a high dose only to visible tumor areas. Participants will: * Receive two sessions of MRI-guided radiotherapy using an MR-Linac. * Complete questionnaires about urinary, bowel, and sexual health before and after treatment. * Have follow-up visits to monitor side effects and PSA levels for up to 2 years.
CONDITIONS
Official Title
Dose De-escalation in Prostate Radiotherapy Using an MR-Linac in Two Fractions
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Men aged 6518 years
- Histological confirmation of prostate adenocarcinoma requiring radical radiotherapy
- Gleason score 3+3, 3+4 or 4+3 (ISUP Grade groups 1, 2 or 3)
- MRI-visible tumour(s) of PIRADS v2 grade 3 or higher, delineable on T2 and diffusion-weighted imaging �2b dynamic contrast-enhanced imaging, with tumour nodule �3c2.5 cm in maximal dimension and able to be boosted by treating clinician
- MRI must be performed within 3 months of trial entry
- MRI-defined lesion confirmed malignant on biopsies (any Gleason grade)
- MRI stages mT1 and T2 or mT3a with 641 mm tumour outside gland AND otherwise favourable intermediate risk characteristics
- PSA �3c20 ng/ml prior to starting androgen deprivation therapy
- WHO Performance status 0-2
- Ability to understand and willingness to sign informed consent
- Ability/willingness to comply with patient reported outcome questionnaires throughout the study
You will not qualify if you...
- Contraindications to MRI (e.g., pacemaker, potentially mobile metal implant, claustrophobia)
- IPSS Score �3e 19
- High grade disease (GG3) occult to MRI-defined lesion
- Prostate volume �3e90 cc
- Comorbidities predisposing to significant toxicity (e.g., inflammatory bowel disease) or precluding long term follow up
- Hip replacement or other pelvic metalwork causing artefact on diffusion-weighted imaging
- Previous pelvic radiotherapy
- Patients needing more than 6 months of androgen deprivation therapy due to disease parameters
- Previous invasive malignancy within last 2 years excluding certain low-risk skin and bladder cancers or small renal masses on surveillance
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 1 location
1
The Netherlands Cancer Institute
Amsterdam, Netherlands, 1066CX
Actively Recruiting
Research Team
F
Floris Pos, MD, PhD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here