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Trial registered on ANZCTR
Registration number
ACTRN12625000224426p
Ethics application status
Submitted, not yet approved
Date submitted
29/01/2025
Date registered
28/03/2025
Date last updated
28/03/2025
Date data sharing statement initially provided
28/03/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Salvage sTereotactic Ablative radiotherapy for Recurrent prostate
cancer With Androgen suppression and Rectal Spacer (STARWARS)
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Scientific title
Salvage sTereotactic Ablative radiotherapy for patients with Recurrent prostate cancer With Androgen suppression and Rectal Spacer, assessing toxicity and quality of life
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Secondary ID [1]
313766
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None
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Universal Trial Number (UTN)
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Trial acronym
STARWARS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
prostate cancer
336379
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Condition category
Condition code
Cancer
332903
332903
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0
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will receive salvage reirradiation Stereotactic Ablative Radiotherapy (SABR) to the prostate, 35Gy in 5 fractions, one fraction per week, with rectal spacer.
Each fraction will take approximately 15 minutes. Adherence to the intervention will be assessed using review of medical records.
All patients will also receive a 6-month course of Androgen Deprivation Therapy (ADT) starting concurrently with their radiotherapy. ADT agent used will be Goserelin 10.8mg, two injections given 3 monthly (each administered over < 1 minute), and medical records will be reviewed to assess adherence.
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Intervention code [1]
330350
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Treatment: Other
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Comparator / control treatment
No Control Group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Acute (<3 months) genitourinary (GU) toxicity
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Assessment method [1]
340430
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CTCAEV5.0 will be used to assess acute GU toxicity
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Timepoint [1]
340430
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Weeks 1, 3, 5 and 13 from start of SABR treatment (cumulative)
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Primary outcome [2]
340431
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Acute (<3 months) gastrointestinal (GI) toxicity
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Assessment method [2]
340431
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CTCAEV5.0 will be used to assess acute GI toxicity
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Timepoint [2]
340431
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Weeks 1, 3, 5 and 13 from start of SABR treatment (cumulative)
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Primary outcome [3]
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Acute (<3 months) effects on patient quality of life (QOL)
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Assessment method [3]
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EPIC-26 questionnaire QOL domains for urinary and bowel and International Prostate Symptom Score (IPSS) will be used
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Timepoint [3]
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Weeks 1, 3, 5 and 13 from start of SABR treatment (cumulative)
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Secondary outcome [1]
444038
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Late (> 6 months) GI toxicity
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Assessment method [1]
444038
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CTCAEV5.0 will be used to assess late GI toxicity
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Timepoint [1]
444038
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At 6 months, 12 months, 18 months, 24 months, 30 months, 36 months, 42 months, 48 months, 54 months and 60 months post SABR.
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Secondary outcome [2]
444039
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Late (> 6 months) GU toxicity
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Assessment method [2]
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CTCAEV5.0 will be used to assess late GU toxicity
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Timepoint [2]
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At 6 months, 12 months, 18 months, 24 months, 30 months, 36 months, 42 months, 48 months, 54 months and 60 months from treatment
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Secondary outcome [3]
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Biochemical disease-free survival
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Assessment method [3]
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Assessed using serum PSA levels, with biochemical failure defined by Phoenix criteria (PSA nadir + 2ng/mL)
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Timepoint [3]
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PSA will be collected at baseline, and at 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 months from treatment.
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Secondary outcome [4]
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Use of subsequent salvage ADT
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Assessment method [4]
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Assessed at follow-up through clinical history and review of medical records
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Timepoint [4]
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Determined during follow-up at 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 months from treatment.
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Secondary outcome [5]
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Late (>6 months) effects on patient QOL
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Assessment method [5]
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EPIC-26 questionnaire 'Quality of Life' domains for urinary and bowel, and International Prostate Symptom Score (IPSS) will be used to assess patient QOL
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Timepoint [5]
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Assessed at 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 months from treatment
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Eligibility
Key inclusion criteria
- Histologically confirmed locally recurrent prostate cancer
- Recurrence at least 2 years after completion of previous curative intent definitive prostate radiation therapy (2 years from end date of androgen deprivation therapy if androgen deprivation therapy was given with prostate radiation therapy)
- Able to undergo pre-treatment multiparametric magnetic resonance imaging (mpMRI) and prostate specific membrane antigen positron emission tomography/ computed tomography
(PSMA-PET/CT)
- Capacity to consent to treatment and comply with follow-up schedule and completion of toxicity and QOL questionnaires
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Poor baseline urinary function (IPSS>20)
- Contraindication to MRI or PSMA-PET/CT
- Contraindication to gold-fiducial insertion or rectal spacer insertion
- Anticoagulation medication use (that is unsafe to be discontinued for fiducial marker and rectal spacer insertion)
- Bleeding diathesis (that is unsafe for fiducial marker and rectal spacer insertion)
- Evidence of pelvic nodal disease or distant metastasis on PSMA-PET/CT
- Prior ultra-hypofractionated radiation therapy (>5 Gy/ fraction)
- Castrate resistant prostate cancer – defined as PSA >3 ng/ml while testosterone <0.7nmol/l)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2025
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
27506
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The Alfred - Melbourne
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Recruitment hospital [2]
27510
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Latrobe Regional Hospital - Traralgon
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Recruitment postcode(s) [1]
43617
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3004 - Melbourne
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Recruitment postcode(s) [2]
43621
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3844 - Traralgon
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Funding & Sponsors
Funding source category [1]
318227
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Hospital
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Name [1]
318227
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Alfred Health Radiation Oncology Centre
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Address [1]
318227
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Country [1]
318227
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Health
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Address
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Country
Australia
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Secondary sponsor category [1]
320611
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None
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Name [1]
320611
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Address [1]
320611
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Country [1]
320611
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
316870
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
316870
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
316870
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Australia
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Date submitted for ethics approval [1]
316870
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27/11/2024
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Approval date [1]
316870
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Ethics approval number [1]
316870
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Summary
Brief summary
The study aims to assess if salvage reirradiation with stereotactic ablative body radiation therapy (SABR) is a safe and feasible management option for locally recurrent prostate cancer. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have locally recurrent prostate cancer following prior radiotherapy to the prostate. Study details: All participants will receive prostate SABR reirradiation (over 5 fractions) and 6 months of ADT. At baseline, participants will require imaging, blood tests, and questionnaire completion. Further blood tests will be required every 6 months up to 5 years post treatment, and at 2 years, some participants will require a further biopsy while all participants will require MRI. The findings will help guide clinicians on whether prostate SABR re-irradiation is a safe and effective option for this group of patients who currently have limited evidence-based local salvage treatment options.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Therese Kang
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Address
139266
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Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne 3002, VIC
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Country
139266
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Australia
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Phone
139266
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+61 3 90762360
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Fax
139266
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Email
139266
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[email protected]
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Contact person for public queries
Name
139267
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Therese Kang
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Address
139267
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Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne 3002, VIC
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Country
139267
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Australia
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Phone
139267
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+61 3 90762337
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Fax
139267
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Email
139267
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[email protected]
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Contact person for scientific queries
Name
139268
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Therese Kang
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Address
139268
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Alfred Health Radiation Oncology, 55 Commercial Road, Melbourne 3002, VIC
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Country
139268
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Australia
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Phone
139268
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+61 3 90762337
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Fax
139268
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Email
139268
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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