Evaluation of Hypoxia by PET With F-Miso in Radiation Therapy of Prostate Cancer

Institut Cancerologie de l'Ouest20 enrolled

Overview

With functional imaging development, it becomes possible to increase radiation dose to radioresistant areas (located inside tumor volume) using radiotherapy dose-painting. This strategy is particularly suitable for prostate cancer where tumor hypoxia plays a major role in the resistance of these tumors to radiation. In order to develop intratumoral hypoxia targeting by radiotherapy dose-painting areas, we should characterize changes in hypoxia before treatment and during radiotherapy. * If hypoxia does not change during radiotherapy, radiotherapy dose-painting strategy by an "integrated" boost is performed. * If hypoxia varied (increasing or incomplete regression), a "final" boost strategy of radiotherapy dose-painting(IMRT, stereotactic brachytherapy or high dose rate) after a first fractionated IMRT could be considered. This study should show that PET imaging with fluoromisonidazole (18F-MISO) is an available tool to physicians in assessing tumor hypoxia.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Prostate Adenocarcinoma

Interventions

Eligibility

Sex: MALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * histologically proven prostate adenocarcinoma * Absence of metastases (lymph node or bone) * One or more tumor nodules seen on MRI and PET Choline. * Intermediate Risk : Gleason 7 and PSA (prostate specific antigen)\<20 ng / ml, T \<T2c or Gleason 6 and PSA 10-20 ng / ml, T \<T2c * No concomitant hormonal treatment. (NB: the introduction of hormone therapy during radiotherapy before the second 18F-MISO is a criterion to study exit) * Indication of radiotherapy up to a total dose\> 70 Gy and 2 Gy/day fractions * Signed Informed consent * Social Insurance Exclusion Criteria: * Age \< 18 years old * Patient protected by law

Outcomes

Primary Outcomes

To characterize changes in tumor hypoxia (PET with 18F-MISO) during radiation therapy of prostate cancer.

First PET-scan with 18-F-Miso done before radiation Second PET-scan with 18-F-Miso done 3 to 4 weeks after the beginning of radiation therapy.

Time frame: 3 to 4 weeks after beginning of radiation therapy

Secondary Outcomes

To compare hypoxia imaging (PET with 18F-MISO) with anatomical imaging (PET with 18F-choline) to study the feasibility of a tailored treatment.

Images obtained with PET Choline and MRI (anatomical location) will be merge with images obtained by 18F-MISO PET to search hypoxia on these anatomical areas.

Time frame: before and 3 to 4 weeks after the begining of radiation therapy