z-logo
Premium
SABRE 1 ( S urgery A gainst B rachytherapy – a R andomised E valuation): feasibility randomised controlled trial ( RCT ) of brachytherapy vs radical prostatectomy in low–intermediate risk clinically localised prostate cancer
Author(s) -
Eccles Bryony K.,
Cross William,
Rosario Derek J.,
Doble Andrew,
Parker Chris,
Logue John,
Little Louisa,
Stanton Louise,
Bottomley David
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12127
Subject(s) - medicine , randomized controlled trial , prostate cancer , randomization , brachytherapy , blinding , urology , surgery , radiation therapy , gynecology , cancer
Objective To determine the feasibility of a phase III randomised controlled trial of brachytherapy vs radical prostatectomy ( RP ) in men with low–intermediate risk localised prostate cancer.Patients and Methods This parallel, two‐group, multicentre, randomised controlled feasibility trial enrolled men with histologically confirmed localised, low‐risk prostate cancer and good performance status from five UK hospitals. Participants were randomly allocated (1:1) by remote computer allocation to receive a decision aid ( DA ) DVD or standard information (control group), followed by a second randomisation (1:1) to brachytherapy or RP . There was no ‘blinding’ of staff or patients. Primary outcome was feasibility: a recruitment rate of six patients per centre over the last 6 months of recruitment would deem a phase III trial feasible.Results Between M ay 2009 and M ay 2011, 30 patients were randomised (15 in the DA group and 15 in the control group), and four continued to the second treatment randomisation (one from the DA group and three from the control group). One patient was allocated and received brachytherapy and three RP . SABRE 1 closed early due to poor recruitment. All patients were analysed. Screening logbook analysis showed that the main reasons for declining trial entry were a wish to choose treatment or opting for active monitoring. Results from the DA questionnaire (completed by 10 men) showed that four of the men ‘felt surgery and radiotherapy had been proven in a high quality trial’ and seven felt ‘they should make their treatment decision while knowing their doctors opinion’.Conclusion Recruitment to a RP vs brachytherapy trial in localised prostate cancer was not feasible by the use of this two‐step randomisation using a DA and previous trials in early prostate cancer have had similar difficulties in recruitment, with only a few achieving their accrual target. The best treatment method for treating low‐risk prostate cancer is still unproven in a head‐to‐head trial and the increasing number of options will make choices correspondingly more difficulty without good quality comparative research. More sophisticated techniques for recruitment may be more successful in future trials in this patient population.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here