CompletedInterventional

Study of fewer, larger doses of radiotherapy for men with localised prostate cancer

Standard radiotherapy for prostate cancer often requires up to 20 separate hospital visits. The HERMES trial is looking at whether doctors can safely reduce this to just two or five visits by using larger, highly focused doses of radiation. Participants receive stereotactic body radiotherapy (SBRT) using an advanced machine called an MR-linac. This combines an MRI scanner with a radiotherapy machine, giving doctors a live, clear picture of the prostate so they can fine-tune the radiation beam before each treatment. Half of the men in the trial have five treatments over 10 days, while the other half have two treatments over eight days. Everyone also receives standard hormone therapy. Researchers want to see if the shorter, two-dose option cures cancer just as well and causes no more side effects than five doses. If successful, it could make treatment far faster and more convenient for patients.

At a glance

Status

Completed

Sponsor

Institute of Cancer Research

Enrolment target

Start

01 Apr 2020

Estimated completion

30 Sep 2023

Prostate cancer

What is this study about?

Prostate cancer is the most common cancer in men in the UK. When the cancer is localised—meaning it has not spread outside the prostate gland—radiotherapy is one of the main ways doctors can cure it. Traditionally, this involves daily hospital visits over several weeks. Recent improvements in technology now make it possible to deliver higher, more accurate doses in far fewer visits, which could make treatment much easier for patients.

This study, called the HERMES trial, is exploring an advanced technique known as stereotactic body radiotherapy (SBRT). Men taking part are placed into one of two groups: one group receives five treatments over 10 days, and the other receives two treatments over eight days. The main goal is to find out if the quicker two-dose approach is just as effective and safe as the five-dose schedule.

All treatments in the study are delivered using an advanced machine called an MR-linac. This piece of equipment brings together an MRI scanner and a radiotherapy machine. Because the prostate can move slightly depending on how full the bladder or bowel is, the MR-linac takes fresh MRI pictures each day. The care team can then adjust the radiation beam on the spot, aiming directly at the prostate while keeping the surrounding healthy organs safe.

Doctors believe that both the two-treatment and five-treatment options will offer a similar chance of curing the cancer as standard radiotherapy. By carrying out this trial, researchers hope to confirm whether the two-treatment approach has manageable side effects, paving the way for faster, less disruptive prostate cancer care on the NHS.

Key takeaways

Tests whether two or five high-dose radiotherapy sessions can successfully cure localised prostate cancer.
Uses an advanced MR-linac machine to see the prostate clearly and protect healthy tissue in real time.
Could drastically cut down the number of hospital visits required compared to standard radiotherapy.
Participants will also receive standard hormone therapy for at least six months.
Long-term health and wellbeing are carefully tracked for up to five years.

Who may be eligible?

This trial is for men aged 18 and over who have been diagnosed with localised prostate cancer that has not spread to other parts of the body. Your cancer specialist must have reviewed your case and agreed that radiotherapy is a suitable curative treatment for you. You must also be planning to have hormone therapy for at least six months, which is a standard treatment given alongside radiotherapy for this type of prostate cancer.

Because the treatment machine uses a strong magnet to take pictures, you must be able to have an MRI safely. This means you cannot take part if you have a heart pacemaker, metal hip replacements, or any other metal implants in your pelvis that interfere with the scan. You also need to be comfortable lying still inside an MRI scanner without severe claustrophobia.

Finally, the study is not suitable for men with significant urinary problems, such as severe difficulty emptying the bladder, or those with a very large prostate. Men who have had radiotherapy to the pelvis in the past, or who live with chronic gut conditions such as inflammatory bowel disease, are also unable to join.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am a man aged 18 or older.
I have been diagnosed with localised prostate cancer suitable for radiotherapy.
I am safe to have MRI scans (no pacemaker, hip replacements, or severe claustrophobia).
I do not have severe bladder troubles or inflammatory bowel disease.
I am able and willing to travel to The Royal Marsden Hospital for treatment.
I am happy to take hormone therapy alongside my radiotherapy.

Answer every question to see your result.

What does participation involve?

If you decide to take part, a computer will randomly place you into one of two groups. You will either receive five radiotherapy sessions over 10 days, or two radiotherapy sessions over eight days. All sessions take place at The Royal Marsden Hospital in London. During each visit, you will lie inside the MR-linac machine while it scans your prostate and delivers the treatment. Alongside your radiotherapy, you will take standard hormone therapy for at least six months to help shrink and control the cancer.

After your radiotherapy ends, your care team will monitor you closely to check on your recovery and manage any side effects. You will have check-ups in the clinic or over the phone at 2, 4, 8, and 12 weeks after treatment finishes. After that, reviews happen at 6, 12, and 24 months, and then once a year until five years have passed. During these reviews, you will be asked to fill out short questionnaires about your health, daily activities, and any symptoms you might have.

Potential risks and benefits

Taking part offers the potential benefit of finishing your radiotherapy in just two or five visits, rather than the standard 20 visits, with live MRI scans helping doctors target your cancer precisely. However, all radiotherapy can cause temporary side effects, such as needing to urinate more often, bowel changes, or feeling unusually tired. Because the two-dose treatment is newer and uses larger individual doses, it is possible that side effects could be different or slightly more noticeable than usual. You are free to leave the trial at any time without giving a reason, and choosing to stop will never affect the standard of care you receive from the NHS.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

The Royal Marsden NHS Foundation Trust
City only
London, England

Common questions

Can I choose whether I have two or five treatments?

No. A computer randomly decides which group you join. This ensures the study remains completely fair and unbiased so doctors can trust the results.

Does the radiotherapy treatment hurt?

No, the treatment itself is completely painless, much like having an ordinary X-ray or MRI scan. You simply need to lie still on the treatment bed.

Why do I still need to take hormone therapy?

Hormone therapy is a proven standard treatment for this stage of prostate cancer. It shrinks the tumour and makes the radiotherapy more effective.

Will having an MRI scan during treatment give me extra radiation?

No. Unlike CT scans or standard X-rays, MRI scans use magnetic fields and radio waves, meaning they do not expose you to any extra radiation.

What happens if I change my mind after joining?

You can leave the study at any point. Your doctors will simply discuss standard NHS treatment options with you, and your future care will not be affected.

How to find out more

Stephanie Burnett

HERMES@icr.ac.uk +44 (0)20 8722 4261 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.