Comparison of Two Radiation Therapy Regimens in Treating Patients With Stage II or Stage III Prostate Cancer
| Status: | Completed |
|---|---|
| Conditions: | Prostate Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | June 2002 |
A Phase III Intensity Modulated Radiotherapy Dose Escalation Trial for Prostate Cancer Using Hypofractionation
RATIONALE: Radiation therapy uses high-energy x-rays and other sources of radiation to kill
tumor cells. It is not yet known which radiation therapy regimen is more effective in
treating prostate cancer.
PURPOSE: This randomized phase III trial is comparing two different regimens of radiation
therapy to see how well they work in treating patients with stage II or stage III prostate
cancer.
tumor cells. It is not yet known which radiation therapy regimen is more effective in
treating prostate cancer.
PURPOSE: This randomized phase III trial is comparing two different regimens of radiation
therapy to see how well they work in treating patients with stage II or stage III prostate
cancer.
OBJECTIVES:
- Compare the efficacy of conventional intensity-modulated radiotherapy (IMRT) vs
hypofractionated IMRT, in terms of freedom from biochemical failure in men with
intermediate- to high-risk prostate cancer.
- Compare the local control, freedom from distant metastasis, and overall survival of
patients treated with these regimens.
- Determine local failure, using biopsy of the prostate, when objective tests
(prostate-specific antigen, ultrasound, and digital rectal exam) suggest relapse in
these patients.
- Compare the extent of disease eradication using biopsy of the prostate at 2 years after
therapy in these patients.
- Compare the quality of life of patients treated with these regimens.
- Determine the impact of these regimens on patient preferences and utilities.
OUTLINE: This is a randomized study. Patients are stratified according to pretreatment
prostate-specific antigen (no greater than 10 ng/mL vs greater than 10 to 20 ng/mL vs
greater than 20 ng/mL), Gleason score (5-7 vs 8-10), and risk status (high risk vs
intermediate risk). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo conventional intensity-modulated radiotherapy (IMRT) 5 days a
week for 7.5 weeks in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients undergo hypofractionated IMRT 5 days a week for 5 weeks in the absence
of disease progression or unacceptable toxicity.
Patients with high-risk disease also undergo androgen deprivation therapy for 2 years.
Quality of life is assessed at baseline, every 6 months for 1 year, and then annually for 4
years.
Patients are followed at 3 months, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 300 patients (150 per treatment arm) will be accrued for this
study within 3 years.
- Compare the efficacy of conventional intensity-modulated radiotherapy (IMRT) vs
hypofractionated IMRT, in terms of freedom from biochemical failure in men with
intermediate- to high-risk prostate cancer.
- Compare the local control, freedom from distant metastasis, and overall survival of
patients treated with these regimens.
- Determine local failure, using biopsy of the prostate, when objective tests
(prostate-specific antigen, ultrasound, and digital rectal exam) suggest relapse in
these patients.
- Compare the extent of disease eradication using biopsy of the prostate at 2 years after
therapy in these patients.
- Compare the quality of life of patients treated with these regimens.
- Determine the impact of these regimens on patient preferences and utilities.
OUTLINE: This is a randomized study. Patients are stratified according to pretreatment
prostate-specific antigen (no greater than 10 ng/mL vs greater than 10 to 20 ng/mL vs
greater than 20 ng/mL), Gleason score (5-7 vs 8-10), and risk status (high risk vs
intermediate risk). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo conventional intensity-modulated radiotherapy (IMRT) 5 days a
week for 7.5 weeks in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients undergo hypofractionated IMRT 5 days a week for 5 weeks in the absence
of disease progression or unacceptable toxicity.
Patients with high-risk disease also undergo androgen deprivation therapy for 2 years.
Quality of life is assessed at baseline, every 6 months for 1 year, and then annually for 4
years.
Patients are followed at 3 months, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 300 patients (150 per treatment arm) will be accrued for this
study within 3 years.
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma of the prostate
- Clinical stage T1b-T3c disease
- No clinical or radiographic evidence of metastasis
- Prostate-specific antigen (PSA) less than 80 ng/mL
- Gleason score at least 5
- One of the following criteria must be met:
- PSA greater than 10 ng/mL
- Gleason score greater than 6
- T2b or greater palpable disease
- Three or more biopsy cores involved with a Gleason score of at least 5
PATIENT CHARACTERISTICS:
Age
- Not specified
Performance status
- Zubrod 0-1
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Not specified
Renal
- Not specified
Other
- No other medical condition that would preclude study participation
- No other active malignancy within the past 5 years except nonmetastatic skin cancer
or early stage chronic lymphocytic leukemia (well-differentiated small cell
lymphocytic leukemia)
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- No more than 4 months of prior androgen deprivation therapy
- Neoadjuvant and adjuvant androgen deprivation therapy is allowed for high-risk
disease only
Radiotherapy
- No prior pelvic radiotherapy
Surgery
- No prior or planned radical prostate surgery
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