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Preference-based Comparative Study on Definitive Radiotherapy of Prostate Cancer With Protons

Not Applicable
Recruiting
Conditions
Prostate Cancer
Interventions
Radiation: Radiotherapy with protons
Radiation: Radiotherapy with photons
Registration Number
NCT02766686
Lead Sponsor
Technische Universität Dresden
Brief Summary

ProtoChoice-P is a prospective multicenter trial to evaluate proton therapy in patients suffering from prostate cancer. Primary aim of the study is a decrease of moderate or severe genito-urinary or intestinal side effects (Common Terminology Criteria for Adverse Events (CTCAE) 4.0 grade 2 or higher) by the use of proton therapy. Secondary endpoints contain assessment of quality of life, biochemical recurrence and recurrence free survival as well as overall survival and economic comparison between photon and proton therapy.

Detailed Description

The hypothesis of the study is a 7.5% decrease of combined genito-urinary and intestinal side effects from 15% with photon therapy to 7.5% by the use of protons. With an alpha of 0.05 and 80% power it is therefore necessary to treat 131 patients with protons to detect such difference. With an estimated drop-out rate of 10% 146 patients have to be recruited to the proton arm. As randomization to photon or proton therapy is not possible in a multicenter setting with only few proton facilities available patients treated with photons will be prospectively matched to their proton counterparts. Stratification criteria will include: Age, high dose volume, androgen deprivation, history of surgery, obstructive disease, increased risk for rectal bleeding, socio-economic criteria and use of rectal balloon during radiotherapy. Comparison of the primary endpoint will be restricted to patients without irradiation of lymphatic drainage.

Recruitment & Eligibility

Status
RECRUITING
Sex
Male
Target Recruitment
146
Inclusion Criteria
  • life expectancy ≥ 10 years
  • adenocarcinoma of the prostate confirmed by punch biopsy
  • locally limited to locally advanced adenocarcinomas without evidence of distant metastases i.e. T1-3b N0-1 M0
  • stage-related indicated neoadjuvant / adjuvant androgen deprivation possible (neoadjuvant ≤ 6 months)
  • good general condition (ECOG performance status 0 - 1)
  • marker seed implantation before irradiation (optional) or possibility of Image-guided Radiation Therapy (IGRT) by CT
  • adequate compliance for follow-up
  • written informed consent
Exclusion Criteria
  • distant metastases
  • previous radiotherapy of the lesser pelvis
  • previous or concomitant other malignant disease except when there is no impact on treatment or follow-up of the prostate cancer
  • participation in another clinical study, if it's excluded by the study protocols

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Radiotherapy with protonsRadiotherapy with protonsProton radiotherapy 74-80 Gray equivalent (GyE), 2Gy per fraction, 5 fractions peer week
Radiotherapy with photons with lymph drainage vesselsRadiotherapy with photonsPhoton-IMRT with lymph drainage vessels, 74-80 Gy, 2Gy per fraction, 5 fractions peer week
Radiotherapy with photonsRadiotherapy with photonsPhoton-Intensity-Modulated Radiation Therapy (IMRT) without lymph drainage vessels, 74-80 Gy, 2Gray (Gy) per fraction, 5 fractions peer week
Primary Outcome Measures
NameTimeMethod
Cumulative incidence of moderate/ severe side effectsafter 2 years ( measured from the first day of treatment)

≥ grade 2 by CTCAE combined for genito-urinary and gastrointestinal side effects

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (3)

University Hospital Carl Gustav Carus, Department of Radiotherapy and Radiation Oncology

🇩🇪

Dresden, Germany

Klinikum rechts der Isar, Technische Universität München

🇩🇪

Munich, Germany

Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen

🇩🇪

Tubingen, Germany

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