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Prostate Cancer Patients Treated With Alternative Radiation Oncology Strategies

Not Applicable
Recruiting
Conditions
Prostate Cancer
Interventions
Radiation: Hypofractionated radiotherapy with protons
Radiation: Normofractionated radiotherapy with photons
Radiation: Hypofractionated radiotherapy with photons
Registration Number
NCT04083937
Lead Sponsor
University Hospital Heidelberg
Brief Summary

As the most common male carcinoma, prostate cancer is a major tumor entity in oncology. In addition to definitive radiotherapy, surgical procedure is considered to be an oncologically equivalent therapeutic alternative for non-metastatic malignancies in the primary setting. However, a subsequent radiotherapy of the prostate bed is often necessary, which takes place as an "adjuvant" treatment immediately after surgery or in the course of a repeated increase in PSA and usually extends over several weeks. For the primary situation (without previous surgery), several randomized phase III clinical trials have shown that it is possible to shorten radiotherapy by increasing the single dose (called hypofractionation). In the context of two prospective Phase II studies, which were carried out in Heidelberg, it has since been shown that hypofractionation with both photons and protons is safe and feasible even in the postoperative situation.

The current, prospective and randomized PAROS study is now intended to demonstrate a multicentric phase III study as an improvement in the quality of life caused by rectum toxicity (primary endpoint) by the use of protons. The oncological non-inferiority of hypofractionated radiotherapy after surgery is a secondary endpoint.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Male
Target Recruitment
897
Inclusion Criteria
  • histology-proven prostate cancer with Gleason Score and PSA-value;
  • indication for prostate bed irradiation (adjuvant/ salvage) after prostatectomy;
  • Karnofsky-Index ≥ 70%
  • age ≥ 18 years
Exclusion Criteria
  • androgen deprivation therapy
  • lymphatic spread
  • macroscopic tumor/ R2
  • stage IV (M1)
  • previous irradiation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
57.0/ 3.0 (RBE)Hypofractionated radiotherapy with protonsHypofractionated radiotherapy with protons (57.0/ 3.0 Gray relative biological effectiveness \[RBE\]).
70.0/ 2.0 Gray (RBE)Normofractionated radiotherapy with photonsNormofractionated radiotherapy with photons (70.0/ 2.0 Gray)
57.0/ 3.0 Gray (RBE)Hypofractionated radiotherapy with photonsHypofractionated radiotherapy with photons (57.0/ 3.0 Gray)
Primary Outcome Measures
NameTimeMethod
Quality of life (prostate-associated, 12 weeks vs baseline)12 weeks

The primary objective of the present trial is to show a Change in the bowel symptoms according to scores on the EORTC QLQ-PR25 questionaire after proton therapy compared to photon irradiation (week 12 vs. baseline).

Secondary Outcome Measures
NameTimeMethod
Quality of life (general and prostate-associated, 2 years and 5 years vs. baseline)2 and 5 years after baseline

non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to changes in the scores of quality of life based on the EORTC QLQ-PR25 questionaire

biochemical progression-free survival (bPFS)5 years after baseline

non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to biochemical progression-free survival (bPFS)

overall survival (OS)5 years after baseline

non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to overall survival (OS)

Toxicity acc. to NCI CTCAE V 5.0 after 2 and 5 years2 and 5 years after baseline

non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to toxicity

Trial Locations

Locations (1)

University Hospital Heidelberg

🇩🇪

Heidelberg, Germany

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