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Radiation Therapy and Hormone Therapy in Treating Patients With Prostate Cancer

Phase 3
Completed
Conditions
Prostate Cancer
Interventions
Radiation: low-LET photon therapy
Registration Number
NCT00769548
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Radiation therapy uses high energy x-rays to damage tumor cells. Hormone therapy combined with radiation therapy may be a more effective treatment for prostate cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of four different combinations of radiation and hormone therapy in treating patients with prostate cancer.

Detailed Description

OBJECTIVES: I. Examine whether total androgen suppression (TAS) with flutamide/goserelin and whole-pelvic irradiation followed by a cone-down boost to the prostate improves progression-free survival at 5 years by at least 10% compared to TAS and prostate-only irradiation in patients with adenocarcinoma of the prostate at significant risk of nodal involvement. II. Examine whether induction and concurrent (neoadjuvant) TAS and radiotherapy improves the progression-free survival at 5 years by at least 10% compared to adjuvant TAS and radiotherapy. III. Compare treatments with regard to local control, time to distant failure, and overall survival.

OUTLINE: Randomized study. Arm I: Neoadjuvant Antiandrogen Therapy with Radiotherapy. Flutamide, FLUT, NSC-147834; Goserelin, Zoladex, ZDX, NSC-606864; with irradiation of the whole pelvis followed by a boost to the prostate using photons of at least 6 MV. Arm II: Neoadjuvant Antiandrogen Therapy with Radiotherapy; FLUT; ZDX; with irradiation of the prostate using equipment as in Arm I. Arm III: Radiotherapy followed by Adjuvant Antiandrogen Therapy. Irradiation as in Arm I; followed by FLUT; ZDX. Arm IV: Radiotherapy followed by Adjuvant Antiandrogen Therapy. Irradiation as in Arm II; followed by FLUT; ZDX.

PROJECTED ACCRUAL: 1,200 patients will be accrued over 2.5 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
1322
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1goserelin acetateNeoadjuvant total androgen suppression (TAS) given 2 months before and during radiation therapy (RT) to the whole pelvis followed by a prostate boost.
Arm 3low-LET photon therapyRT to the whole pelvis followed by a boost to the prostate followed by 4 months of TAS.
Arm 4goserelin acetateRT to the prostate only followed by 4 months of TAS.
Arm 2goserelin acetateNeoadjuvant TAS given 2 months before and during RT to the prostate only.
Arm 3goserelin acetateRT to the whole pelvis followed by a boost to the prostate followed by 4 months of TAS.
Arm 4low-LET photon therapyRT to the prostate only followed by 4 months of TAS.
Arm 1low-LET photon therapyNeoadjuvant total androgen suppression (TAS) given 2 months before and during radiation therapy (RT) to the whole pelvis followed by a prostate boost.
Arm 2low-LET photon therapyNeoadjuvant TAS given 2 months before and during RT to the prostate only.
Arm 2flutamideNeoadjuvant TAS given 2 months before and during RT to the prostate only.
Arm 3flutamideRT to the whole pelvis followed by a boost to the prostate followed by 4 months of TAS.
Arm 1flutamideNeoadjuvant total androgen suppression (TAS) given 2 months before and during radiation therapy (RT) to the whole pelvis followed by a prostate boost.
Arm 4flutamideRT to the prostate only followed by 4 months of TAS.
Primary Outcome Measures
NameTimeMethod
Progression-free survival (Arms 1, 3 vs. Arms 2, 4)From randomization to the first occurrence of biochemical failure, clinical failure (local or distant), death from any cause, or last follow-up. Analysis occurs after all patients have been potentially followed for 5 years.
Secondary Outcome Measures
NameTimeMethod
Local progressionFrom randomization to the date of local progression or last follow-up. Analysis occurs after all patients have been potentially followed for 5 years.
Overall survivalFrom the date of randomization to the date of death or last follow-up. Analysis occurs after all patients have been potentially followed for 5 years.
Progression-free survival (Arms 1, 2 vs. Arms 3, 4)From randomization to the first occurrence of biochemical failure, clinical failure (local or distant), death from any cause, or last follow-up. Analysis occurs after all patients have been potentially followed for 5 years.
Distant metastasisFrom randomization to the date of metastatic disease or last follow-up. Analysis occurs after all patients have been potentially followed for 5 years.
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