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Radiation Therapy and Chemotherapy in Treating Patients With Stage I Bladder Cancer

Phase 2
Completed
Conditions
Bladder Cancer
Interventions
Radiation: Three-Dimensional Conformal Radiation Therapy
Registration Number
NCT00981656
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in chemotherapy, such as cisplatin, mitomycin C, and fluorouracil, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving radiation therapy together with cisplatin may kill more tumor cells.

PURPOSE: This phase II trial is studying how well radiation therapy given together with chemotherapy works in treating patients with stage I bladder cancer.

Detailed Description

After completion of study treatment, patients are followed up every 3 months for 1 year, every 4 months for 1 year, every 6 months for 3 years, and annually thereafter until termination of the study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
37
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
3DCRT + CTThree-Dimensional Conformal Radiation TherapyConcurrent three-dimensional conformal radiation therapy (3DCRT) and radiosensitizing chemotherapy (CT) consisting of either cisplatin alone or the combination of mitomycin and 5-fluorouracil. Protocol treatment must begin with 15 weeks after a transurethral resection of the tumor (TURBT).
3DCRT + CTMitomycinConcurrent three-dimensional conformal radiation therapy (3DCRT) and radiosensitizing chemotherapy (CT) consisting of either cisplatin alone or the combination of mitomycin and 5-fluorouracil. Protocol treatment must begin with 15 weeks after a transurethral resection of the tumor (TURBT).
3DCRT + CT5-fluorouracilConcurrent three-dimensional conformal radiation therapy (3DCRT) and radiosensitizing chemotherapy (CT) consisting of either cisplatin alone or the combination of mitomycin and 5-fluorouracil. Protocol treatment must begin with 15 weeks after a transurethral resection of the tumor (TURBT).
3DCRT + CTcisplatinConcurrent three-dimensional conformal radiation therapy (3DCRT) and radiosensitizing chemotherapy (CT) consisting of either cisplatin alone or the combination of mitomycin and 5-fluorouracil. Protocol treatment must begin with 15 weeks after a transurethral resection of the tumor (TURBT).
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Free From Radical Cystectomy at 3 YearsThree years from registration

The number of participants who did not undergo a radical cystectomy within three years divided by the number of analyzed participants, presented with the 97.5% lower bound.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Progression to Tumor Stage T2 or Greater at 5 YearsFrom registration to five years

Primary tumor stage T2 = tumor invades muscle; T3 = tumor invades perivesical tissue; T4 = tumor invades any of the following: prostate, uterus, vagina, pelvic wall, abdominal wall. Time to progression is defined as time from registration to the date of first progression, last known follow-up (censored), or death without tumor progression (competing risk). Tumor progression rate was to be estimated using the cumulative incidence method.

Percentage of Participants Free From Radical Cystectomy at 5 YearsFive years from registration

The number of participants who did not undergo a radical cystectomy within five years divided by the number of analyzed participants.

Percent of Participants With Distant Disease Progression at 5 YearsFrom registration to five years

Distant disease progression is defined as the first appearance of disease in a non-regional lymph node, solid organ or bone. Time to distant disease progression is defined as time from registration to the date of first distant disease progression, last known follow-up (censored), or death without distant disease progression (competing risk). Distant disease progression rate is estimated using the cumulative incidence method.

Percent of Participants With Distant Disease Progression at 3 YearsFrom registration to three years

Distant disease progression is defined as the first appearance of disease in a non-regional lymph node, solid organ or bone. Time to distant disease progression is defined as time from registration to the date of first distant disease progression, last known follow-up (censored), or death without distant disease progression (competing risk). Distant disease progression rate is estimated using the cumulative incidence method.

Percentage of Participants Alive at 5 YearsFrom registration to five years

Overall survival time is defined as time from registration to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method.

Distribution of Participants by Highest Grade Adverse EventAdverse events are evaluated 8-10 weeks after end of study treatment (approximately 7 weeks), then every 3 months for one year, every 4 months for one year, every 6 months for 3 years, then annually. Maximum follow-up at time of reporting was 8.6 years.

Common Terminology Criteria for Adverse Events (CTCAE) version 4 grades adverse event severity from 1=mild to 5=death. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data.

American Urological Association Total Symptom Score at Baseline and at 3 YearsBaseline and 3 years

The American Urological Association Total symptom score measures the severity of enlarged prostate symptoms. Possible scores range from 0 to 35, with higher scores indicating worse symptoms.

Percentage of Participants With Progression to Tumor Stage T2 or Greater at 3 YearsFrom registration to three years

Primary tumor stage T2 = tumor invades muscle; T3 = tumor invades perivesical tissue; T4 = tumor invades any of the following: prostate, uterus, vagina, pelvic wall, abdominal wall. Time to progression is defined as time from registration to the date of first progression, last known follow-up (censored), or death without tumor progression (competing risk). Tumor progression rates was to be estimated using the cumulative incidence method.

Percentage of Participants Alive at 3 YearsFrom registration to three years

Overall survival time is defined as time from registration to the date of death from any cause or last known follow-up (censored). Overall survival rates are estimated by the Kaplan-Meier method.

Percentage of Participants Who Have Died From Bladder Cancer at 5 Years (Disease-specific Survival)From registration to five years

Time to death from bladder cancer is defined as time from registration to death from bladder cancer, last known follow-up (censored), or death from other cause (competing risk). More specifically, death absent a distant metastasis, death from non-bladder cancer, and death absent local recurrence comprise the competing risk. Death from bladder cancer rate is estimated using the cumulative incidence method.

Percentage of Participants With Local Recurrence at 3 YearsFrom registration to three years

Time to local recurrence is defined as time from registration to the date of first local recurrence, last known follow-up (censored), or death without local recurrence (competing risk). Local recurrence rate is estimated using the cumulative incidence method.

Trial Locations

Locations (13)

Barberton Citizens Hospital

🇺🇸

Barberton, Ohio, United States

Fox Chase Cancer Center - Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

University of Texas Medical Branch

🇺🇸

Galveston, Texas, United States

Summa Center for Cancer Care at Akron City Hospital

🇺🇸

Akron, Ohio, United States

Emory Crawford Long Hospital

🇺🇸

Atlanta, Georgia, United States

Winship Cancer Institute of Emory University

🇺🇸

Atlanta, Georgia, United States

St. Agnes Hospital Cancer Center

🇺🇸

Baltimore, Maryland, United States

Hudner Oncology Center at Saint Anne's Hospital - Fall River

🇺🇸

Fall River, Massachusetts, United States

Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Beth Israel Medical Center - Petrie Division

🇺🇸

New York, New York, United States

Cancer Care Center, Incorporated

🇺🇸

Salem, Ohio, United States

Cancer Treatment Center

🇺🇸

Wooster, Ohio, United States

Norris Cotton Cancer Center - North

🇺🇸

Saint Johnsbury, Vermont, United States

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