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Medical and Economic Evaluation for Intermediate-risk Prostate Cancer

Not Applicable
Conditions
Prostate Cancer
Interventions
Radiation: Brachytherapy boost with external beam radiotherapy
Radiation: Exclusive external beam radiotherapy
Registration Number
NCT02271659
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

The aim of the present phase III study is two-folded: 1) to show a superiority of external beam radiotherapy combined with a brachytherapy boost versus exclusive external beam radiotherapy and 2) to evaluate the economic impact of each treatment.

The study includes 33 cancer centres, the inclusion time is of 2 years and the follow-up is of 5 years.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
298
Inclusion Criteria
  • age between 18 and 80 years;
  • life expectancy of greater than 10 years;
  • prostate adenocarcinoma histologically proven;
  • prostate cancer has to be of intermediate-risk based on at least one of the three following criteria: PSA between 10 ng/ml and 20 ng/ml, and/or a Gleason score of 7 and/or a T2B. Karnofsky performance status ≥ 60% and consequently performance status ECOG 0-2.
  • the patient has to be the beneficiary of the social security system (order n° 2006-477 from April 26th 2006);
  • the signed consent form.
Exclusion Criteria
  • PSA level > 20;
  • Gleason > 7;
  • clinical T3A or T3B or MRI (a simple suspicion/ doubt on the MRI regarding the T3A won't be an exclusion criterion);
  • prostate volume > 60 cc;
  • pelvic lymph nodes involvement at dissection or imaging (ADP > 1.5 cm);
  • concurrent hormone therapy;
  • the presence of distant metastasis (M1);
  • history of abdominal or pelvic irradiation;
  • history of prostate resection in the previous 6 months and/or not allowing the implantation of markers;
  • history of uncontrolled cancer and/or treated since less than 5 years (excepting the basal-cell carcinoma);
  • urinary discomfort with an IPSS (International Prostate Symptom Score) > 15 (without alpha-blocking);
  • inflammatory bowel disorder such as ulcerative colitis or the Crohn's disease;
  • other undergoing study that may interfere with the present study;
  • patient under legal protection measure.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Brachytherapy boostBrachytherapy boost with external beam radiotherapyBrachytherapy boost with external beam radiotherapy. External beam radiotherapy of 46 Gy delivered to the prostate and the first centimeter of the seminal vesicles with a brachytherapy boost (of iodine-125 seeds (110Gy) or high dose rate (14Gy) with iridium-192) only to the prostate. Each center will choose the appropriate brachytherapy technique
Exclusive external beam irradiationExclusive external beam radiotherapyExclusive external beam radiotherapy. External beam radiotherapy of 46 Gy delivered to the prostate and the first centimeter of the seminal vesicles with an external beam radiotherapy of 80 Gy to the prostate alone.
Primary Outcome Measures
NameTimeMethod
Comparison of the biochemical relapse free survival of the patients in two groups at 5 years for an external beam radiotherapy with a brachytherapy boost versus an exclusive external beam radiotherapy5 years

Biochemical relapse is defined using the Phoenix definition of nadir of Prostate Specific Antigen + 2 ng/ml. This will be studied for both arms

Secondary Outcome Measures
NameTimeMethod
The evaluation of the overall survival at 5 years.5 years

All cause mortality

The evaluation of the specific survival at 5 years5 years

Mortality due to prostate cancer

The evaluation of the survival without any metastatic evolution at 5 years5 years
The study of all toxicities5 years

The toxicities include: acute and late toxicities, sexual toxicities, the quality of life of the patients (CTCAE version 4.0)

Medical and economical evaluation.5 years

The complete medical and economical evaluation of the strategies

Trial Locations

Locations (29)

CHU Jean MINJOZ

🇫🇷

Besançon, France

Clinique Tivoli

🇫🇷

Bordeaux, France

Institut Bergonie

🇫🇷

Bordeaux, France

CHRU Morvan

🇫🇷

Brest, France

Centre Francois Baclesse

🇫🇷

Caen, France

Institut de Cancerologie de Lorraine Alexis Vautrin

🇫🇷

Nancy, France

Centre d'oncologie et de radiothérapie Mâcon

🇫🇷

Macon, France

Clinique Claude Bernard

🇫🇷

Albi, France

Centre Georges François Leclerc

🇫🇷

Dijon, France

Institut Curie

🇫🇷

Paris, France

Hopital de la Tronche

🇫🇷

Grenoble, France

Institut Paoli Calmette

🇫🇷

Marseille, France

Centre Antoine Lacassagne

🇫🇷

Nice, France

Centre Val D'Aurelle

🇫🇷

Montpellier, France

Centre Regional de Lutte Contre Le Cancer Rhone-Alpes Centre Leon Berard

🇫🇷

Lyon, France

Clinique Hartmann

🇫🇷

Neuilly Sur Seine, France

Hopital Saint-Louis

🇫🇷

Paris, France

Hospices Civils de Lyon

🇫🇷

Pierre-Bénite, France

CHU Poitiers

🇫🇷

Poitiers, France

Centre Eugène Marquis

🇫🇷

Rennes, France

Hopital George Pompidou

🇫🇷

Paris, France

Centre Henry Becquerel

🇫🇷

Rouen, France

Polyclinique Courlancy

🇫🇷

Reims, France

Institut Jean Godinot,

🇫🇷

Reims, France

Institut Cancérologique de la Loire

🇫🇷

Saint-priest En Jarez, France

Institut Claudius Regaud

🇫🇷

Toulouse, France

Centre Paul Strauss

🇫🇷

Strasbourg, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

Clinique du TONKIN

🇫🇷

Villeurbanne, France

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