Prostate Cancer
Conditions
Keywords
Proton Radiation Prostate Cancer
Brief summary
The purpose of this study is to compare the effects (good and bad) on patients with prostate cancer by comparing the standard dose of radiation therapy (44 treatments over 8½-9 weeks) with a higher daily dose of radiation (5 treatments over 1-2 weeks) to see if the effects of the treatments are similar or better.
Interventions
RADIATIONProton Radiation Hypofractionation
Dose: 38 Gy(RBE); 7.6 GY(RBE) five days a week in 5 treatments over 1-2 weeks
RADIATIONProton Radiation Standard Fractionation
Dose: 79.2 GY(RBE); 1.8 GY(RBE) five days a week in 44 treatments over 8.5-9 weeks
Sponsors
Proton Collaborative Group
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically confirmed prostate adenocarcinoma within 365 days prior to randomization. * History/physical examination with digital rectal examination of the prostate and baseline toxicity assessment within 90 days prior to randomization. * Histological evaluation of prostate biopsy with assignment of a Gleason score to the biopsy material;Gleason score must be in the range of 2-6. \> 6 cores are strongly recommended. * PSA values \< 10 ng/ml within 90 days prior to randomization. Either done prior to biopsy or at least 21 days after prostate biopsy. * Clinical stages T1a-T2a N0 M0 (AJCC Criteria 7th Ed.). Staging must be done by treating investigator. * No pelvic lymph nodes \> 1.5 cm in greatest dimension unless the enlarged lymph node is biopsied and negative. * Patients must be at least 18 years old. * ECOG performance status 0-1 (appendix I) documented within 90 days prior to randomization. * IPSS score \<= 16. * Patients must give IRB approved, study specific, informed consent. * Patients must complete all mandatory tests listed in section 4.0 within the specified time frames. * Patients must be able to start treatment within 56 days of randomization.
Exclusion criteria
* Previous prostate cancer surgery to include: prostatectomy, hyperthermia and cryosurgery. * Previous pelvic radiation for prostate cancer. * Androgen deprivation therapy prior to radiation is allowed. However, it is not acceptable if continued during radiation or as adjuvant therapy. * Active rectal diverticulitis, Crohn's disease affecting the rectum, or ulcerative colitis. * Prior systemic chemotherapy for prostate cancer. * History of proximal urethral stricture requiring dilatation. * Current and continuing anticoagulation with warfarin sodium (Coumadin, heparin, low-molecular weight heparin, Clopidogrel bisulfate (Plavix),or equivalent. (Unless it can be stopped to manage treatment related toxicity, to have a biopsy if needed, or for marker placement). * Any major medical, addictive or psychiatric illnesses which would affect the consent process, completion of treatment and/or interfere with follow-up. Consent by legal authorized representative is not permitted in this study. * Evidence of any other cancer within the past 5 years and \< 50% probability of a 5 year survival. (Prior or concurrent diagnosis of basal cell or non-invasive squamous cell cancer of the skin is allowed).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To assess if hypo-fractionation will result in 2-year freedom from failure (FFF) that is non-inferior to 2-year FFF following standard fractionation. FFF will be measured by recurrence, metastasis, PSA or start of salvage therapy. | At 5 years post treatment completion +/- 90 days | The events for FFF will be the first occurrence of clinical failure (local recurrence, regional recurrence, or distant metastasis), biochemical failure by the Phoenix definition (PSA ≥ 2 ng/ml over the current nadir PSA),or the start of salvage therapy including androgen deprivation. |
Secondary
| Measure | Time frame |
|---|---|
| To determine the incidence of grade 2 or greater GU and GI toxicity in each of the regimens. | At 6 months and 2 years post randomization |
Countries
United States
Outcome results
None listed