Radiation Therapy With or Without Bicalutamide and Goserelin in Treating Patients With Prostate Cancer

NCT ID: NCT00067015

Last Updated: 2015-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

3 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-05-31

Study Completion Date

2008-09-30

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation therapy in different ways may cause less damage to normal tissue and may improve quality of life and help patients live more comfortably. Androgens can stimulate the growth of prostate cancer cells. Drugs such as goserelin and bicalutamide may fight cancer by stopping the production of androgens. It is not yet known whether radiation therapy is more effective with or without goserelin and bicalutamide in treating prostate cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of high-dose radiation therapy with or without bicalutamide and goserelin in treating patients who have prostate cancer.

Detailed Description

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OBJECTIVES:

* Compare the quality of life of patients with high-grade intermediate-risk or unfavorable-risk adenocarcinoma of the prostate when treated with high-dose intensity-modulated radiotherapy alone versus with androgen deprivation comprising bicalutamide and goserelin.
* Compare the prostate-specific antigen relapse-free, distant metastases-free, and overall survival of patients treated with these regimens.
* Compare the toxicity of these regimens in these patients.
* Compare the local control in patients treated with these regimens, based on post-treatment sextant biopsies performed 4 years after study completion.

OUTLINE: This is a randomized study. Patients are stratified according to prostate-specific antigen level, Gleason score, and clinical stage. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo high-dose intensity-modulated radiotherapy (IMRT) 4-5 times per week for 10 weeks (a total of 48 treatments).
* Arm II: Patients receive oral bicalutamide once daily for 18.5 weeks. Three to seven days after the initiation of bicalutamide, patients also receive goserelin subcutaneously monthly for 2 years. Beginning after 10 weeks of hormonal therapy, patients undergo concurrent high-dose IMRT 4-5 times per week for 8.5 weeks (a total of 42 treatments). Patients discontinue bicalutamide on or near the end of radiotherapy.

In both arms, treatment continues in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, every 3 months for 1.5 years after the completion of radiotherapy, then 6 months later, and then annually for 2 years.

Patients are followed every 6-8 months for 4 years and then annually for 2 years.

PROJECTED ACCRUAL: A total of 400 patients (200 per treatment arm) will be accrued for this study within 4-5 years.

Conditions

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Prostate Cancer

Keywords

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adenocarcinoma of the prostate stage III prostate cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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IMRT alone to 86.4 Gy

External radiotherapy is given for 10 weeks, Monday through Friday for a total of 48 sessions. The total dose of radiotherapy delivered during these 10 weeks is 86.4 Gy. The radiation treatments are delivered with a high precision technique called intensity modulated radiotherapy or IMRT. For this treatment, no hormonal therapy is required.

Group Type EXPERIMENTAL

assessment of therapy complications

Intervention Type PROCEDURE

quality-of-life assessment

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

IMRT TO 75.6 Gy plus Adjuvant Androgen Deprivation

Prior to a planned course of radiotherapy, which will last for eight and a half weeks, 10 weeks of hormonal therapy are given. The hormonal therapy will start with a daily pill called Casodex. Three to seven days after starting this pill, a Zoladex injection will be administered in addition to the Casodex pill. Zoladex hormonal therapy is given in the form of a monthly injection. After 10 weeks from the initiation of hormone therapy, you will begin external radiotherapy. For these treatments only 42 treatment sessions are given. The total dose of radiotherapy delivered during these 8.5 weeks is 75.6 Gy. The hormone injections continue during the radiation treatments and for 2 years after the radiation treatments. The pills are only taken for the 10 weeks before and also during the radiation treatments, however afterwards the pills are discontinued.

Group Type EXPERIMENTAL

bicalutamide

Intervention Type DRUG

goserelin acetate

Intervention Type DRUG

assessment of therapy complications

Intervention Type PROCEDURE

quality-of-life assessment

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Interventions

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bicalutamide

Intervention Type DRUG

goserelin acetate

Intervention Type DRUG

assessment of therapy complications

Intervention Type PROCEDURE

quality-of-life assessment

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the prostate
* Unfavorable-risk disease, including at least 2 of the following characteristics:

* Prostate-specific antigen level greater than 10 ng/mL
* Gleason score greater than 7
* Stage T4
* Intermediate-risk disease with a Gleason score of at least 8 allowed
* Lymph nodes clinically negative by imaging studies or histologically negative by node sampling or lymph node dissection
* Prostate size less than 75 grams
* No distant metastases by bone scan, CT scan, or MRI

PATIENT CHARACTERISTICS:

Age

* 18 and over

Performance status

* Karnofsky 80-100%

Life expectancy

* Not specified

Hematopoietic

* Not specified

Hepatic

* Bilirubin no greater than 1.5 times upper limit of normal (ULN)
* SGOT and SGPT no greater than 1.5 times ULN

Renal

* Not specified

Other

* No documented history of inflammatory bowel disease
* No bilateral hip replacements
* No other invasive cancer except localized basal cell or squamous cell skin cancer unless disease free for at least 5 years
* No major medical or psychiatric illness that would preclude study completion, compliance, or follow-up

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No prior chemotherapy for prostate cancer

Endocrine therapy

* No prior androgen-deprivation therapy

Radiotherapy

* No prior pelvic radiotherapy
* No prior prostate brachytherapy

Surgery

* No prior bilateral orchiectomy
* No prior radical prostatectomy
* No prior cryotherapy for prostate cancer
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Memorial Sloan Kettering Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael J. Zelefsky, MD

Role: PRINCIPAL_INVESTIGATOR

Memorial Sloan Kettering Cancer Center

Locations

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Memorial Sloan-Kettering Cancer Center

New York, New York, United States

Site Status

Countries

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United States

Other Identifiers

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P30CA008748

Identifier Type: NIH

Identifier Source: secondary_id

View Link

MSKCC-03040

Identifier Type: -

Identifier Source: secondary_id

03-040

Identifier Type: -

Identifier Source: org_study_id