Radiotherapy of the Prostate and the Pelvic Lymph Nodes After Neoadjuvant Antihormonal Treatment

NCT ID: NCT01903408

Last Updated: 2023-02-01

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

PHASE2

Total Enrollment

199 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-05-31

Study Completion Date

2020-05-31

Brief Summary

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For patients with prostate cancer and a high risk of lymph node involvement or confirmed pelvic lymph node metastases, radiotherapy of the whole pelvis is a treatment option. However, conventional radiotherapy of the pelvis has limited by gastrointestinal and urogenital side effects. The PLATIN trial investigates an intensity-modulated radiotherapy of the pelvic lymphatic drainage that spares small bowel, bladder and rectum. A higher dose is given during each session to the prostate or the prostate bed and to confirmed lymph node metastases. Prior to radiotherapy, two months of neoadjuvant antihormonal treatment are required, and continuation during radiotherapy and for a further two years are strongly recommended.

Detailed Description

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The PLATIN trial is designed as a prospective, non-randomized, five-arm trial. Arm 1: Definitive radiotherapy of the pelvic lymphatic drainage with integrated boost to the prostate.

Arm 2: As arm 1, with additional boost to macroscopic lymph node metastases. Arm 3: Postoperative radiotherapy of the pelvic lymphatic drainage with integrated boost to the prostate bed.

Arm 4: As arm 3, additional boost to macroscopic lymph node metastases. Arm 5: Patients with previous radiotherapy to the prostate bed. Radiotherapy of the pelvic lymphatic drainage above the previous treatment fields with integrated boost to macroscopic lymph node metastases.

Conditions

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Prostate Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1: Boost to prostate

IMRT of the pelvic lymphatic drainage (51 Gy) and integrated boost to the prostate (76.5 Gy) in 34 fractions Arm finished recruitment and follow-up

Group Type OTHER

Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

Intervention Type RADIATION

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Arm 2: Boost to prostate and lymph node metastases

IMRT of the pelvic lymphatic drainage (51 Gy), SIB to the prostate (76.5 Gy) \& pelvic lymph node mets (61.2 Gy) in 34 Fx

Group Type OTHER

Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

Intervention Type RADIATION

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Arm 3: Boost to prostate bed

IMRT of the pelvic lymphatic drainage (51 Gy) and integrated boost to the prostate bed (68 Gy) in 34 fractions Arm finished recruitment and follow-up and is published

Group Type OTHER

Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

Intervention Type RADIATION

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Arm 4: Boost to prostate bed and lymph node metastases

IMRT of the pelvic lymphatic drainage (51 Gy), SIB to the prostate bed 68 Gy) \& lymph node metastases (61.2 Gy) in 34 Fx

Group Type OTHER

Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

Intervention Type RADIATION

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Arm 5: Boost to lymph node metastases

Patients with previous irradiation of the prostate bed: IMRT of the pelvic lymphatic drainage (46.8 Gy) above the previous treatment fields, SIB to lymph node metastases (63.2 Gy) in 26 Fx

Group Type OTHER

Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

Intervention Type RADIATION

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Interventions

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Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB

The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* histologically confirmed prostate cancer with Gleason Score
* risk of lymph node involvement \>20% (according to Roach Formula), pelvic lymph node metastases in CT/MRI or histologically confirmed lymph node involvement
* Karnofsky Index \>/= 70%
* age 18-75 years
* neoadjuvant antihormonal treatment for 2 months, continuation until the end of radiotherapy
* written informed consent

Exclusion Criteria

* stage IV (distant metastases)
* lymph node metastases outside the pelvis
* rising prostate-specific antigen (PSA) under antihormonal treatment
* severe wound complications after laparatomy
* severe lymph edema of the legs, elephantiasis, postthrombotic syndrome
* decompensated comorbidity of the lungs, heart, metabolic system, hematopoetic system or kidneys, coagulopathy
* history of other malignancy within the last 5 years (except for basal cell carcinoma or squamous carcinoma of the skin)
* previous irradiation of the pelvic lymph nodes
* concurrent participation in a clinical trial that might influence the results of either trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Klaus Tschira Stiftung gGmbH

UNKNOWN

Sponsor Role collaborator

Heidelberg University

OTHER

Sponsor Role lead

Responsible Party

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Klaus Herfarth, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Klaus Herfarth, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Heidelberg, Department of Radiation Oncology

Locations

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Department of Radiation Oncology, University Hospital Heidelberg

Heidelberg, , Germany

Site Status

Countries

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Germany

References

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Habl G, Katayama S, Uhl M, Kessel KA, Edler L, Debus J, Herfarth K, Sterzing F. Helical intensity-modulated radiotherapy of the pelvic lymph nodes with a simultaneous integrated boost to the prostate--first results of the PLATIN 1 trial. BMC Cancer. 2015 Nov 7;15:868. doi: 10.1186/s12885-015-1886-5.

Reference Type RESULT
PMID: 26547188 (View on PubMed)

Katayama S, Habl G, Kessel K, Edler L, Debus J, Herfarth K, Sterzing F. Helical intensity-modulated radiotherapy of the pelvic lymph nodes with integrated boost to the prostate bed - initial results of the PLATIN 3 Trial. BMC Cancer. 2014 Jan 14;14:20. doi: 10.1186/1471-2407-14-20.

Reference Type RESULT
PMID: 24422782 (View on PubMed)

Koerber SA, Winter E, Katayama S, Slynko A, Haefner MF, Uhl M, Sterzing F, Habl G, Schubert K, Debus J, Herfarth K. Elective Node Irradiation With Integrated Boost to the Prostate Using Helical IMRT-Clinical Outcome of the Prospective PLATIN-1 Trial. Front Oncol. 2019 Aug 13;9:751. doi: 10.3389/fonc.2019.00751. eCollection 2019.

Reference Type RESULT
PMID: 31456941 (View on PubMed)

Other Identifiers

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ARO 2009-05

Identifier Type: REGISTRY

Identifier Source: secondary_id

Klaus Tschira 00.153.2009

Identifier Type: -

Identifier Source: org_study_id

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