Implant and External Radiation for Prostate Cancer With or Without Hormonal Therapy: A Prospective Randomized Trial

April 12, 2016 updated by: Gregory Merrick, M.D., Schiffler Cancer Center
Determine the role of androgen deprivation therapy in high risk patients receiving 45 Gy of pelvic radiotherapy plus a Pd-103 boost and the impact of the duration of ADT in hormonally-manipulated patients.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

In calender year 2005, 220, 000 men will be diagnosed with prostate cancer and approximately 30,000 will subsequently die of metastatic disease. Although the vast majority of men will be diagnosed with clinically localized and potentially curable disease, the selection of one local modality over another remains a focus of significant controversy within the uro-oncology community. However, patients with higher risk features are most often managed with radiotherapeutic approaches to include androgen deprivation therapy.

Prostate brachytherapy represents the ultimate-three dimensional conformal therapy and permits dose escalation far exceeding other modalities. Following permanent prostate brachytherapy with or without supplemental external beam radiation therapy, favorable long-term biochemical outcomes have been reported for patients with low, intermediate and high risk features with a morbidity profile that compares favorably with competing local modalities (1,2).

Several prospective randomized trials have demonstrated that androgen deprivation therapy in conjunction with conventional doses of external beam radiation therapy (65-70 Gy)results in improvement in disease-free and overall survival in patients with locally advanced prostate cancer (3,4).

Study Type

Interventional

Enrollment (Actual)

6

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Washington
      • Seattle, Washington, United States, 98104
        • Seattle Prostate Institute
      • Seattle, Washington, United States, 98108
        • Groupe Health Cooperative, Veterans Adminstration Hospital and University of Washington
    • West Virginia
      • Wheeling, West Virginia, United States, 26003
        • Schiffler Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  • High risk patients - Two to three of the following: PSA 10-30 ng/mL, Gleason score greater than or equal to 6, clinical stage greater than or equal to T2c (2002 ACJJ).
  • CT of the abdomen and pelvis and bone scan without evidence of metastases.
  • An enzymatic prostatic acid phosphatase must be obtained prior to randomization.
  • A serum testosterone must be obtained prior to initiation of androgen deprivation therapy.
  • No prior pelvic external beam radiation therapy for prostate cancer or other malignancies.
  • No prior androgen deprivation therapy.
  • Minimum 5 year life expectancy.
  • No other invasive cancer diagnosis other than non-melanoma skin cancer within the last 5 years.

Exclusion Criteria:

  • Exclusion criteria will be limited to patients who do not meet the above eligibility criteria.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: no hormones
All patients will receive a 5-week course of external beam radiation therapy to the pelvis and a Pd-103 brachytherapy implant with no hormones
Radiation: External beam radiation
All patients will receive a 5-week course of external beam radiation therapy to the pelvis and a Pd-103 brachytherapy implant
Active Comparator: 9 months of hormone therapy
All patients will receive a 5-week course of external beam radiation therapy to the pelvis and a Pd-103 brachytherapy implant with a 9 month course of hormone therapy
Radiation: External beam radiation
All patients will receive a 5-week course of external beam radiation therapy to the pelvis and a Pd-103 brachytherapy implant
Drug: Lupron
9 months of an LHRH agonist and 4 months of an anti-androgen) is optimal for securing long-term biochemical control (a stable, non-rising PSA).
Drug: Casodex
9 months of an LHRH agonist and 4 months of an anti-androgen) is optimal for securing long-term biochemical control (a stable, non-rising PSA).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PSA 3 and 6 months following implantation then every 6 months.
Time Frame: 3 and 6 months following implantation then every 6 months
PSA 3 and 6 months following implantation then every 6 months.
3 and 6 months following implantation then every 6 months
Serum testosterone levels at 3 and 6 months in hormonally manipulated patients.
Time Frame: 3 and 6 months
Serum testosterone levels at 3 and 6 months in hormonally manipulated patients
3 and 6 months
Androgen deprivation therapy will not be reinitiated unless the post-treatment PSA exceeds 10 ng/mL or distant metastases are detected.
Time Frame: as needed
Androgen deprivation therapy will not be reinitiated unless the post-treatment PSA exceeds 10 ng/mL or distant metastases are detected.
as needed

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
EPIC on 6 and 12 months and then annually.
Time Frame: 6 and 12 months and then annually.
EPIC on 6 and 12 months and then annually.
6 and 12 months and then annually.
Hormonally manipulated patients will obtain a DEXA scan.
Time Frame: as needed
Hormonally manipulated patients will obtain a DEXA scan.
as needed
For documented osteoporosis, Zometa (4 mg IV over 15 minutes) every 3 months is recommended.
Time Frame: every 3 months is recommended.
For documented osteoporosis, Zometa (4 mg IV over 15 minutes) every 3 months is recommended.
every 3 months is recommended.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Schiffler Cancer Center

Collaborators

Kent E. Wallner, M.D.
Sylvester, John, M.D.

Investigators

  • Principal Investigator: Gregory S Merrick, MD, Schiffler Cancer Center, Wheeling, WV
  • Study Chair: Kent E. Wallner, MD, Group Health Cooperative, Veterans Administration Hospital, and University of Washington
  • Study Chair: John Sylvester, MD, Seattle Prostate Institute Seattle, WA 98104

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2004

Primary Completion (Actual)

July 1, 2009

Study Completion (Actual)

July 1, 2009

Study Registration Dates

First Submitted

October 20, 2005

First Submitted That Met QC Criteria

October 20, 2005

First Posted (Estimate)

October 24, 2005

Study Record Updates

Last Update Posted (Estimate)

April 14, 2016

Last Update Submitted That Met QC Criteria

April 12, 2016

Last Verified

April 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 05-8-4

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Prostate Cancer

Clinical Trials on External beam radiation

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Hong Kong

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe