Prostate Cancer Clinical Trial
Official title:
A PHASE III TRIAL OF THE STUDY OF ENDOCRINE THERAPY USED AS A CYTOREDUCTIVE AND CYTOSTATIC AGENT PRIOR TO RADIATION THERAPY IN GOOD PROGNOSIS LOCALLY CONFINED ADENOCARCINOMA OF THE PROSTATE
RATIONALE: Radiation therapy (RT) uses high-energy x-rays to damage tumor cells. Androgens
can stimulate the growth of prostate cancer cells. Hormone therapy using flutamide,
goserelin, and leuprolide may fight prostate cancer by reducing the production of androgens.
It is not yet known which regimen of antiandrogen therapy is most effective for prostate
cancer.
PURPOSE: Randomized phase III trial to study the effectiveness of radiation therapy with or
without antiandrogen therapy in treating patients who have stage I or stage II prostate
cancer.
OBJECTIVES: Primary: To evaluate whether a combination of Zoladex and flutamide used as
cytoreductive agents prior to and during definitive radiation therapy improves overall
survival over radiation therapy alone in locally confined carcinomas of the prostate;
Secondary: To compare the rates of disease-specific survival, clinical relapse (local
progression and/or distant failure), freedom from prostate-specific antigen (PSA) failure,
freedom from second clinical relapse, freedom from second PSA relapse, and disease-free
survival; To compare the prostate re-biopsy at two years; To measure the effect on sexual
function.
OUTLINE: This is a randomized, multicenter study. Patients were stratified by PSA level (less
than 4 vs 4-20), tumor differentiation (well vs moderate vs poor), nodal status (N0 [nodes
evaluated by surgical sampling] vs NX [nodes evaluated negative by imaging methods only]),
and participating center. Patients are randomized to one of two treatment arms. Arm I:
Patients receive oral flutamide 3 times a day and goserelin subcutaneously once every 4
weeks, or once as a time release injection (intramuscular leuprolide may be substituted for
goserelin), beginning 2 months prior to radiotherapy and continuing until completion of
radiotherapy. Patients undergo radiotherapy daily 4-5 days per week for almost 8 weeks. Arm
II: Patients undergo radiotherapy only, as in arm I. Patients are followed every 3 months for
the remainder of the first year, every 4 months for the second year, every 6 months for the
third through fifth years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 1980 patients within 5 years.
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