Prostate CancerPhase 3NCT00033631
Radiation Therapy in Treating Patients With Stage II Prostate Cancer
A Phase 3 study testing 70.2 Gy 3D-CRT/IMRT and 79.2 Gy 3D-CRT/IMRT in people with Prostate Cancer, run by Radiation Therapy Oncology Group at 86 sites in 2 countries.
Trial summary
RATIONALE: Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. It is not yet known which dose of radiation therapy is more effective in treating stage II prostate cancer. Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Prostate Cancer
- What is being tested?
- 70.2 Gy 3D-CRT/IMRT and 79.2 Gy 3D-CRT/IMRT
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,534 participants
- Where
- 86 sitesin 2 countries
- Study dates
- Mar 2002to 22 Dec 2022
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma of the prostate
- Clinical stage T1b-T2b
- Meets one of the following criteria:
- Gleason score 2-6 AND prostate-specific antigen (PSA) ≥ 10 ng/mL but < 20 ng/mL
- Gleason score 7 AND PSA < 15 ng/mL
- No regional lymph node involvement
- No distant metastases
PATIENT CHARACTERISTICS:
Age:
- Any age
Performance status:
- Zubrod 0-1
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
Other:
- No other invasive malignancy within the past 5 years except localized basal cell or squamous cell skin cancer
- No other major medical or psychiatric illness that would preclude study participation
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- No prior cytotoxic chemotherapy
- No concurrent cytotoxic chemotherapy
Endocrine therapy:
- At least 3 months since prior finasteride
- No other prior hormonal therapy, including:
- Luteinizing hormone-releasing hormone agonists (e.g., goserelin or leuprolide)
- Antiandrogens (e.g., flutamide or bicalutamide)
- Estrogens (e.g., diethylstilbestrol)
- No concurrent (neoadjuvant or adjuvant) hormonal therapy
Radiotherapy:
- No prior pelvic irradiation or brachytherapy
Surgery:
- No prior radical surgery (prostatectomy) or cryosurgery for prostate cancer
- No prior surgical castration (bilateral orchiectomy)
Other:
- At least 3 months since prior finasteride or phytoestrogen preparation (PC-SPES)
Trial locations and contacts
86 sites in 2 countries.
86 sites in 2 countries
United States72 sites
Summa Center for Cancer Care at Akron City Hospital
Akron, Ohio, 44309-2090
Lovelace Medical Center - Downtown
Albuquerque, New Mexico, 87102
Veterans Affairs Medical Center - Ann Arbor
Ann Arbor, Michigan, 48105
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109-0942
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, 21201
Veterans Affairs Medical Center - Brooklyn
Brooklyn, New York, 11209
New York Methodist Hospital
Brooklyn, New York, 11215
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Roswell Park Cancer Institute
Buffalo, New York, 14263-0001
Cancer Institute of New Jersey at Cooper University Hospital - Camden
Camden, New Jersey, 08103
Charles M. Barrett Cancer Center at University Hospital
Cincinnati, Ohio, 45267
Central Maryland Oncology Center
Columbia, Maryland, 21044
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390
Danville Regional Medical Center
Danville, Virginia, 24541
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234-6200
Oncology Center at Saint Margaret Mercy Healthcare Center
Hammond, Indiana, 46320
Independence Regional Health Center
Independence, Missouri, 64050
Foote Memorial Hospital
Jackson, Michigan, 49201
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Providence Medical Center
Kansas City, Kansas, 66112
Truman Medical Center - Hospital Hill
Kansas City, Missouri, 64108
Saint Luke's Cancer Institute at Saint Luke's Hospital
Kansas City, Missouri, 64111
Kansas City Cancer Center at St. Joseph's Medical Mall
Kansas City, Missouri, 64114
St. Joseph Medical Center
Kansas City, Missouri, 64114
North Kansas City Hospital
Kansas City, Missouri, 64116
Parvin Radiation Oncology
Kansas City, Missouri, 64116
CCOP - Kansas City
Kansas City, Missouri, 64131
Radiation Oncology Associates of Kansas City at Northland Radiation Oncology Center
Kansas City, Missouri, 64154
Thompson Cancer Survival Center
Knoxville, Tennessee, 37916
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Wilford Hall Medical Center
Lackland Air Force Base, Texas, 78236
Breslin Cancer Center at Ingham Regional Medical Center
Lansing, Michigan, 48910
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Veterans Affairs Medical Center - Long Beach
Long Beach, California, 90822
Community Memorial Hospital Cancer Care Center
Menomonee Falls, Wisconsin, 53051
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, 53226
Cancer Center at Ball Memorial Hospital
Muncie, Indiana, 47303-3499
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
Murray, Utah, 84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
Ogden, Utah, 84403
Menorah Medical Center
Overland Park, Kansas, 66209
Johnson County Radiation Therapy
Overland Park, Kansas, 66210
Bay Medical
Panama City, Florida, 32401
Cancer Center of Paoli Memorial Hospital
Paoli, Pennsylvania, 19301-1792
Regional Cancer Center at Singing River Hospital
Pascagoula, Mississippi, 39581
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
Philadelphia, Pennsylvania, 19107-5541
MNAP Oncologic Center
Philadelphia, Pennsylvania, 19115
Albert Einstein Cancer Center
Philadelphia, Pennsylvania, 19141
Naval Medical Center - Portsmouth
Portsmouth, Virginia, 23708-2197
All Saints Cancer Center at Wheaton Franciscan Healthcare
Racine, Wisconsin, 53405
Cancer Centers of North Carolina - Raleigh
Raleigh, North Carolina, 27607
Rex Cancer Center at Rex Hospital
Raleigh, North Carolina, 27607
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center
Reading, Pennsylvania, 19612-6052
Saint Mary's Regional Medical Center
Reno, Nevada, 89503
William Beaumont Hospital - Royal Oak Campus
Royal Oak, Michigan, 48073
Radiological Associates of Sacramento Medical Group, Incorporated
Sacramento, California, 95815
CentraCare Clinic - River Campus
Saint Cloud, Minnesota, 56303
Heartland Regional Medical Center
Saint Joseph, Missouri, 64506
LDS Hospital
Salt Lake City, Utah, 84143
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, 94115
Shawnee Mission Medical Center
Shawnee Mission, Kansas, 66204
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
St Louis, Missouri, 63110
Dixie Regional Medical Center - East Campus
St. George, Utah, 84770
Mount Nittany Medical Center
State College, Pennsylvania, 16803
SUNY Upstate Medical University Hospital
Syracuse, New York, 13210
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
Washington Cancer Institute at Washington Hospital Center
Washington D.C., District of Columbia, 20010
Precision Radiotherapy at University Pointe
West Chester, Ohio, 45069
Cancer Treatment Center
Wooster, Ohio, 44691
CCOP - Main Line Health
Wynnewood, Pennsylvania, 19096
Lankenau Cancer Center at Lankenau Hospital
Wynnewood, Pennsylvania, 19096
Canada14 sites
Tom Baker Cancer Centre - Calgary
Calgary, Alberta, T2N 4N2
Cross Cancer Institute at University of Alberta
Edmonton, Alberta, T6G 1Z2
Northeastern Ontario Regional Cancer Centre
Greater Sudbury, Ontario, P3E 5J1
Margaret and Charles Juravinski Cancer Centre
Hamilton, Ontario, L8V 5C2
London Regional Cancer Program at London Health Sciences Centre
London, Ontario, N6A 4L6
Hopital Notre-Dame du CHUM
Montreal, Quebec, H2L 4M1
McGill Cancer Centre at McGill University
Montreal, Quebec, H2W 1S6
Centre Hospitalier Universitaire de Quebec
Québec, Quebec, G1R 2J6
Saint John Regional Hospital
Saint John, New Brunswick, E2L 4L2
Saskatoon Cancer Centre at the University of Saskatchewan
Saskatoon, Saskatchewan, S7N 4H4
Doctor H. Bliss Murphy Cancer Centre
St. John's, Newfoundland and Labrador, A1B 3V6
Cancer Care Program at Thunder Bay Regional Health Sciences
Thunder Bay, Ontario, P7B 6V4
Edmond Odette Cancer Centre at Sunnybrook
Toronto, Ontario, M4N 3M5
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
About this study
Official title: A Phase III Randomized Study Of High Dose 3D-CRT/IMRT Versus Standard Dose 3D-CRT/IMRT In Patients Treated For Localized Prostate Cancer
RATIONALE: Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. It is not yet known which dose of radiation therapy is more effective in treating stage II prostate cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of two different doses of specialized radiation therapy in treating patients who have stage II prostate cancer.
Read the detailed description
OBJECTIVES:
- Compare the overall survival of patients with stage II adenocarcinoma of the prostate treated with high- vs standard-dose three-dimensional conformal or intensity-modulated radiotherapy.
- Compare the freedom from prostate-specific antigen failure, disease-specific survival, local progression, and distant metastases in patients treated with these regimens.
- Compare the probability of tumor control and normal tissue complications in patients treated with these regimens.
- Compare the incidence of grade 2 or greater genitourinary and gastrointestinal acute and late toxicity in patients treated with these regimens.
- Compare the quality of life, including sexual function, of patients treated with these regimens.
- Correlate histopathologic or tumor-specific cytogenetic or chromosomal markers with cancer control outcomes in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to Gleason score and prostate-specific antigen (PSA) level (Gleason score 2-6, PSA ≥10 mg/mL but < 20 ng/mL vs Gleason score 7, PSA < 15 ng/mL) and radiation modality (three-dimensional conformal radiotherapy [3D-CRT] vs intensity-modulated radiotherapy [IMRT]). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo standard-dose 3D-CRT or IMRT once daily, 5 days a week, for 7.8 weeks (39 treatment days).
- Arm II: Patients undergo high-dose 3D-CRT or IMRT once daily, 5 days a week, for 8.8 weeks (44 treatment days).
Quality of life (QOL) is assessed initially at baseline. After completion of radiotherapy, QOL is assessed every 3 months for 1 year and then every 6 months for 4 years.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 1,520 patients (760 per treatment arm) will be accrued for this study within 5 years.
- Conditions
- Prostate Cancer
- Being tested
- 70.2 Gy 3D-CRT/IMRT, 79.2 Gy 3D-CRT/IMRT
- Keywords
- adenocarcinoma of the prostate, stage IIB prostate cancer, stage IIA prostate cancer
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
70.2 Gy 3D-CRT/IMRTRadiation
Also called 3D conformal radiation therapy, intensity modulated radiation therapy
Radiation will be delivered via 3D conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) in 1.8 Gy minimum dose fractions to a total of 70.2 Gy in 39 Fractions. All fields treated once daily, five fractions per week. No more than 2% of the planning target volume and none of the clinical target volume may receive less than 70.2 Gy.
79.2 Gy 3D-CRT/IMRTRadiation
Also called 3D conformal radiation therapy, intensity modulated radiation therapy
Radiation will be delivered via 3D conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) in 1.8 Gy minimum dose fractions to a total of 79.2 Gy in 44 fractions. All fields treated once daily, five fractions per week. No more than 2% of the planning target volume and none of the clinical target volume may receive less than 79.2 Gy.
| Study group | Role | What they receive |
|---|---|---|
| 70.2 Gy | Active comparator | 70.2 Gy 3D-CRT/IMRT Receives: Radiation: 70.2 Gy 3D-CRT/IMRT |
| 79.2 Gy | Experimental | 79.2 Gy 3D-CRT/IMRT Receives: Radiation: 79.2 Gy 3D-CRT/IMRT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival
Survival time is defined as time from randomization to the date of death from any cause and is estimated by the Kaplan-Meier Method. Patients last know to be alive are censored at date of last contact.
Measured: From randomization to date of failure (death) or last follow-up. Analysis occurs after all patients have been potentially followed for 8 years.
Secondary outcomes (10)
Prostate-specific Antigen (PSA) Failure by American Society for Therapeutic Radiology and Oncology (ASTRO) Definition
Failure is defined as having 3 consecutive elevations of post-treatment PSA or starting hormones after one or more elevations in post-treatment PSA but before three consecutive elevations were documented. The failure day date was the midpoint between last non-rising PSA and first PSA rise. Failure rates are estimated by the cumulative incidence method. Patients last known to be alive are censored at date of last contact.
Measured: From randomization to date of failure (3 consecutive rises) or death or last follow-up. Analysis occurred after patients have been potentially followed for 5 years.
Disease Specific Survival
Survival time is defined as time from randomization to the date of death due to prostate cancer and is estimated by the cumulative incidence method. Patients last know to be alive are censored at date of last contact. Death due to prostate cancer was defined as primary cause of death certified as due to prostate cancer, or death in association with any of the following conditions: Further clinical tumor progression occurring after initiation of salvage anti-tumor therapy, a rise (that exceeds 1.0 ng/ml) in the serum PSA level on at least two consecutive occasions that occurred during or after salvage androgen suppression therapy, or disease progression in the absence of any anti-tumor therapy.
Measured: From randomization to date of failure (death due to prostate cancer) or death from other cause or last follow-up. Analysis occurs at the same time as the primary endpoint.
Local Progression
Failure time is defined as time from randomization to the date of progression (increase in palpable abnormality), failure of regression of the palpable tumor by two years, and redevelopment of a palpable abnormality after complete disappearance of previous abnormalities. Failure rates are estimated by the cumulative incidence method. Patients last know to be alive are censored at date of last contact.
Measured: From randomization to date of failure (local progression) or death or last follow-up. Analysis occurs at the same time as the primary endpoint.
Distant Metastases
Failure time is defined as time from randomization to the date of documented regional nodal recurrence or development of distant disease. Failure rates are estimated by the cumulative incidence method. Patients last know to be alive are censored at date of last contact.
Measured: From randomization to date of failure (distant metastasis) or death or last follow-up. Analysis occurs at the same time as the primary endpoint.
Grade 2 or Greater Genitourinary or Gastrointestinal Toxicity
Rate of acute 2+ grade genitourinary(GU)/gastrointestinal(GI) toxicity graded by Common Toxicity Criteria (CTC) version 2.0
Measured: From the start of treatment to 90 days. Analysis occurs at the same time as the primary endpoint
Percentage of Participants With Erectile Disfuction at 12 Months
The International Index of Erectile Function Questionnaire (IIEF) is the primary measure for erectile function (ED). IIEF question number 1 ("How often were you able to get an erection during sexual activity?") is scored from: none/almost never (response 0-1) or < half the time (response 2-3) to most times/almost always/always (response 4-5). A response of 0 to 3 on question number 1 of the IIEF is considered erectile dysfunction.
Measured: Twelve months from randomization
Number of Participants With Improved, Stable, and Declined Spitzer Quality of Life Index (SQLI) at 12 Months
The SQLI measures quality of life for patients with cancer and other chronic diseases. Possible scores range from 0 to 10, with higher scores indicating a better outcome. Change from Baseline is defined as 12 month SQLI - baseline SQLI and is classified as follows:
Improvement: when change >= to the standard error of measurement with reliability quotient of 0.5 (SEM); Stable: when -SEM < change < SEM; Declined: when change <= SEM.
Measured: Baseline and 12 months from randomization
Quality Adjusted Survival by SQLI
Measured: From randomization to 5 years.
Tumor Control Probability
Measured: From randomization to date of failure (tumor progression) or last follow-up. Analysis can occur any time after the primary endpoint analysis.
Normal Tissue Complication Probability
Measured: From randomization to last follow-up. Analysis can occur any time after the primary endpoint analysis.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2003 (estimated)
- Study startMar 2002
- Primary completionApr 2014
- Study completion22 Dec 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Prostate CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 1,534 participants (actual)
Sponsor and investigators
- Lead sponsor
- Radiation Therapy Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Jeff M. Michalski, MD, Principal investigator, Washington University - Saint LouisJames Purdy, Ph.D., Study chair, UC DavisDeborah W Bruner, Ph.D., Study chair, Emory UniversityMahul Amin, M.D., Study chair, Cedars-Sinai
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00033631
- Sponsor's protocol ID
- RTOG-0126
- Other IDs
- CDR0000069306
- Status last verified
- Dec 2022
- First submitted
- 9 Apr 2002
- Last updated
- 18 Jan 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Cranmer-Sargison G. A treatment planning investigation into the dosimetric effects of systematic prostate patient rotational set-up errors. Med Dosim. 2008 Autumn;33(3):199-205. doi: 10.1016/j.meddos.2007.06.005.
PubMed 18674684Potrebko PS, McCurdy BM, Butler JB, El-Gubtan AS, Nugent Z. Optimal starting gantry angles using equiangular-spaced beams with intensity modulated radiation therapy for prostate cancer on RTOG 0126: a clinical study of 5 and 7 fields. Radiother Oncol. 2007 Nov;85(2):299-305. doi: 10.1016/j.radonc.2007.06.019. Epub 2007 Sep 7.
PubMed 17825932Spratt DE, Tang S, Sun Y, Huang HC, Chen E, Mohamad O, Armstrong AJ, Tward JD, Nguyen PL, Lang JM, Zhang J, Mitani A, Simko JP, DeVries S, van der Wal D, Pinckaers H, Monson JM, Campbell HA, Wallace J, Ferguson MJ, Bahary JP, Schaeffer EM, Sandler HM, Tran PT, Rodgers JP, Esteva A, Yamashita R, Feng FY. Artificial Intelligence Predictive Model for Hormone Therapy Use in Prostate Cancer. NEJM Evid. 2023 Aug;2(8):EVIDoa2300023. doi: 10.1056/EVIDoa2300023. Epub 2023 Jun 29.
PubMed 38320143Alexander GS, Krc RF, Assif JW, Sun K, Molitoris JK, Tran P, Rana Z, Bentzen SM, Mishra MV. Conditional Risks of Biochemical Failure and Prostate Cancer-Specific Death in Patients Undergoing External Beam Radiotherapy: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Netw Open. 2023 Sep 5;6(9):e2335069. doi: 10.1001/jamanetworkopen.2023.35069.
PubMed 37751207Spratt DE, Liu VYT, Michalski J, Davicioni E, Berlin A, Simko JP, Efstathiou JA, Tran PT, Sandler HM, Hall WA, Thompson DJS, Parliament MB, Dayes IS, Correa RJM, Robertson JM, Gore EM, Doncals DE, Vigneault E, Souhami L, Karrison TG, Feng FY. Genomic Classifier Performance in Intermediate-Risk Prostate Cancer: Results From NRG Oncology/RTOG 0126 Randomized Phase 3 Trial. Int J Radiat Oncol Biol Phys. 2023 Oct 1;117(2):370-377. doi: 10.1016/j.ijrobp.2023.04.010. Epub 2023 May 2.
PubMed 37137444Kim S, Kong JH, Lee Y, Lee JY, Kang TW, Kong TH, Kim MH, You SH. Dose-escalated radiotherapy for clinically localized and locally advanced prostate cancer. Cochrane Database Syst Rev. 2023 Mar 8;3(3):CD012817. doi: 10.1002/14651858.CD012817.pub2.
PubMed 36884035Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary JP, Lau H, Duclos M, Parliament M, Morton G, Hamstra D, Seider M, Lock MI, Patel M, Gay H, Vigneault E, Winter K, Sandler H. Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol. 2018 Jun 14;4(6):e180039. doi: 10.1001/jamaoncol.2018.0039. Epub 2018 Jun 14.
PubMed 29543933
Study at a glance
From the registry record, last updated by the sponsor on 18 Jan 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Randomized Study Of High Dose 3D-CRT/IMRT Versus Standard Dose 3D-CRT/IMRT In Patients Treated For Localized Prostate Cancer
- ClinicalTrials.gov ID
- NCT00033631
- Acronym / sponsor ID
- RTOG-0126
- Conditions
- Prostate Cancer
- Keywords
- adenocarcinoma of the prostate, stage IIB prostate cancer, stage IIA prostate cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,534 participants (actual)
- Lead sponsor
- Radiation Therapy Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Mar 2002
- Primary completion
- Apr 2014 (actual)
- Study completion
- 22 Dec 2022 (actual)
- First posted
- 27 Jan 2003 (estimated)
- Results
- Posted 8 Feb 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. It is not yet known which dose of radiation therapy is more effective in treating stage II prostate cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of two different doses of specialized radiation therapy in treating patients who have stage II prostate cancer.
Detailed description
OBJECTIVES:
- Compare the overall survival of patients with stage II adenocarcinoma of the prostate treated with high- vs standard-dose three-dimensional conformal or intensity-modulated radiotherapy.
- Compare the freedom from prostate-specific antigen failure, disease-specific survival, local progression, and distant metastases in patients treated with these regimens.
- Compare the probability of tumor control and normal tissue complications in patients treated with these regimens.
- Compare the incidence of grade 2 or greater genitourinary and gastrointestinal acute and late toxicity in patients treated with these regimens.
- Compare the quality of life, including sexual function, of patients treated with these regimens.
- Correlate histopathologic or tumor-specific cytogenetic or chromosomal markers with cancer control outcomes in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to Gleason score and prostate-specific antigen (PSA) level (Gleason score 2-6, PSA ≥10 mg/mL but < 20 ng/mL vs Gleason score 7, PSA < 15 ng/mL) and radiation modality (three-dimensional conformal radiotherapy [3D-CRT] vs intensity-modulated radiotherapy [IMRT]). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo standard-dose 3D-CRT or IMRT once daily, 5 days a week, for 7.8 weeks (39 treatment days).
- Arm II: Patients undergo high-dose 3D-CRT or IMRT once daily, 5 days a week, for 8.8 weeks (44 treatment days).
Quality of life (QOL) is assessed initially at baseline. After completion of radiotherapy, QOL is assessed every 3 months for 1 year and then every 6 months for 4 years.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 1,520 patients (760 per treatment arm) will be accrued for this study within 5 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 70.2 Gy | Active comparator | Radiation: 70.2 Gy 3D-CRT/IMRT70.2 Gy 3D-CRT/IMRT |
| 79.2 Gy | Experimental | Radiation: 79.2 Gy 3D-CRT/IMRT79.2 Gy 3D-CRT/IMRT |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 70.2 Gy 3D-CRT/IMRTAlso: 3D conformal radiation therapy, intensity modulated radiation therapyRadiation will be delivered via 3D conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) in 1.8 Gy minimum dose fractions to a total of 70.2 Gy in 39 Fractions. All fields treated once daily, five fractions per week. No more than 2% of the planning target volume and none of the clinical target volume may receive less than 70.2 Gy. | Radiation | 70.2 Gy |
| 79.2 Gy 3D-CRT/IMRTAlso: 3D conformal radiation therapy, intensity modulated radiation therapyRadiation will be delivered via 3D conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT) in 1.8 Gy minimum dose fractions to a total of 79.2 Gy in 44 fractions. All fields treated once daily, five fractions per week. No more than 2% of the planning target volume and none of the clinical target volume may receive less than 79.2 Gy. | Radiation | 79.2 Gy |
Primary outcome
Overall Survival
Time frame: From randomization to date of failure (death) or last follow-up. Analysis occurs after all patients have been potentially followed for 8 years.
Survival time is defined as time from randomization to the date of death from any cause and is estimated by the Kaplan-Meier Method. Patients last know to be alive are censored at date of last contact.
10 secondary outcomes
Prostate-specific Antigen (PSA) Failure by American Society for Therapeutic Radiology and Oncology (ASTRO) Definition
Time frame: From randomization to date of failure (3 consecutive rises) or death or last follow-up. Analysis occurred after patients have been potentially followed for 5 years.
Disease Specific Survival
Time frame: From randomization to date of failure (death due to prostate cancer) or death from other cause or last follow-up. Analysis occurs at the same time as the primary endpoint.
Local Progression
Time frame: From randomization to date of failure (local progression) or death or last follow-up. Analysis occurs at the same time as the primary endpoint.
Distant Metastases
Time frame: From randomization to date of failure (distant metastasis) or death or last follow-up. Analysis occurs at the same time as the primary endpoint.
Grade 2 or Greater Genitourinary or Gastrointestinal Toxicity
Time frame: From the start of treatment to 90 days. Analysis occurs at the same time as the primary endpoint
Percentage of Participants With Erectile Disfuction at 12 Months
Time frame: Twelve months from randomization
Number of Participants With Improved, Stable, and Declined Spitzer Quality of Life Index (SQLI) at 12 Months
Time frame: Baseline and 12 months from randomization
Quality Adjusted Survival by SQLI
Time frame: From randomization to 5 years.
Tumor Control Probability
Time frame: From randomization to date of failure (tumor progression) or last follow-up. Analysis can occur any time after the primary endpoint analysis.
Normal Tissue Complication Probability
Time frame: From randomization to last follow-up. Analysis can occur any time after the primary endpoint analysis.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jan 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 18674684Cranmer-Sargison G. A treatment planning investigation into the dosimetric effects of systematic prostate patient rotational set-up errors. Med Dosim. 2008 Autumn;33(3):199-205. doi: 10.1016/j.meddos.2007.06.005.
- Results publication: PubMed 17825932Potrebko PS, McCurdy BM, Butler JB, El-Gubtan AS, Nugent Z. Optimal starting gantry angles using equiangular-spaced beams with intensity modulated radiation therapy for prostate cancer on RTOG 0126: a clinical study of 5 and 7 fields. Radiother Oncol. 2007 Nov;85(2):299-305. doi: 10.1016/j.radonc.2007.06.019. Epub 2007 Sep 7.
- Derived from this study: PubMed 38320143Spratt DE, Tang S, Sun Y, Huang HC, Chen E, Mohamad O, Armstrong AJ, Tward JD, Nguyen PL, Lang JM, Zhang J, Mitani A, Simko JP, DeVries S, van der Wal D, Pinckaers H, Monson JM, Campbell HA, Wallace J, Ferguson MJ, Bahary JP, Schaeffer EM, Sandler HM, Tran PT, Rodgers JP, Esteva A, Yamashita R, Feng FY. Artificial Intelligence Predictive Model for Hormone Therapy Use in Prostate Cancer. NEJM Evid. 2023 Aug;2(8):EVIDoa2300023. doi: 10.1056/EVIDoa2300023. Epub 2023 Jun 29.
- Derived from this study: PubMed 37751207Alexander GS, Krc RF, Assif JW, Sun K, Molitoris JK, Tran P, Rana Z, Bentzen SM, Mishra MV. Conditional Risks of Biochemical Failure and Prostate Cancer-Specific Death in Patients Undergoing External Beam Radiotherapy: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Netw Open. 2023 Sep 5;6(9):e2335069. doi: 10.1001/jamanetworkopen.2023.35069.
- Derived from this study: PubMed 37137444Spratt DE, Liu VYT, Michalski J, Davicioni E, Berlin A, Simko JP, Efstathiou JA, Tran PT, Sandler HM, Hall WA, Thompson DJS, Parliament MB, Dayes IS, Correa RJM, Robertson JM, Gore EM, Doncals DE, Vigneault E, Souhami L, Karrison TG, Feng FY. Genomic Classifier Performance in Intermediate-Risk Prostate Cancer: Results From NRG Oncology/RTOG 0126 Randomized Phase 3 Trial. Int J Radiat Oncol Biol Phys. 2023 Oct 1;117(2):370-377. doi: 10.1016/j.ijrobp.2023.04.010. Epub 2023 May 2.
- Derived from this study: PubMed 36884035Kim S, Kong JH, Lee Y, Lee JY, Kang TW, Kong TH, Kim MH, You SH. Dose-escalated radiotherapy for clinically localized and locally advanced prostate cancer. Cochrane Database Syst Rev. 2023 Mar 8;3(3):CD012817. doi: 10.1002/14651858.CD012817.pub2.
- Derived from this study: PubMed 29543933Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary JP, Lau H, Duclos M, Parliament M, Morton G, Hamstra D, Seider M, Lock MI, Patel M, Gay H, Vigneault E, Winter K, Sandler H. Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol. 2018 Jun 14;4(6):e180039. doi: 10.1001/jamaoncol.2018.0039. Epub 2018 Jun 14.
- Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.Link provided by the sponsor.
Related trials for Prostate Cancer
Active, not recruiting
Streamlined Geriatric and Oncological Evaluation Based On IC Technology
Breast Cancer, Comorbidities and Coexisting Conditions
Active, not recruitingObservational study
MRI Fusion Biopsy vs. Micro-Ultrasound Guided Biopsy
Prostate Cancer
Enrolling by invitationObservational study
Natural History Study of Early Life Exposures in Agriculture (ELEA)
Prostate Cancer, Leukemia
Not yet recruitingPhase 1/2
STAR0602 With Nivolumab in Non Small Cell Lung Cancer and in Metastatic Castrate-Resistant Prostate Cancer, and STAR0602 Alone in Thymic Carcinoma
NSCLC, Non-Small Cell Lung Cancer
Recruiting
Rehabilitation and Sex Therapy to Optimize Recovery After Prostate Cancer Treatment
Prostate Cancer, Urinary Incontinence
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jeff M. Michalski, MD principal investigator
Washington University - Saint Louis
James Purdy, Ph.D. study chair
UC Davis
Deborah W Bruner, Ph.D. study chair
Emory University
86 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing 70.2 Gy 3D-CRT/IMRT and 79.2 Gy 3D-CRT/IMRT in people with Prostate Cancer, run by Radiation Therapy Oncology Group at 86 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 86 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Feb 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall Survival (time frame: From randomization to date of failure (death) or last follow-up. Analysis occurs after all patients have been potentially followed for 8 years.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00033631, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jan 2023.