Trial Outcomes & Findings for Radiation Therapy in Treating Patients With Stage II or Stage III Prostate Cancer (NCT NCT00091390)

NCT ID: NCT00091390

Last Updated: 2020-08-10

Results Overview

Adverse events (AE) were graded using the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild, Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to AE. "Late" is defined as occurring after 9 months from the start of study treatment. Because of the lead time of 9 months, the percentage at 18-months was estimated by the 9-month rate using the cumulative incidence method starting at the 10th month. Death was treated as a competing risk.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

129 participants

Primary outcome timeframe

From 9 to 18 months after start of study treatment

Results posted on

2020-08-10

Participant Flow

Participant milestones

Participant milestones
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Overall Study
STARTED
129
Overall Study
Eligible and Started Study Treatment
125
Overall Study
Eligible, Started Treatment, Has AE Data
115
Overall Study
COMPLETED
125
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Overall Study
Protocol Violation
1
Overall Study
No protocol treatment
3

Baseline Characteristics

Radiation Therapy in Treating Patients With Stage II or Stage III Prostate Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Age, Continuous
68 years
n=39 Participants
Sex: Female, Male
Female
0 Participants
n=39 Participants
Sex: Female, Male
Male
125 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
99 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
23 Participants
n=39 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=39 Participants
Race (NIH/OMB)
Asian
2 Participants
n=39 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=39 Participants
Race (NIH/OMB)
Black or African American
32 Participants
n=39 Participants
Race (NIH/OMB)
White
86 Participants
n=39 Participants
Race (NIH/OMB)
More than one race
2 Participants
n=39 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=39 Participants
Zubrod Performance Scale
0 (Asymptomatic)
121 Participants
n=39 Participants
Zubrod Performance Scale
1 (Symptomatic but completely ambulatory)
4 Participants
n=39 Participants
Baseline Prostate-Specific Antigen (PSA)
≤10
87 Participants
n=39 Participants
Baseline Prostate-Specific Antigen (PSA)
>10 - ≤20
38 Participants
n=39 Participants
Gleason score
2-6
13 Participants
n=39 Participants
Gleason score
7
90 Participants
n=39 Participants
Gleason score
8-10
22 Participants
n=39 Participants
Prior hormone therapy
Yes
54 Participants
n=39 Participants
Prior hormone therapy
No
71 Participants
n=39 Participants
T Stage
T1c-T2c
114 Participants
n=39 Participants
T Stage
T3a-T3b
11 Participants
n=39 Participants

PRIMARY outcome

Timeframe: From 9 to 18 months after start of study treatment

Population: Eligible participants who started study treatment

Adverse events (AE) were graded using the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild, Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to AE. "Late" is defined as occurring after 9 months from the start of study treatment. Because of the lead time of 9 months, the percentage at 18-months was estimated by the 9-month rate using the cumulative incidence method starting at the 10th month. Death was treated as a competing risk.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Late Grade 3-5 Genitourinary (GU) and Gastrointestinal (GI) Adverse Events (AE) at 18 Months
2.56 percentage of participants
Interval 0.834 to 7.738

SECONDARY outcome

Timeframe: From treatment start to 9 months

Population: Eligible participants who started study treatment

Adverse events (AE) were graded using the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. Grade refers to the severity of the AE. The CTCAE v3.0 assigns Grades 1 through 5 with unique clinical descriptions of severity for each AE based on this general guideline: Grade 1 Mild, Grade 2 Moderate, Grade 3 Severe, Grade 4 Life-threatening or disabling, Grade 5 Death related to AE. Acute is defined as occurring within 9 months from the start of study treatment.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Number of Participants With Acute Grade 3-5 Genitourinary (GU) and Gastrointestinal (GI) Adverse Events (AE)
2.61 percentage of participants
Interval 0.1 to 5.95

SECONDARY outcome

Timeframe: From registration to ten years

Population: Eligible participants who started study treatment

The ASTRO criteria for biochemical failure is three consecutive rises in prostate-specific antigen (PSA) level above the nadir after radiation therapy. The PSA nadir is defined as as the lowest PSA value reached immediately before a biochemical failure. The date of failure is midway between the last non-rising PSA and the first rise in PSA. Time to failure is defined as time from registration to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rate is estimated using the cumulative incidence method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Biochemical Failure at 10 Years Using American Society for Therapeutic Radiation and Oncology (ASTRO) Definition
14.7 percentage of participants
Interval 8.9 to 21.9

SECONDARY outcome

Timeframe: From registration to ten years

Population: Eligible participants who started study treatment

The Phoenix criteria for biochemical failure is a rise of 2 ng/mL or more above the nadir after radiation therapy. Time to failure is defined as time from registration to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rate is estimated using the cumulative incidence method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Biochemical Failure at 10 Years Using the Phoenix Definition
22.6 percentage of participants
Interval 15.3 to 30.6

SECONDARY outcome

Timeframe: From registration to 10 years

Population: Eligible participants who started study treatment

Overall survival time is defined as time from registration to the date of death from any cause or last known follow-up (censored). Overall survival rate is estimated by the Kaplan-Meier method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants Alive at 10 Years
75.7 percentage of participants
Interval 67.2 to 84.1

SECONDARY outcome

Timeframe: From registration to ten years

Population: Eligible participants who started study treatment

The following will be considered as death due to prostate cancer (failure): * Death certified as due to prostate cancer. * Death from other causes with active malignancy (clinical or biochemical progression). * Death due to complications of treatment, irrespective of the status of malignancy. Time to failure is defined as time from registration to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rate is estimated using the cumulative incidence method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Death Due to Prostate Cancer at 10 Years
6.4 percentage of participants
Interval 2.6 to 12.6

SECONDARY outcome

Timeframe: From registration to ten years

Population: Eligible participants who started study treatment

Distant failure required documentation of regional nodal recurrence or distant disease relapse. Time to failure is defined as time from registration to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rate is estimated using the cumulative incidence method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Distant Failure at 10 Years
7.7 percentage of participants
Interval 3.5 to 14.0

SECONDARY outcome

Timeframe: From registration to ten years

Population: Eligible participants who started study treatment

Local failure is defined as documented local progression as determined by clinical exam. Time to failure is defined as time from registration to the date of first failure, last known follow-up (censored), or death without failure (competing risk). Failure rate is estimated using the cumulative incidence method.

Outcome measures

Outcome measures
Measure
External Beam Radiotherapy and High Dose Brachytherapy Boost
n=125 Participants
High Dose brachytherapy boost: 19 Gy in two fractions (on day of placement and 6-24 hours later) before or after external beam radiotherapy, such that all study treatment occurs within 8 weeks. External beam radiotherapy: 45 Gy as 1.8 Gy five days a week for five weeks.
Percentage of Participants With Local Failure at 10 Years
1.7 percentage of participants
Interval 0.3 to 5.4

Adverse Events

EBRT and HDR Brachytherapy Boost

Serious events: 49 serious events
Other events: 110 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
EBRT and HDR Brachytherapy Boost
n=115 participants at risk
External beam radiation therapy (EBRT) and high dose rate (HDR) brachytherapy boost.
Blood and lymphatic system disorders
Hemoglobin
0.87%
1/115
Gastrointestinal disorders
Diarrhea NOS
1.7%
2/115
Gastrointestinal disorders
Fecal incontinence
0.87%
1/115
Gastrointestinal disorders
Gastrointestinal - Other
0.87%
1/115
Gastrointestinal disorders
Rectal hemorrhage
1.7%
2/115
General disorders
Fatigue
1.7%
2/115
General disorders
Pain - Other
0.87%
1/115
Infections and infestations
Infection - Other
0.87%
1/115
Investigations
Blood creatinine increased
0.87%
1/115
Metabolism and nutrition disorders
Fanconi syndrome acquired
0.87%
1/115
Metabolism and nutrition disorders
Hyponatremia
0.87%
1/115
Musculoskeletal and connective tissue disorders
Arthritis NOS
0.87%
1/115
Musculoskeletal and connective tissue disorders
Musculoskeletal/soft tissue - Other
0.87%
1/115
Psychiatric disorders
Depression
0.87%
1/115
Psychiatric disorders
Libido decreased
1.7%
2/115
Renal and urinary disorders
Bladder pain
1.7%
2/115
Renal and urinary disorders
Pollakiuria
18.3%
21/115
Renal and urinary disorders
Renal/genitourinary - Other
2.6%
3/115
Renal and urinary disorders
Ureteric obstruction
0.87%
1/115
Renal and urinary disorders
Urethral obstruction
0.87%
1/115
Renal and urinary disorders
Urethral pain
5.2%
6/115
Renal and urinary disorders
Urethral stricture
2.6%
3/115
Renal and urinary disorders
Urinary bladder hemorrhage
1.7%
2/115
Renal and urinary disorders
Urinary incontinence
5.2%
6/115
Renal and urinary disorders
Urinary retention
2.6%
3/115
Renal and urinary disorders
Urogenital hemorrhage
1.7%
2/115
Reproductive system and breast disorders
Erectile dysfunction NOS
13.9%
16/115
Reproductive system and breast disorders
Penile pain
0.87%
1/115
Vascular disorders
Flushing
0.87%
1/115
Vascular disorders
Hot flushes NOS
1.7%
2/115
Vascular disorders
Hypertension NOS
0.87%
1/115

Other adverse events

Other adverse events
Measure
EBRT and HDR Brachytherapy Boost
n=115 participants at risk
External beam radiation therapy (EBRT) and high dose rate (HDR) brachytherapy boost.
Blood and lymphatic system disorders
Hemoglobin
8.7%
10/115
Gastrointestinal disorders
Constipation
6.1%
7/115
Gastrointestinal disorders
Diarrhea NOS
26.1%
30/115
Gastrointestinal disorders
Proctitis NOS
10.4%
12/115
Gastrointestinal disorders
Rectal hemorrhage
20.0%
23/115
General disorders
Fatigue
20.0%
23/115
General disorders
Pain - Other
5.2%
6/115
Psychiatric disorders
Libido decreased
20.0%
23/115
Renal and urinary disorders
Bladder pain
8.7%
10/115
Renal and urinary disorders
Cystitis NOS
9.6%
11/115
Renal and urinary disorders
Pollakiuria
78.3%
90/115
Renal and urinary disorders
Renal/genitourinary - Other
18.3%
21/115
Renal and urinary disorders
Urethral obstruction
7.8%
9/115
Renal and urinary disorders
Urethral pain
16.5%
19/115
Renal and urinary disorders
Urethral stricture
6.1%
7/115
Renal and urinary disorders
Urinary incontinence
20.9%
24/115
Renal and urinary disorders
Urinary retention
40.0%
46/115
Renal and urinary disorders
Urogenital hemorrhage
19.1%
22/115
Reproductive system and breast disorders
Ejaculatory disorder NOS
6.1%
7/115
Reproductive system and breast disorders
Erectile dysfunction NOS
57.4%
66/115
Reproductive system and breast disorders
Penile pain
7.0%
8/115
Vascular disorders
Hot flushes NOS
12.2%
14/115

Additional Information

Wendy Seiferheld

NRG Oncology

Results disclosure agreements

  • Principal investigator is a sponsor employee PI's are required to abide by the sponsor's publication guidelines which require review by coauthors and subsequent review and approval by the sponsor.
  • Publication restrictions are in place

Restriction type: OTHER