Prostate CancerPhase 3NCT00567580
Prostate Radiation Therapy or Short-Term Androgen Deprivation Therapy and Pelvic Lymph Node Radiation Therapy With or Without Prostate Radiation Therapy in Treating Patients With a Rising Prostate Specific Antigen (PSA) After Surgery for Prostate Cancer
A Phase 3 study testing PBRT, PLNRT and AA in people with Prostate Cancer, run by Radiation Therapy Oncology Group at 460 sites in 4 countries.
Trial summary
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as flutamide, bicalutamide, and luteinizing hormone-releasing hormone agonist, may lessen the amount of androgens made by the body. 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?
- PBRT, PLNRT and AA
- Type of treatment
- Pill or oral medicine, Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,792 participants
- Where
- 460 sitesin 4 countries
- Study dates
- Feb 2008to 12 Jul 2018
- 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
Who may be able to join
- Adenocarcinoma of the prostate treated primarily with radical prostatectomy, pathologically proven to be lymph node negative by pelvic lymphadenectomy (N0) or lymph node status pathologically unknown (undissected pelvic lymph nodes [Nx]), i.e. lymph node dissection is not required;
- Any type of radical prostatectomy will be permitted, including retropubic, perineal, laparoscopic or robotically assisted. There is no time limit for the date of radical prostatectomy.
- A post-radical prostatectomy entry prostate-specific antigen (PSA) of ≥ 0.1 and < 2.0 ng/mL at least 6 weeks (45 days) after prostatectomy and within 30 days of registration;
- One of the following pathologic classifications:
- T3N0/Nx disease with or without a positive prostatectomy surgical margin; or
- T2N0/Nx disease with or without a positive prostatectomy surgical margin;
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- Prostatectomy Gleason score of 9 or less;
- Zubrod Performance Status of 0-1;
- Age ≥ 18;
- No distant metastases, based upon the following minimum diagnostic workup:
- History/physical examination (including digital rectal exam) within 8 weeks (60 days) prior to registration;
- A computerized tomography (CT) scan of the pelvis (with contrast if renal function is acceptable; a noncontrast CT is permitted if the patient is not a candidate for contrast) or magnetic resonance imaging (MRI) of the pelvis within 120 days prior to registration;
- Bone scan within 120 days prior to registration; if the bone scan is suspicious, a plain x-ray and/or MRI must be obtained to rule out metastasis.
- Adequate bone marrow function, within 90 days prior to registration, defined as follows:
- Platelets ≥ 100,000 cells/mm^3 based upon compete blood count (CBC);
- Hemoglobin ≥ 10.0 g/dl based upon CBC (Note: The use of transfusion or other intervention to achieve Hgb ≥ 10.0 g/dl is recommended).
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 2 x the upper limit of normal within 90 days prior to registration;
- Serum total testosterone must be ≥ 40% of the lower limit of normal (LLN) of the assay used (testosterone ÷ LLN must be ≥ 0.40) within 90 days prior to registration (Note: Patients who have had a unilateral orchiectomy are eligible as long as this requirement is met);
- Patients must sign a study-specific informed consent prior to study entry.
Who cannot join
- A palpable prostatic fossa abnormality/mass suggestive of recurrence, unless shown by biopsy under ultrasound guidance not to contain cancer;
- N1 patients are ineligible, as are those with pelvic lymph node enlargement ≥ 1.5 cm in greatest dimension by CT scan or MRI of the pelvis, unless the enlarged lymph node is sampled and is negative;
- Androgen deprivation therapy started prior to prostatectomy for > 6 months (180 days) duration. Note: The use of finasteride or dutasteride (±tamsulosin) for longer periods prior to prostatectomy is acceptable;
- Androgen deprivation therapy started after prostatectomy and prior to registration (Note: The use of finasteride or dutasteride (±tamsulosin) after prostatectomy is not acceptable - must be stopped within 3 months after prostatectomy. Androgen deprivation therapy must be stopped within 3 months after prostatectomy);
- Neoadjuvant chemotherapy before or after prostatectomy;
- Prior chemotherapy for any other disease site if given within 5 years prior to registration;
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- Prior cryosurgery or brachytherapy of the prostate; prostatectomy should be the primary treatment and not a salvage procedure;
- Prior pelvic radiotherapy;
- Prior invasive malignancy (except non-melanomatous skin cancer) or superficial bladder cancer unless disease free for a minimum of 5 years [for example, carcinoma in situ of the oral cavity is permissible];
- Severe, active co-morbidity, defined as follows:
- History of inflammatory bowel disease;
- History of hepatitis B or C; Blood tests are not required to determine if the patient has had hepatitis B or C, unless the patient reports a history of hepatitis.
- Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months;
- Transmural myocardial infarction within the last 6 months;
- Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration;
- Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration;
- Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; AST or ALT are required; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol.
- Acquired Immune Deficiency Syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; Note, however, that human immunodeficiency viruses (HIV) testing is not required for entry into this protocol. The need to exclude patients with acquired immunodeficiency syndrome (AIDS) from this protocol is necessary because the treatments involved in this protocol may result in increased toxicity and immunosuppression.
- Prior allergic reaction to the study drug(s) involved in this protocol.
Trial locations and contacts
460 sites in 4 countries.
316 sites in 4 countries
United States300 sites
Kapiolani Medical Center at Pali Momi
‘Aiea, Hawaii, 96701
Rosenfeld Cancer Center at Abington Memorial Hospital
Abington, Pennsylvania, 19001
Hickman Cancer Center at Bixby Medical Center
Adrian, Michigan, 49221
McDowell Cancer Center at Akron General Medical Center
Akron, Ohio, 44307
Summa Center for Cancer Care at Akron City Hospital
Akron, Ohio, 44309-2090
New York Oncology Hematology, PC at Albany Regional Cancer Care
Albany, New York, 12206
New Mexico Cancer Center
Albuquerque, New Mexico, 87109
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87131-5636
Tulane Cancer Center Office of Clinical Research
Alexandria, Louisiana, 71315-3198
INOVA Alexandria Hospital
Alexandria, Virginia, 22304
AnMed Cancer Center
Anderson, South Carolina, 29621
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, 48109-0942
Langlade Memorial Hospital
Antigo, Wisconsin, 54409
Fox Valley Hematology and Oncology - East Grant Street
Appleton, Wisconsin, 54911-3496
Theda Care Cancer Institute
Appleton, Wisconsin, 54911
Randolph Hospital
Asheboro, North Carolina, 27203-5400
Mission Hospitals - Memorial Campus
Asheville, North Carolina, 28801
Emory Crawford Long Hospital
Atlanta, Georgia, 30308
Piedmont Hospital
Atlanta, Georgia, 30309
Winship Cancer Institute of Emory University
Atlanta, Georgia, 30322
Northside Hospital Cancer Center
Atlanta, Georgia, 30342-1611
Auburn Radiation Oncology
Auburn, California, 95603
Aurora Presbyterian Hospital
Aurora, Colorado, 80012
Rocky Mountain Cancer Centers - Aurora
Aurora, Colorado, 80012
University of Colorado Cancer Center at UC Health Sciences Center
Aurora, Colorado, 80045
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, 21201
Greater Baltimore Medical Center Cancer Center
Baltimore, Maryland, 21204
St. Agnes Hospital Cancer Center
Baltimore, Maryland, 21229
Barberton Citizens Hospital
Barberton, Ohio, 44203
Memorial Sloan-Kettering Cancer Center - Basking Ridge
Basking Ridge, New Jersey, 07920
Mary Bird Perkins Cancer Center - Baton Rouge
Baton Rouge, Louisiana, 70809
UPMC Cancer Center at Beaver Medical Center
Beaver, Pennsylvania, 15009
Texas Oncology, PA at Harris Center HEB
Bedford, Texas, 76022
St. Joseph Cancer Center
Bellingham, Washington, 98225
Beloit Memorial Hospital
Beloit, Wisconsin, 53511
MeritCare Bemidji
Bemidji, Minnesota, 56601
St. Luke's Cancer Network at St. Luke's Hospital
Bethlehem, Pennsylvania, 18015
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Billings Clinic - Downtown
Billings, Montana, 59107-7000
UAB Comprehensive Cancer Center
Birmingham, Alabama, 35294
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
Boise, Idaho, 83706
Massachusetts General Hospital
Boston, Massachusetts, 02114
Dana-Farber/Brigham and Women's Cancer Center
Boston, Massachusetts, 02115
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
Boston, Massachusetts, 02115
Boston University Cancer Research Center
Boston, Massachusetts, 02118
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
Boulder Community Hospital
Boulder, Colorado, 80301-9019
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
New York Methodist Hospital
Brooklyn, New York, 11215
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Roswell Park Cancer Institute
Buffalo, New York, 14263-0001
Peninsula Medical Center
Burlingame, California, 94010
Fletcher Allen Health Care - University Health Center Campus
Burlington, Vermont, 05401
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Radiation Oncology Centers - Cameron Park
Cameron Park, California, 95682
Sands Cancer Center
Canandaigua, New York, 14424
Aultman Cancer Center at Aultman Hospital
Canton, Ohio, 44710-1799
Cancer Institute of Cape Girardeau, LLC
Cape Girardeau, Missouri, 63703
Mercy Cancer Center at Mercy San Juan Medical Center
Carmichael, California, 95608
Rocky Mountain Oncology
Casper, Wyoming, 82609
East Bay Radiation Oncology Center
Castro Valley, California, 94546
Valley Medical Oncology Consultants - Castro Valley
Castro Valley, California, 94546
Sandra L. Maxwell Cancer Center
Cedar City, Utah, 84720
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Chapel Hill, North Carolina, 27599-7295
Hollings Cancer Center at Medical University of South Carolina
Charleston, South Carolina, 29425
West Virginia University Health Sciences Center - Charleston
Charleston, West Virginia, 25304
Blumenthal Cancer Center at Carolinas Medical Center
Charlotte, North Carolina, 28232-2861
Martha Jefferson Hospital Cancer Care Center
Charlottesville, Virginia, 22901
Mount Sinai Hospital Medical Center
Chicago, Illinois, 60608
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
Chicago, Illinois, 60611-3013
University of Chicago Cancer Research Center
Chicago, Illinois, 60637-1470
Creticos Cancer Center at Advocate Illinois Masonic Medical Center
Chicago, Illinois, 60657
Enloe Cancer Center at Enloe Medical Center
Chico, California, 95926
Adena Regional Medical Center
Chillicothe, Ohio, 45601
Siteman Cancer Center at Barnes-Jewish St. Peters Hospital - St. Peters
City of Saint Peters, Missouri, 63376
UPMC Cancer Center at Jefferson Regional Medical Center
Clairton, Pennsylvania, 15025
Case Comprehensive Cancer Center
Cleveland, Ohio, 44106-5065
Cleveland Clinic Cancer Center at Fairview Hospital
Cleveland, Ohio, 44111
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Henry Ford Macomb Hospital
Clinton Township, Michigan, 48038
Central Maryland Oncology Center
Columbia, Maryland, 21044
John B. Amos Cancer Center
Columbus, Georgia, 31904
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210-1240
Riverside Methodist Hospital Cancer Care
Columbus, Ohio, 43214-3998
CCOP - Columbus
Columbus, Ohio, 43215
Grant Medical Center Cancer Care
Columbus, Ohio, 43215
Mount Carmel Health - West Hospital
Columbus, Ohio, 43222
Doctors Hospital at Ohio Health
Columbus, Ohio, 43228
Memorial Sloan-Kettering Cancer Center
Commack, New York, 11725
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Northside Hospital-Forsyth
Cumming, Georgia, 30041
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
Danville Regional Medical Center
Danville, Virginia, 24541
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
Grady Memorial Hospital
Delaware, Ohio, 43015
Texas Oncology, PA at Texas Cancer Center - Denton South
Denton, Texas, 76210
St. Anthony Central Hospital
Denver, Colorado, 80204
Porter Adventist Hospital
Denver, Colorado, 80210
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
St. Joseph Hospital
Denver, Colorado, 80218
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
John Stoddard Cancer Center at Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Josephine Ford Cancer Center at Henry Ford Hospital
Detroit, Michigan, 48202
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
St. Luke's Hospital Cancer Care Center
Duluth, Minnesota, 55805
Northeast Radiation Oncology Center
Dunmore, Pennsylvania, 18512
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Elkhart General Hospital
Elkhart, Indiana, 46515
Community Cancer Center
Elyria, Ohio, 44035
Hematology Oncology Center
Elyria, Ohio, 44035
Swedish Medical Center
Englewood, Colorado, 80110
Willamette Valley Cancer Center - Eugene
Eugene, Oregon, 97401
Center for Cancer Care at Exeter Hospital
Exeter, New Hampshire, 03833
Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital
Fairbanks, Alaska, 99701
Hudner Oncology Center at Saint Anne's Hospital - Fall River
Fall River, Massachusetts, 02721
MeritCare Broadway
Fargo, North Dakota, 58102
CCOP - MeritCare Hospital
Fargo, North Dakota, 58122
Roger Maris Cancer Center at MeritCare Hospital
Fargo, North Dakota, 58122
Piedmont Fayette Hospital
Fayetteville, Georgia, 30214
St. Francis Hospital
Federal Way, Washington, 98003
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
McLaren Cancer Institute
Flint, Michigan, 48532
Central Wisconsin Cancer Program at Agnesian HealthCare
Fond du Lac, Wisconsin, 54935
Radiation Oncology Associates Southwest
Fort Wayne, Indiana, 46804
Parkview Regional Cancer Center at Parkview Health
Fort Wayne, Indiana, 46805
Klabzuba Cancer Center at Harris Methodist Fort Worth Hospital
Fort Worth, Texas, 76104
Leonard C. Ferguson Cancer Center
Freeport, Illinois, 61032
Valley Medical Oncology
Fremont, California, 94538
Washington Township Hospital
Fremont, California, 94538
California Cancer Center - Woodward Park Office
Fresno, California, 93720
Cancer Care Associates
Fresno, California, 93720
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
University of Florida Shands Cancer Center
Gainesville, Florida, 32610-0232
AtlantiCare Cancer Care Institute at AtlantiCare Regional Medical Center - Mainland Campus
Galloway, New Jersey, 08240
University of Texas Medical Branch
Galveston, Texas, 77555-0361
Adams Cancer Center
Gettysburg, Pennsylvania, 17325
Tate Cancer Center at Baltimore Washington Medical Center
Glen Burnie, Maryland, 21061
Center for Cancer Care at Goshen General Hospital
Goshen, Indiana, 46526
Altru Cancer Center at Altru Hospital
Grand Forks, North Dakota, 58201
Three Rivers Community Hospital
Grants Pass, Oregon, 97527
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
North Colorado Medical Center
Greeley, Colorado, 80631
Bellin Memorial Hospital
Green Bay, Wisconsin, 54301
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54307-3508
Moses Cone Regional Cancer Center at Wesley Long Community Hospital
Greensboro, North Carolina, 27403-1198
UPMC Cancer Center - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
Cancer Centers of the Carolinas - Faris Road
Greenville, South Carolina, 29605
Cancer Centers of the Carolinas - Grove Commons
Greenville, South Carolina, 29605
Cancer Centers of the Carolinas - Eastside
Greenville, South Carolina, 29615
CCOP - Greenville
Greenville, South Carolina, 29615
Cancer Centers of the Carolinas - Greer Medical Oncology
Greer, South Carolina, 29650
Cancer Centers of the Carolinas - Greer Radiation Oncology
Greer, South Carolina, 29650
Legacy Mount Hood Medical Center
Gresham, Oregon, 97030
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Ingalls Cancer Care Center at Ingalls Memorial Hospital
Harvey, Illinois, 60426
Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
Hilton Head Radiation Oncology Center
Hilton Head Island, South Carolina, 29926
Veterans Affairs Medical Center - Hines
Hines, Illinois, 60141
Cancer Research Center of Hawaii
Honolulu, Hawaii, 96813
Queen's Cancer Institute at Queen's Medical Center
Honolulu, Hawaii, 96813
Straub Clinic and Hospital, Incorporated
Honolulu, Hawaii, 96813
Hawaii Medical Center - East
Honolulu, Hawaii, 96817
Memorial Hermann Hospital - Memorial City
Houston, Texas, 77024
Cape Cod Hospital
Hyannis, Massachusetts, 02601
Cleveland Clinic Cancer Center
Independence, Ohio, 44131
Foote Memorial Hospital
Jackson, Michigan, 49201
West Tennessee Cancer Center at Jackson-Madison County General Hospital
Jackson, Tennessee, 38301
Baptist Cancer Institute - Jacksonville
Jacksonville, Florida, 32207
Integrated Community Oncology Network at Southside Cancer Center
Jacksonville, Florida, 32207
Baptist Medical Center South
Jacksonville, Florida, 32258
Integrated Community Oncology Network
Jacksonville Beach, Florida, 32250
UPMC Cancer Center at the John P. Murtha Pavilion
Johnstown, Pennsylvania, 15901
Borgess Medical Center
Kalamazoo, Michigan, 49001
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Kingsbury Center for Cancer Care at Cheshire Medical Center
Keene, New Hampshire, 03431
Howard Community Hospital
Kokomo, Indiana, 46904
Franciscan Skemp Healthcare - La Crosse Campus
La Crosse, Wisconsin, 54601
Gundersen Lutheran Center for Cancer and Blood
La Crosse, Wisconsin, 54601
Rebecca and John Moores UCSD Cancer Center
La Jolla, California, 92093-0658
Center for Cancer Therapy at LaPorte Hospital and Health Services
La Porte, Indiana, 46350
Lancaster General Hospital
Lancaster, Pennsylvania, 17604
St. Mary Regional Cancer Center
Langhorne, Pennsylvania, 19047
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
University of New Mexico Cancer Center - South
Las Cruces, New Mexico, 88011
CCOP - Nevada Cancer Research Foundation
Las Vegas, Nevada, 89106
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756-0002
Texas Oncology, PA at Lake Vista Cancer Center
Lewisville, Texas, 75067
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Lima Memorial Hospital
Lima, Ohio, 45804
Cancer Resource Center - Lincoln
Lincoln, Nebraska, 68510
Saint Elizabeth Cancer Institute at Saint Elizabeth Regional Medical Center
Lincoln, Nebraska, 68510
St. Mary Mercy Hospital
Livonia, Michigan, 48154
Logan Regional Hospital
Logan, Utah, 84321
Veterans Affairs Medical Center - Long Beach
Long Beach, California, 90822
Hope Cancer Care Center at Longmont United Hospital
Longmont, Colorado, 80501
Longview Cancer Center
Longview, Texas, 75601
Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
Los Angeles, California, 90048
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, 90089-9181
Norton Suburban Hospital
Louisville, Kentucky, 40207
McKee Medical Center
Loveland, Colorado, 80539
Lowell General Hospital
Lowell, Massachusetts, 01854
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, 53792-6164
Immanuel St. Joseph's
Mankato, Minnesota, 56002
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology - Maplewood
Maplewood, Minnesota, 55109
Strecker Cancer Center at Marietta Memorial Hospital
Marietta, Ohio, 45750
Bay Area Cancer Care Center at Bay Area Medical Center
Marinette, Wisconsin, 54143
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
Marlton, New Jersey, 08053
Contra Costa Regional Medical Center
Martinez, California, 94553-3156
Northwest Ohio Oncology Center
Maumee, Ohio, 43537-1839
Hillcrest Cancer Center at Hillcrest Hospital
Mayfield Heights, Ohio, 44124
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
Dubs Cancer Center at Rogue Valley Medical Center
Medford, Oregon, 97504
Providence Cancer Center at PMCC
Medford, Oregon, 97504
Community Memorial Hospital Cancer Care Center
Menomonee Falls, Wisconsin, 53051
Lake/University Ireland Cancer Center
Mentor, Ohio, 44060
Columbia Saint Mary's Hospital - Ozaukee
Mequon, Wisconsin, 53097
Baptist-South Miami Regional Cancer Program
Miami, Florida, 33176
Southwest General Health Center
Middleburg Heights, Ohio, 44130
Middlesex Hospital Cancer Center
Middletown, Connecticut, 06457
Upper Delaware Valley Cancer Center
Milford, Pennsylvania, 18337
Columbia-Saint Mary's Water Tower Medical Commons
Milwaukee, Wisconsin, 53211
Vince Lombardi Cancer Clinic at Aurora St. Luke's Medical Center
Milwaukee, Wisconsin, 53215
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, 53226
Veterans Affairs Medical Center - Milwaukee
Milwaukee, Wisconsin, 53295
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Saint Joseph Regional Medical Center
Mishawaka, Indiana, 46545-1470
Providence Holy Cross Cancer Center
Mission Hills, California, 91346-9600
Memorial Medical Center
Modesto, California, 95355
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus
Moline, Illinois, 61265
Intercommunity Cancer Center
Monroeville, Pennsylvania, 15146
UPMC - Moon
Moon Township, Pennsylvania, 15108
Coleman Radiation Oncology Center at Carter General Hospital
Morehead City, North Carolina, 28557
El Camino Hospital Cancer Center
Mountain View, California, 94040
D.N. Greenwald Center
Mukwonago, Wisconsin, 53149
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
Murray, Utah, 84157
Alle-Kiski Medical Center
Natrona Heights, Pennsylvania, 15065
UPMC Cancer Center - Natrona Heights
Natrona Heights, Pennsylvania, 15065
CarolinaEast Cancer Care
New Bern, North Carolina, 28560
George Bray Cancer Center at the Hospital of Central Connecticut - New Britain Campus
New Britain, Connecticut, 06050
Saint Peter's University Hospital
New Brunswick, New Jersey, 08901
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
New Brunswick, New Jersey, 08903
Jameson Memorial Hospital - North Campus
New Castle, Pennsylvania, 16105
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, 70112
Medical Center of Louisiana - New Orleans
New Orleans, Louisiana, 70112
CCOP - Ochsner
New Orleans, Louisiana, 70121
Stich Radiation Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center
New York, New York, 10021
St. Luke's - Roosevelt Hospital Center - St.Luke's Division
New York, New York, 10025
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
Licking Memorial Cancer Care Program at Licking Memorial Hospital
Newark, Ohio, 43055
Sentara Cancer Institute at Sentara Norfolk General Hospital
Norfolk, Virginia, 23507
William W. Backus Hospital
Norwich, Connecticut, 06360
Sutter Health - Western Division Cancer Research Group
Novato, California, 94945
Alta Bates Summit Medical Center - Summit Campus
Oakland, California, 94609
Bay Area Breast Surgeons, Incorporated
Oakland, California, 94609
CCOP - Bay Area Tumor Institute
Oakland, California, 94609
Larry G Strieff MD Medical Corporation
Oakland, California, 94609
Tom K Lee, Incorporated
Oakland, California, 94609
Regional Cancer Center at Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
Ogden, Utah, 84403
Oklahoma University Cancer Institute
Oklahoma City, Oklahoma, 73104
CCOP - Missouri Valley Cancer Consortium
Omaha, Nebraska, 68106
Methodist Estabrook Cancer Center
Omaha, Nebraska, 68114
Immanuel Medical Center
Omaha, Nebraska, 68122
Alegant Health Cancer Center at Bergan Mercy Medical Center
Omaha, Nebraska, 68124
Lakeside Hospital
Omaha, Nebraska, 68130
Creighton University Medical Center
Omaha, Nebraska, 68131-2197
Nebraska Medical Center
Omaha, Nebraska, 68198
St. Joseph Hospital Regional Cancer Center - Orange
Orange, California, 92868
UHHS Chagrin Highlands Medical Center
Orange, Ohio, 44122
Integrated Community Oncology Network - Orange Park
Orange Park, Florida, 32073
St. Charles Mercy Hospital
Oregon, Ohio, 43616
Florida Hospital Cancer Institute at Florida Hospital Orlando
Orlando, Florida, 32803-1273
Florida Cancer Center - Palatka
Palatka, Florida, 32177
Cancer Center of Paoli Memorial Hospital
Paoli, Pennsylvania, 19301-1792
Feather River Hospital Cancer Center
Paradise, California, 95969
Parma Community General Hospital
Parma, Ohio, 44129
Regional Cancer Center at Singing River Hospital
Pascagoula, Mississippi, 39581
Capital Health Regional Cancer Center
Pennington, New Jersey, 08534
Arizona Center for Cancer Care - Peoria
Peoria, Arizona, 85381
Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
Philadelphia, Pennsylvania, 19107-5541
Fox Chase Cancer Center - Philadelphia
Philadelphia, Pennsylvania, 19111-2497
Albert Einstein Cancer Center
Philadelphia, Pennsylvania, 19141
Arizona Oncology Services Foundation
Phoenix, Arizona, 85013
FirstHealth Moore Regional Community Hospital Comprehensive Cancer Center
Pinehurst, North Carolina, 28374
Canada13 sites
Tom Baker Cancer Centre - Calgary
Calgary, Alberta, T2N 4N2
Cross Cancer Institute at University of Alberta
Edmonton, Alberta, T6G 1Z2
Margaret and Charles Juravinski Cancer Centre
Hamilton, Ontario, L8V 5C2
London Regional Cancer Program at London Health Sciences Centre
London, Ontario, N6A 4L6
Maisonneuve-Rosemont Hospital
Montreal, Quebec, H1T 2M4
Hopital Notre-Dame du CHUM
Montreal, Quebec, H2L 4M1
Centre Hospitalier Universitaire de Quebec
Québec, Quebec, G1R 2J6
Allan Blair Cancer Centre at Pasqua Hospital
Regina, Saskatchewan, S4T 7T1
Saint John Regional Hospital
Saint John, New Brunswick, E2L 4L2
Saskatoon Cancer Centre at the University of Saskatchewan
Saskatoon, Saskatchewan, S7N 4H4
CHUS-Hopital Fleurimont
Sherbrooke, Quebec, J1H 5N4
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
Israel2 sites
Rabin Medical Center - Beilinson Campus
Petah Tikva, 49100
Tel-Aviv Sourasky Medical Center
Tel Aviv, 64239
About this study
Official title: A Phase III Trial of Short Term Androgen Deprivation With Pelvic Lymph Node or Prostate Bed Only Radiotherapy (SPPORT) in Prostate Cancer Patients With a Rising PSA After Radical Prostatectomy
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as flutamide, bicalutamide, and luteinizing hormone-releasing hormone agonist, may lessen the amount of androgens made by the body. It is not yet known which regimen of radiation therapy with or without androgen-deprivation therapy is more effective for prostate cancer.
PURPOSE: This randomized phase III trial is studying prostate radiation therapy to see how well it works compared with short-term androgen deprivation therapy given together with pelvic lymph node radiation therapy with or without prostate radiation therapy in treating patients with a rising PSA after surgery for prostate cancer.
Read the detailed description
OBJECTIVES:
Primary
- To determine whether the addition of short-term androgen deprivation (STAD) to prostate bed radiotherapy (PBRT) improves freedom from progression (FFP) (i.e., maintenance of a prostate-specific antigen [PSA] less than the nadir+2 ng/mL, absence of clinical failure, and absence of death from any cause) for 5 years, over that of PBRT alone in men treated with salvage radiotherapy after radical prostatectomy.
- To determine whether STAD, pelvic lymph node radiotherapy (PLNRT), and PBRT improves FFP over that of STAD+PBRT and PBRT alone in men treated with salvage radiotherapy after radical prostatectomy.
Secondary
- To compare secondary biochemical failure, the development of hormone-refractory disease , distant metastasis, cause-specific mortality, and overall mortality at five years.
- To compare acute and late morbidity based on Common Toxicity Criteria for Adverse Effects (CTCAE), v. 3.0.
- To measure the expression of cell kinetic, apoptotic pathway, and angiogenesis-related genes in archival diagnostic tissue to better define the risk of FFP, distant failure, cause-specific mortality, and overall mortality after salvage radiotherapy for prostate cancer, independently of conventional clinical parameters now used.
- To quantify blood product-based proteomic and genomic (single nucleotide polymorphisms) patterns and urine-based genomic patterns before and at different times after treatment to better define the risk of FFP, distant failure, cause-specific mortality, and overall mortality after salvage radiotherapy for prostate cancer, independently of conventional clinical parameters now used.
- To assess the degree, duration, and significant differences of disease-specific health-related quality of life (HRQOL) decrements among treatment arms.
- To assess whether mood is improved and depression is decreased with the more aggressive therapy if it improves FFP.
- To collect paraffin-embedded tissue blocks, serum, plasma, urine, and buffy coat cells for future translational research analyses.
Tertiary
- To assess whether an incremental gain in FFP and survival with more aggressive therapy outweighs decrements in the primary generic domains of HRQOL (i.e., mobility, self care, usual activities, pain/discomfort, and anxiety/depression).
- To evaluate the cost-utility of the treatment arm demonstrating the most significant benefit (in terms of the primary outcome) in comparison with other widely accepted cancer and non-cancer therapies.
- To assess associations between serum levels of beta-amyloid and measures of cognition and mood and depression.
- An exploratory aim is to assess the relationship(s) between the American Urological Association Symptom Index (AUA SI) and urinary morbidity using the CTCAE v. 3.0 grading system.
OUTLINE: Patients are stratified according to seminal vesicle involvement (yes vs no), prostatectomy Gleason score (≤ 7 vs 8-9), pre-radiotherapy PSA (≥ 0.1 and ≤ 1.0 ng/mL vs > 1.0 and < 2.0 ng/mL), and pathology stage (pT2 and margin negative vs all others). Patients are randomized to 1 of 3 treatment arms.
Follow-up occurs 3, 6, and 12 months after the completion of radiation therapy, then every 6 months for 6 years, and then annually thereafter.
- Conditions
- Prostate Cancer
- Being tested
- PBRT, PLNRT, AA, LHRH agonist
- Keywords
- stage IIB prostate cancer, stage IIA prostate cancer, stage III prostate cancer, adenocarcinoma of the prostate
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PBRTRadiation
Also called Prostate bed radiotherapy, Three-Dimensional Conformal Radiation Therapy (3D-CRT), Intensity modulated RT (IMRT)
1.8 Gy per fraction once daily, 5 days a week totaling 64.8-70.2 Gy. 3D-CRT or IMRT required.
PLNRTRadiation
Also called Pelvic lymph node radiotherapy
1.8 Gy per fraction once daily, 5 days a week, totaling 45 Gy. 3D-CRT or IMRT required.
AADrug
Also called flutamide, bicalutamide
Antiandrogen (AA) therapy can be either 250 mg flutamide by mouth three times a day or 50 mg bicalutamide by mouth once a day.
LHRH agonistDrug
Also called leuprolide, goserelin, buserelin, triptorelin
Luteinizing hormone-releasing hormone (LHRH) agonist can be any analog approved by the FDA (or by Health Canada for Canadian institutions) and may be given in any possible combination such that the total LHRH treatment time is 4-6 months. LHRH analogs are administered with a variety of techniques, including subcutaneous insertion of a solid plug in the abdominal wall, intramuscular injection, and subcutaneous injection.
| Study group | Role | What they receive |
|---|---|---|
| PBRT Alone | Active comparator | Prostate bed radiotherapy (PBRT) begins within 6 weeks (+/- 2 weeks) after registration. Receives: Radiation: PBRT |
| PBRT + STAD | Experimental | Prostate bed radiotherapy (PBRT) and short term androgen deprivation therapy (STAD) consisting of antiandrogen (AA) and luteinizing hormone-releasing hormone (LHRH) agonist therapy begins within 6 weeks (+/- 2 weeks) after registration. STAD starts first, 2 months (+/- 2 weeks) before radiotherapy (RT), and lasts for 4-6 months. LHRH can last 4-6 months. AA starts at the same time as LHRH (or up to 2 weeks prior ), lasts approximately 4 months, and should end on the last day of RT (+/- 2 weeks). Receives: Radiation: PBRT; Drug: AA; Drug: LHRH agonist |
| PLNRT + PBRT + STADT | Experimental | Pelvic lymph node radiotherapy (PLNRT), prostate bed radiotherapy (PBRT), and short term androgen deprivation therapy (STAD) consisting of antiandrogen (AA) and luteinizing hormone-releasing hormone (LHRH) agonist therapy begins within 6 weeks (+/- 2 weeks) after registration. STAD starts first, 2 months (+/- 2 weeks) before RT, and lasts for 4-6 months. LHRH can last 4-6 months. AA starts at the same time as LHRH (or up to 2 weeks prior ), lasts approximately 4 months, and should end on the last day of RT (+/- 2 weeks). Receives: Radiation: PBRT; Radiation: PLNRT; Drug: AA; Drug: LHRH agonist |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Free From Progression (FFP) at 5 Years
Progression is defined as the first occurrence of the following events: biochemical failure by the Phoenix definition (prostate-specific antigen [PSA] ≥ 2 ng/ml over the nadir PSA), clinical failure (local, regional or distant), or death from any cause. The initiation of second salvage therapy before progression was a protocol violation and resulted in censoring. Progression time is defined as time from randomization to the date of progression, second salvage therapy (censored), or last known follow-up (censored). Freedom from progression rates are estimated using the Kaplan-Meier method. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but results were reported early. See Limitations and Caveats section.
Measured: From randomization to five years.
Secondary outcomes (14)
Percentage of Participants With Secondary Biochemical Failure (Alternative Biochemical Failure)
Secondary biochemical (failure) is defined as either of two occurrences: 1. For detectable post-baseline PSA values (≥ 0.1), the first occurrence of a PSA value that is both ≥ 0.4 and a second rise above nadir; 2.The start of second salvage therapy. Failure time is defined as time from randomization to the date of failure, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but results were reported early. See Limitations and Caveats section.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Free From Hormone-refractory Disease (Castrate-resistant Disease)
Hormone-refractory disease (failure) is defined as three rises in PSA after the start of second salvage androgen deprivation therapy. Failure time is defined as time from randomization to the date of failure, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but the data monitoring committee decided to release results after the third interim analysis.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants With Local Failure
Local failure is defined as first occurrence of local clinical progression. Failure time is defined as time from randomization to the date of failure, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but the data monitoring committee decided to release results after the third interim analysis.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants With Distant Metastasis
Distant metastasis (failure) is defined as the occurrence of distant metastasis determined by imaging. Failure time is defined as time from randomization to the date of failure, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but the data monitoring committee decided to release results after the third interim analysis.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Who Died Due to Prostate Cancer (Cause-specific Mortality)
Cause-specific mortality (failure) is defined as death due to prostate cancer or complications of protocol treatment (centrally reviewed), or death following disease progression (clinical or biochemical) in the absence of or after the initiation of any salvage therapy. [Biochemical progression is indicated by any rise in PSA.] Failure time is defined as time from randomization to the date of failure, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but the data monitoring committee decided to release results after the third interim analysis.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Alive (Overall Mortality)
Survival time is defined as time from randomization to the date of death from any cause or last known follow-up (censored). Survival rates are estimated by the Kaplan-Meier method. Pairwise comparisons of the overall distributions of failure times are reported in statistical analysis section, with five-year rates reported here. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but the data monitoring committee decided to release results after the third interim analysis.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Experiencing Grade 2+ and 3+ Adverse Events ≤ 90 Days of the Completion of Radiotherapy (RT)
Common Terminology Criteria for Adverse Events (version 3.0) grades adverse event severity from 1=mild to 5=death. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data. Pairwise comparisons of Arm 2 vs Arm 1 and Arm 3 vs. Arm 2 are reported in the statistical analysis.
Measured: From randomization to 90 days after completion of radiotherapy (approximately 7-8 weeks).
Percentage of Participants Experiencing Late Grade 2+ and 3+ Adverse Events > 90 Days From the Completion of Radiotherapy (RT)
Common Terminology Criteria for Adverse Events (version 3.0) grades adverse event severity from 1=mild to 5=death. Late adverse events (AE) are defined as occurring > 90 days from the completion of RT. Failure time is defined as time from randomization to the date of first late grade 2 or grade 3 adverse event, death (competing risk), or last known follow-up (censored). Failure rates for data summary are estimated using the cumulative incidence method, with 5-year rates provided here. Pairwise comparisons of the distributions of failure times between Arm 2 and Arm 1 and between Arm 3 and Arm 2, reported in the statistical analysis section, use cause-specific hazard rates for which deaths are censored.
Measured: AE: from 91 days after completion of RT (approximately 7-8 weeks) to last follow-up. Vital status: from randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Comparison of Disease-specific Health Related Quality of Life (HRQOL) Change by the Expanded Prostate Cancer Index Composite (EPIC), Hopkins Verbal Learning Test Revised (HVLT-R), Trail Making Test A & B, and Controlled Oral Word Association Test (COWAT)
Measured: From the 6th week of radiation therapy to 5 years post radiation therapy.
Assessment of Mood and Depression Change Using QOL Measured by the Hopkins Symptom Checklist (HSCL-25)
Measured: From the 6th week of radiation therapy to 5 years post radiation therapy.
Assessment and Comparison of Quality Adjusted Life Year (QALY) and Quality Adjusted FFP Year (QAFFPY)
Measured: From the 6th week of radiation therapy to 5 years post radiation therapy.
Evaluation and Comparison of the Cost-utility Using EuroQoL - 5 Dimensions (EQ-5D)
Measured: From the 6th week of radiation therapy to 5 years post radiation therapy.
Prognostic Value of Genomic and Proteomic Markers for the Primary and Secondary Clinical Endpoints
Measured: Date of randomization to timepoint of the respective primary or secondary endpoint.
Assessment of the Relationship(s) Between the American Urological Association Symptom Index (AUA SI) and Urinary Morbidity (Adverse Event Terms: Urinary Frequency/Urgency) Using the CTCAE v. 3.0 Grading System
Measured: From the 6th week of radiation therapy to 5 years post radiation therapy.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Dec 2007 (estimated)
- Study startFeb 2008
- Primary completion12 Jul 2018
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 (1)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
- 1,792 participants (actual)
Sponsor and investigators
- Lead sponsor
- Radiation Therapy Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI), Cancer and Leukemia Group B, NRG Oncology
- Responsible party
- Sponsor
- Investigators
- Alan Pollack, MD, PhD, Principal investigator, University of Miami
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00567580
- Sponsor's protocol ID
- RTOG-0534
- Other IDs
- CDR0000577574, NCI-2009-00733
- Status last verified
- May 2024
- First submitted
- 4 Dec 2007
- Last updated
- 9 May 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Pollack A, Karrison TG, Balogh AG, Gomella LG, Low DA, Bruner DW, Wefel JS, Martin AG, Michalski JM, Angyalfi SJ, Lukka H, Faria SL, Rodrigues GB, Beauchemin MC, Lee RJ, Seaward SA, Allen AM, Monitto DC, Seiferheld W, Sartor O, Feng F, Sandler HM. The addition of androgen deprivation therapy and pelvic lymph node treatment to prostate bed salvage radiotherapy (NRG Oncology/RTOG 0534 SPPORT): an international, multicentre, randomised phase 3 trial. Lancet. 2022 May 14;399(10338):1886-1901. doi: 10.1016/S0140-6736(21)01790-6.
PubMed 35569466
Study at a glance
From the registry record, last updated by the sponsor on 9 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Trial of Short Term Androgen Deprivation With Pelvic Lymph Node or Prostate Bed Only Radiotherapy (SPPORT) in Prostate Cancer Patients With a Rising PSA After Radical Prostatectomy
- ClinicalTrials.gov ID
- NCT00567580
- Acronym / sponsor ID
- RTOG-0534
- Conditions
- Prostate Cancer
- Keywords
- stage IIB prostate cancer, stage IIA prostate cancer, stage III prostate cancer, adenocarcinoma of the prostate
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 1,792 participants (actual)
- Lead sponsor
- Radiation Therapy Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI), Cancer and Leukemia Group B, NRG Oncology
- Study start
- Feb 2008
- Primary completion
- 12 Jul 2018 (actual)
- First posted
- 5 Dec 2007 (estimated)
- Results
- Posted 2 Mar 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as flutamide, bicalutamide, and luteinizing hormone-releasing hormone agonist, may lessen the amount of androgens made by the body. It is not yet known which regimen of radiation therapy with or without androgen-deprivation therapy is more effective for prostate cancer.
PURPOSE: This randomized phase III trial is studying prostate radiation therapy to see how well it works compared with short-term androgen deprivation therapy given together with pelvic lymph node radiation therapy with or without prostate radiation therapy in treating patients with a rising PSA after surgery for prostate cancer.
Detailed description
OBJECTIVES:
Primary
- To determine whether the addition of short-term androgen deprivation (STAD) to prostate bed radiotherapy (PBRT) improves freedom from progression (FFP) (i.e., maintenance of a prostate-specific antigen [PSA] less than the nadir+2 ng/mL, absence of clinical failure, and absence of death from any cause) for 5 years, over that of PBRT alone in men treated with salvage radiotherapy after radical prostatectomy.
- To determine whether STAD, pelvic lymph node radiotherapy (PLNRT), and PBRT improves FFP over that of STAD+PBRT and PBRT alone in men treated with salvage radiotherapy after radical prostatectomy.
Secondary
- To compare secondary biochemical failure, the development of hormone-refractory disease , distant metastasis, cause-specific mortality, and overall mortality at five years.
- To compare acute and late morbidity based on Common Toxicity Criteria for Adverse Effects (CTCAE), v. 3.0.
- To measure the expression of cell kinetic, apoptotic pathway, and angiogenesis-related genes in archival diagnostic tissue to better define the risk of FFP, distant failure, cause-specific mortality, and overall mortality after salvage radiotherapy for prostate cancer, independently of conventional clinical parameters now used.
- To quantify blood product-based proteomic and genomic (single nucleotide polymorphisms) patterns and urine-based genomic patterns before and at different times after treatment to better define the risk of FFP, distant failure, cause-specific mortality, and overall mortality after salvage radiotherapy for prostate cancer, independently of conventional clinical parameters now used.
- To assess the degree, duration, and significant differences of disease-specific health-related quality of life (HRQOL) decrements among treatment arms.
- To assess whether mood is improved and depression is decreased with the more aggressive therapy if it improves FFP.
- To collect paraffin-embedded tissue blocks, serum, plasma, urine, and buffy coat cells for future translational research analyses.
Tertiary
- To assess whether an incremental gain in FFP and survival with more aggressive therapy outweighs decrements in the primary generic domains of HRQOL (i.e., mobility, self care, usual activities, pain/discomfort, and anxiety/depression).
- To evaluate the cost-utility of the treatment arm demonstrating the most significant benefit (in terms of the primary outcome) in comparison with other widely accepted cancer and non-cancer therapies.
- To assess associations between serum levels of beta-amyloid and measures of cognition and mood and depression.
- An exploratory aim is to assess the relationship(s) between the American Urological Association Symptom Index (AUA SI) and urinary morbidity using the CTCAE v. 3.0 grading system.
OUTLINE: Patients are stratified according to seminal vesicle involvement (yes vs no), prostatectomy Gleason score (≤ 7 vs 8-9), pre-radiotherapy PSA (≥ 0.1 and ≤ 1.0 ng/mL vs > 1.0 and < 2.0 ng/mL), and pathology stage (pT2 and margin negative vs all others). Patients are randomized to 1 of 3 treatment arms.
Follow-up occurs 3, 6, and 12 months after the completion of radiation therapy, then every 6 months for 6 years, and then annually thereafter.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| PBRT Alone | Active comparator | Radiation: PBRTProstate bed radiotherapy (PBRT) begins within 6 weeks (+/- 2 weeks) after registration. |
| PBRT + STAD | Experimental | Radiation: PBRT, Drug: AA, Drug: LHRH agonistProstate bed radiotherapy (PBRT) and short term androgen deprivation therapy (STAD) consisting of antiandrogen (AA) and luteinizing hormone-releasing hormone (LHRH) agonist therapy begins within 6 weeks (+/- 2 weeks) after registration. STAD starts first, 2 months (+/- 2 weeks) before radiotherapy (RT), and lasts for 4-6 months. LHRH can last 4-6 months. AA starts at the same time as LHRH (or up to 2 weeks prior ), lasts approximately 4 months, and should end on the last day of RT (+/- 2 weeks). |
| PLNRT + PBRT + STADT | Experimental | Radiation: PBRT, Radiation: PLNRT, Drug: AA, Drug: LHRH agonistPelvic lymph node radiotherapy (PLNRT), prostate bed radiotherapy (PBRT), and short term androgen deprivation therapy (STAD) consisting of antiandrogen (AA) and luteinizing hormone-releasing hormone (LHRH) agonist therapy begins within 6 weeks (+/- 2 weeks) after registration. STAD starts first, 2 months (+/- 2 weeks) before RT, and lasts for 4-6 months. LHRH can last 4-6 months. AA starts at the same time as LHRH (or up to 2 weeks prior ), lasts approximately 4 months, and should end on the last day of RT (+/- 2 weeks). |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (19 listed)
- Adenocarcinoma of the prostate treated primarily with radical prostatectomy, pathologically proven to be lymph node negative by pelvic lymphadenectomy (N0) or lymph node status pathologically unknown (undissected pelvic lymph nodes [Nx]), i.e. lymph node dissection is not required;
- A post-radical prostatectomy entry prostate-specific antigen (PSA) of ≥ 0.1 and < 2.0 ng/mL at least 6 weeks (45 days) after prostatectomy and within 30 days of registration;
- One of the following pathologic classifications:
- Prostatectomy Gleason score of 9 or less;
- Zubrod Performance Status of 0-1;
Key exclusion criteria (19 listed)
- A palpable prostatic fossa abnormality/mass suggestive of recurrence, unless shown by biopsy under ultrasound guidance not to contain cancer;
- N1 patients are ineligible, as are those with pelvic lymph node enlargement ≥ 1.5 cm in greatest dimension by CT scan or MRI of the pelvis, unless the enlarged lymph node is sampled and is negative;
- Androgen deprivation therapy started prior to prostatectomy for > 6 months (180 days) duration. Note: The use of finasteride or dutasteride (±tamsulosin) for longer periods prior to prostatectomy is acceptable;
- Androgen deprivation therapy started after prostatectomy and prior to registration (Note: The use of finasteride or dutasteride (±tamsulosin) after prostatectomy is not acceptable - must be stopped within 3 months after prostatectomy. Androgen deprivation therapy must be stopped within 3 months after prostatectomy);
- Neoadjuvant chemotherapy before or after prostatectomy;
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 |
|---|---|---|
| PBRTAlso: Prostate bed radiotherapy, Three-Dimensional Conformal Radiation Therapy (3D-CRT), Intensity modulated RT (IMRT)1.8 Gy per fraction once daily, 5 days a week totaling 64.8-70.2 Gy. 3D-CRT or IMRT required. | Radiation | PBRT + STAD, PBRT Alone, PLNRT + PBRT + STADT |
| PLNRTAlso: Pelvic lymph node radiotherapy1.8 Gy per fraction once daily, 5 days a week, totaling 45 Gy. 3D-CRT or IMRT required. | Radiation | PLNRT + PBRT + STADT |
| AAAlso: flutamide, bicalutamideAntiandrogen (AA) therapy can be either 250 mg flutamide by mouth three times a day or 50 mg bicalutamide by mouth once a day. | Drug | PBRT + STAD, PLNRT + PBRT + STADT |
| LHRH agonistAlso: leuprolide, goserelin, buserelin, triptorelinLuteinizing hormone-releasing hormone (LHRH) agonist can be any analog approved by the FDA (or by Health Canada for Canadian institutions) and may be given in any possible combination such that the total LHRH treatment time is 4-6 months. LHRH analogs are administered with a variety of techniques, including subcutaneous insertion of a solid plug in the abdominal wall, intramuscular injection, and subcutaneous injection. | Drug | PBRT + STAD, PLNRT + PBRT + STADT |
Primary outcome
Percentage of Participants Free From Progression (FFP) at 5 Years
Time frame: From randomization to five years.
Progression is defined as the first occurrence of the following events: biochemical failure by the Phoenix definition (prostate-specific antigen [PSA] ≥ 2 ng/ml over the nadir PSA), clinical failure (local, regional or distant), or death from any cause. The initiation of second salvage therapy before progression was a protocol violation and resulted in censoring. Progression time is defined as time from randomization to the date of progression, second salvage therapy (censored), or last known follow-up (censored). Freedom from progression rates are estimated using the Kaplan-Meier method. The study was designed for the final analysis to occur after all participants had been on study for at least 5 years, but results were reported early. See Limitations and Caveats section.
14 secondary outcomes
Percentage of Participants With Secondary Biochemical Failure (Alternative Biochemical Failure)
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Free From Hormone-refractory Disease (Castrate-resistant Disease)
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants With Local Failure
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants With Distant Metastasis
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Who Died Due to Prostate Cancer (Cause-specific Mortality)
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Alive (Overall Mortality)
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Percentage of Participants Experiencing Grade 2+ and 3+ Adverse Events ≤ 90 Days of the Completion of Radiotherapy (RT)
Time frame: From randomization to 90 days after completion of radiotherapy (approximately 7-8 weeks).
Percentage of Participants Experiencing Late Grade 2+ and 3+ Adverse Events > 90 Days From the Completion of Radiotherapy (RT)
Time frame: AE: from 91 days after completion of RT (approximately 7-8 weeks) to last follow-up. Vital status: from randomization to last follow-up. Maximum follow-up at time of analysis was 10.5 years.
Comparison of Disease-specific Health Related Quality of Life (HRQOL) Change by the Expanded Prostate Cancer Index Composite (EPIC), Hopkins Verbal Learning Test Revised (HVLT-R), Trail Making Test A & B, and Controlled Oral Word Association Test (COWAT)
Time frame: From the 6th week of radiation therapy to 5 years post radiation therapy.
Assessment of Mood and Depression Change Using QOL Measured by the Hopkins Symptom Checklist (HSCL-25)
Time frame: From the 6th week of radiation therapy to 5 years post radiation therapy.
Assessment and Comparison of Quality Adjusted Life Year (QALY) and Quality Adjusted FFP Year (QAFFPY)
Time frame: From the 6th week of radiation therapy to 5 years post radiation therapy.
Evaluation and Comparison of the Cost-utility Using EuroQoL - 5 Dimensions (EQ-5D)
Time frame: From the 6th week of radiation therapy to 5 years post radiation therapy.
Prognostic Value of Genomic and Proteomic Markers for the Primary and Secondary Clinical Endpoints
Time frame: Date of randomization to timepoint of the respective primary or secondary endpoint.
Assessment of the Relationship(s) Between the American Urological Association Symptom Index (AUA SI) and Urinary Morbidity (Adverse Event Terms: Urinary Frequency/Urgency) Using the CTCAE v. 3.0 Grading System
Time frame: From the 6th week of radiation therapy to 5 years post radiation therapy.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 May 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 35569466Pollack A, Karrison TG, Balogh AG, Gomella LG, Low DA, Bruner DW, Wefel JS, Martin AG, Michalski JM, Angyalfi SJ, Lukka H, Faria SL, Rodrigues GB, Beauchemin MC, Lee RJ, Seaward SA, Allen AM, Monitto DC, Seiferheld W, Sartor O, Feng F, Sandler HM. The addition of androgen deprivation therapy and pelvic lymph node treatment to prostate bed salvage radiotherapy (NRG Oncology/RTOG 0534 SPPORT): an international, multicentre, randomised phase 3 trial. Lancet. 2022 May 14;399(10338):1886-1901. doi: 10.1016/S0140-6736(21)01790-6.
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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.
Alan Pollack, MD, PhD principal investigator
University of Miami
460 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing PBRT, PLNRT and AA in people with Prostate Cancer, run by Radiation Therapy Oncology Group at 460 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 19 inclusion and 19 exclusion criteria. 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: status not confirmed, as of the sponsor's last update on 9 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 460 sites in United States, Canada, Israel, China. 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 2 Mar 2021). 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?
Percentage of Participants Free From Progression (FFP) at 5 Years (time frame: From randomization to five 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 NCT00567580, which also lists 1 linked publication.
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 9 May 2025.