PLATIN: Radiotherapy of the Prostate and the Pelvic Lymph Nodes After Neoadjuvant Antihormonal Treatment
Study Details
Study Description
Brief Summary
For patients with prostate cancer and a high risk of lymph node involvement or confirmed pelvic lymph node metastases, radiotherapy of the whole pelvis is a treatment option. However, conventional radiotherapy of the pelvis has limited by gastrointestinal and urogenital side effects. The PLATIN trial investigates an intensity-modulated radiotherapy of the pelvic lymphatic drainage that spares small bowel, bladder and rectum. A higher dose is given during each session to the prostate or the prostate bed and to confirmed lymph node metastases. Prior to radiotherapy, two months of neoadjuvant antihormonal treatment are required, and continuation during radiotherapy and for a further two years are strongly recommended.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2 |
Detailed Description
The PLATIN trial is designed as a prospective, non-randomized, five-arm trial. Arm 1:
Definitive radiotherapy of the pelvic lymphatic drainage with integrated boost to the prostate.
Arm 2: As arm 1, with additional boost to macroscopic lymph node metastases. Arm 3:
Postoperative radiotherapy of the pelvic lymphatic drainage with integrated boost to the prostate bed.
Arm 4: As arm 3, additional boost to macroscopic lymph node metastases. Arm 5: Patients with previous radiotherapy to the prostate bed. Radiotherapy of the pelvic lymphatic drainage above the previous treatment fields with integrated boost to macroscopic lymph node metastases.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Arm 1: Boost to prostate IMRT of the pelvic lymphatic drainage (51 Gy) and integrated boost to the prostate (76.5 Gy) in 34 fractions Arm finished recruitment and follow-up |
Radiation: Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB
The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)
|
| Other: Arm 2: Boost to prostate and lymph node metastases IMRT of the pelvic lymphatic drainage (51 Gy), SIB to the prostate (76.5 Gy) & pelvic lymph node mets (61.2 Gy) in 34 Fx |
Radiation: Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB
The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)
|
| Other: Arm 3: Boost to prostate bed IMRT of the pelvic lymphatic drainage (51 Gy) and integrated boost to the prostate bed (68 Gy) in 34 fractions Arm finished recruitment and follow-up and is published |
Radiation: Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB
The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)
|
| Other: Arm 4: Boost to prostate bed and lymph node metastases IMRT of the pelvic lymphatic drainage (51 Gy), SIB to the prostate bed 68 Gy) & lymph node metastases (61.2 Gy) in 34 Fx |
Radiation: Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB
The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)
|
| Other: Arm 5: Boost to lymph node metastases Patients with previous irradiation of the prostate bed: IMRT of the pelvic lymphatic drainage (46.8 Gy) above the previous treatment fields, SIB to lymph node metastases (63.2 Gy) in 26 Fx |
Radiation: Intensity-modulated radiotherapy of the pelvic lymph nodes using SIB
The intervention is the use of modern radiation techniques with simultaneous integrated boost (SIB)
|
Outcome Measures
Primary Outcome Measures
- Rate of safe feasibility (SDR) [2 years]
Proportion of treatments begun as planned without grade 3-4 NCI common toxicity criteria adverse events (CTC AE) or treatment disruption among all patients that fulfill inclusion criteria and have been treated according to trial protocol for at least a week.
Secondary Outcome Measures
- Biochemical recurrence free survival [2 years]
- Quality of Life [2 years]
Measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30
Eligibility Criteria
Criteria
Inclusion Criteria:
-
histologically confirmed prostate cancer with Gleason Score
-
risk of lymph node involvement >20% (according to Roach Formula), pelvic lymph node metastases in CT/MRI or histologically confirmed lymph node involvement
-
Karnofsky Index >/= 70%
-
age 18-75 years
-
neoadjuvant antihormonal treatment for 2 months, continuation until the end of radiotherapy
-
written informed consent
Exclusion Criteria:
-
stage IV (distant metastases)
-
lymph node metastases outside the pelvis
-
rising prostate-specific antigen (PSA) under antihormonal treatment
-
severe wound complications after laparatomy
-
severe lymph edema of the legs, elephantiasis, postthrombotic syndrome
-
decompensated comorbidity of the lungs, heart, metabolic system, hematopoetic system or kidneys, coagulopathy
-
history of other malignancy within the last 5 years (except for basal cell carcinoma or squamous carcinoma of the skin)
-
previous irradiation of the pelvic lymph nodes
-
concurrent participation in a clinical trial that might influence the results of either trial
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Radiation Oncology, University Hospital Heidelberg | Heidelberg | Germany | 69120 |
Sponsors and Collaborators
- Heidelberg University
- Klaus Tschira Stiftung gGmbH
Investigators
- Principal Investigator: Klaus Herfarth, Prof. Dr., University Hospital Heidelberg, Department of Radiation Oncology
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Klaus Tschira 00.153.2009
- ARO 2009-05