The purpose of this study is to compare the efficacy and safety of combined radiotherapy and hormone therapy and hormone therapy alone in the treatment of clinically locally advanced prostate cancer (T3-T4 or pT3 on biopsy, N0, M0).
The drug being tested in this study is called leuprorelin SR. Leuprorelin SR is being tested to treat people who have prostate cancer. This study will look at the overall survival of people who take leuprorelin SR in addition to radiation therapy compared to those who take only leuprorelin SR. The study will enroll approximately 273 patients. Participants will be randomly assigned to one of the two treatment groups. * Combined Radiotherapy and Hormone Therapy * Hormone Therapy alone. All participants will receive leuprorelin injection every 3 months and flutamide tablets thrice daily for first 30 days as part of hormone therapy. Participants randomized to combined radiotherapy and hormone therapy group, will also receive radiotherapy 70 +/- 4 Gy in 35 fractions at a rate of 5 fractions of 2 Gy per week. This multi-center trial will be conducted in France and Tunisia. The overall time to participate in this study is 8 years. The scheduled duration of hormone therapy was 3 years in both arms, with an additional treatment-free follow-up period of 2 years i.e. a total follow-up period of 5 years. Post-protocol collection of information relative to survival will be performed after the end the 5-year follow-up period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
273
Leuprorelin SR injection
Radiotherapy 70 +/- 4 Gy
Flutamide tablets
Clinique Mutualiste
Saint-Etienne, France
Progression-free survival at 5 years
PFS=time from randomization to first documentation of progression (death, biological progression or clinical progression). PFS at Year 5=probability of participants' PFS at Year 5. Biological progression definition I: halfway point between nadir and first rise with prostate-specific antigen (PSA) ≥1 nanogram per milliliter (ng/mL) signifying progression and date of introduction of prostate treatment for all participants, including those leaving prematurely for reason other than progression/death; definition II: first date when PSA=nadir+2 ng/mL and date of introduction of prostate treatment, for participants leaving prematurely for reason other than progression/death. Clinical progression: local clinical progression-\>50% increase in prostate volume relative to lowest volume, recurrence of palpable prostatic tumor after complete regression, positive biopsy; locoregional progression=pelvic regional lymph node lesion development; metastatic progression=distant lesions identification.
Time frame: Year 5
Time to Biological Progression
Biological progression as per definition I is defined as halfway point between nadir and first rise with PSA greater than or equal to (≥) 1 ng/mL signifying progression and date of introduction of prostate treatment for all participants, including those leaving prematurely for reason other than progression/death; and as per definition II, it is defined as first date when PSA=nadir+2 ng/mL and date of introduction of prostate treatment, for participants leaving prematurely for reason other than progression/death. Time to onset of biological progression will be performed using the Kaplan- Meier method taking into account the date of onset of the first biological progression. The participants will be censored on the date of death, lost to follow-up or living without biological progression on the date of the last news.
Time frame: Baseline up to Year 5
Time to Clinical Progression
Clinical progression is based on three parameters: local clinical progression which is defined as greater than (\>) 50 percent (%) increase in prostate volume relative to lowest volume, recurrence of palpable prostatic tumor after complete regression, positive biopsy; locoregional progression which is defined as pelvic regional lymph node lesion development; and metastatic progression which is defined as distant lesions identification. Time to onset of clinical progression will be performed using the Kaplan-Meier method based on the date of onset of the first progression among local, locoregional or metastatic clinical progressions.
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Time frame: Baseline up to Year 5
Overall Survival
Overall survival will be measured as the time from the date of randomization to the date of death. Participants will be censored in case of lost to follow-up or alive on the date of the last news.
Time frame: Baseline up to Year 5
Time to Locoregional Progression
Locoregional progression is defined as the development of pelvic regional lymph node lesion(s) identified by computed tomography (CT) scan or ultrasound and confirmed by biopsy in the absence of any other signs of progression. It will be performed using the Kaplan-Meier method taking into account the date of onset of locoregional progression.
Time frame: Baseline up to Year 5
Time to Onset of Metastatic Progression
Metastatic progression is defined as identification of distant lesions. Time to onset of metastatic progression will be performed using the Kaplan-Meier method taking into account the date of onset of the first metastatic progression. The participants will be censored in case of death, lost to follow-up or alive without metastatic progression on the date of the last news.
Time frame: Baseline up to Year 5
Specific Survival
Analysis of specific survival using the Kaplan-Meier method takes into account the dates of death linked to the disease. The participants will be censored in case of death, lost to follow-up or alive on the date of the last news.
Time frame: Baseline up to Year 5
Number of Deaths linked to the disease
Time frame: Baseline up to Year 5