As the most common male carcinoma, prostate cancer is a major tumor entity in oncology. In addition to definitive radiotherapy, surgical procedure is considered to be an oncologically equivalent therapeutic alternative for non-metastatic malignancies in the primary setting. However, a subsequent radiotherapy of the prostate bed is often necessary, which takes place as an "adjuvant" treatment immediately after surgery or in the course of a repeated increase in PSA and usually extends over several weeks. For the primary situation (without previous surgery), several randomized phase III clinical trials have shown that it is possible to shorten radiotherapy by increasing the single dose (called hypofractionation). In the context of two prospective Phase II studies, which were carried out in Heidelberg, it has since been shown that hypofractionation with both photons and protons is safe and feasible even in the postoperative situation. The current, prospective and randomized PAROS study is now intended to demonstrate a multicentric phase III study as an improvement in the quality of life caused by rectum toxicity (primary endpoint) by the use of protons. The oncological non-inferiority of hypofractionated radiotherapy after surgery is a secondary endpoint.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
897
hypofractionated radiotherapy with photons (total dose 57.0 Gray in 19 fractions)
hypofractionated radiotherapy with protons (total dose 57.0 Gray relative biological effectiveness (RBE) in 19 fractions)
normofractionated radiotherapy with photons (total dose 70.0 Gray in 35 fractions)
University Hospital Heidelberg
Heidelberg, Germany
RECRUITINGQuality of life (prostate-associated, 12 weeks vs baseline)
The primary objective of the present trial is to show a Change in the bowel symptoms according to scores on the EORTC QLQ-PR25 questionaire after proton therapy compared to photon irradiation (week 12 vs. baseline).
Time frame: 12 weeks
biochemical progression-free survival (bPFS)
non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to biochemical progression-free survival (bPFS)
Time frame: 5 years after baseline
overall survival (OS)
non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to overall survival (OS)
Time frame: 5 years after baseline
Toxicity acc. to NCI CTCAE V 5.0 after 2 and 5 years
non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to toxicity
Time frame: 2 and 5 years after baseline
Quality of life (general and prostate-associated, 2 years and 5 years vs. baseline)
non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to changes in the scores of quality of life based on the EORTC QLQ-C30 questionaire
Time frame: 2 and 5 years after baseline
Quality of life (general and prostate-associated, 2 years and 5 years vs. baseline)
non-inferiority of hypofractionated radiotherapy compared to normofractionated radiotherapy with regard to changes in the scores of quality of life based on the EORTC QLQ-PR25 questionaire
Time frame: 2 and 5 years after baseline
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