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A Phase III Prospective Randomized Trial of Standard-fractionation vs. Hypo-fractionation With Proton Radiation Therapy for Low Risk Adenocarcinoma of the Prostate

Phase 3
18 Years
Open (Enrolling)
Prostate Cancer

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Trial Information

A Phase III Prospective Randomized Trial of Standard-fractionation vs. Hypo-fractionation With Proton Radiation Therapy for Low Risk Adenocarcinoma of the Prostate

Inclusion Criteria:

- Histologically confirmed prostate adenocarcinoma within 365 days prior to

- History/physical examination with digital rectal examination of the prostate and
baseline toxicity assessment within 90 days prior to randomization.

- Histological evaluation of prostate biopsy with assignment of a Gleason score to the
biopsy material;Gleason score must be in the range of 2-6. > 6 cores are strongly

- PSA values < 10 ng/ml within 90 days prior to randomization. Either done prior to
biopsy or at least 21 days after prostate biopsy.

- Clinical stages T1a-T2a N0 M0 (AJCC Criteria 7th Ed.). Staging must be done by
treating investigator.

- No pelvic lymph nodes > 1.5 cm in greatest dimension unless the enlarged lymph node
is biopsied and negative.

- Patients must be at least 18 years old.

- ECOG performance status 0-1 (appendix I) documented within 90 days prior to

- IPSS score < 16.

- Patients must give IRB approved, study specific, informed consent.

- Patients must complete all mandatory tests listed in section 4.0 within the specified
time frames.

- Patients must be able to start treatment within 56 days of randomization.

Exclusion Criteria:

- Previous prostate cancer surgery to include: prostatectomy, hyperthermia and

- Previous pelvic radiation for prostate cancer.

- Androgen deprivation therapy prior to radiation is allowed. However, it is not
acceptable if continued during radiation or as adjuvant therapy.

- Active rectal diverticulitis, Crohn's disease affecting the rectum, or ulcerative

- Prior systemic chemotherapy for prostate cancer.

- History of proximal urethral stricture requiring dilatation.

- Current and continuing anticoagulation with warfarin sodium (Coumadin, heparin,
low-molecular weight heparin, Clopidogrel bisulfate (Plavix),or equivalent. (Unless
it can be stopped to manage treatment related toxicity, to have a biopsy if needed,
or for marker placement).

- Any major medical, addictive or psychiatric illnesses which would affect the consent
process, completion of treatment and/or interfere with follow-up. Consent by legal
authorized representative is not permitted in this study.

- Evidence of any other cancer within the past 5 years and < 50% probability of a 5
year survival. (Prior or concurrent diagnosis of basal cell or non-invasive squamous
cell cancer of the skin is allowed).

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

To determine if hypo-fractionation will result in freedom from failure (FFF) that is equivalent to FFF following standard fractionation. FFF will be measured by recurrence, metastasis, PSA or start of salvage therapy.

Outcome Description:

The events for FFF will be the first occurrence of clinical failure (local recurrence, regional recurrence, or distant metastasis), biochemical failure by the Phoenix definition (PSA ≥ 2 ng/ml over the current nadir PSA),or the start of salvage therapy including androgen deprivation.

Outcome Time Frame:

At 5 years post treatment completion +/- 90 days

Safety Issue:


Principal Investigator

Carlos Vargas, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Proton Collaborative Group


United States: Institutional Review Board

Study ID:




Start Date:

November 2010

Completion Date:

December 2021

Related Keywords:

  • Prostate Cancer
  • Proton Radiation Prostate Cancer
  • Prostatic Neoplasms



ProCure Proton Therapy Center Warrenville, Illinois  60555
ProCure Proton Therapy Center Oklahoma City, Oklahoma  73142