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Brief Title: Adjuvant Radiotherapy in Patients With Pathological High-risk Bladder Cancer (GETUG-AFU 30)
Official Title: Adjuvant Radiotherapy in Patients With Pathological High-risk Bladder Cancer: A Randomized Multicentre Phase II Study
Study ID: NCT03333356
Brief Summary: This is a randomized multicentre study in patients with high-risk MIBC to investigate adjuvant radiotherapy after radical cystectomy and pelvic lymph node dissection. The objective of the study is to provide evidence that adjuvant radiotherapy improves loco-regional control with potential benefits in survival. The study will also evaluate the quality of life of patients and the tolerance of the treatment.
Detailed Description: INDICATION: Patients with pathological high-risk muscle invasive bladder cancer treated by radical cystectomy and pelvic lymph nodes dissection METHODOLOGY: Multicenter randomised phase II study in high-risk bladder cancer patients treated by radical cystectomy with pelvic lymph nodes dissection assessing : * Experimental Arm: adjuvant pelvic radiotherapy consisting of 28 x 1.8 Gy fractions (total dose of 50.4 Gy), 5 days per week, 1 fraction /day (duration of RT is 38 days). * Standard Arm: surveillance. Eligible patients will be randomised, in a 3:1 ratio, to receive either: adjuvant pelvic radiotherapy (Experimental Arm), or surveillance (Standard Arm). PRIMARY OBJECTIVE: The primary objective of the trial is to assess the efficacy of adjuvant radiotherapy in patients with high-risk bladder cancer after radical cystectomy and pelvic lymph nodes dissection. Efficacy will be assessed in terms of pelvic recurrence-free survival (PRFS) at 3 years. SECONDARY OBJECTIVES: For each treatment arm (adjuvant pelvic radiotherapy \[Experimental Arm\], or surveillance \[Standard Arm\]), these objectives will be evaluated independently. * To evaluate 5-year pelvic recurrence-free survival (PRFS) * To evaluate disease-free survival (DFS) at 3 and 5 years. * To evaluate overall survival (OS) at 3 and 5 years. * To evaluate metastasis-free survival (MFS) at 3 and 5 years. * To evaluate disease-specific survival (DSS) at 3 and 5 years. * To evaluate the tolerance and safety of each treatment strategy. * To evaluate patients' quality of life. Ancillary studies Objectives: * Investigation of individual predisposition to develop radiotherapy induced late digestive toxicity using the radiation-induced lymphocyte apoptosis (RILA) assay * The analyse of genomic and transcriptome correlation between different clusters and oncological outcomes * Dosimetric banking to evaluate the correlation of Dose-Volume Histogram with: * Gastrointestinal toxicity grade ≥2; * Pelvic recurrence (radiotherapy volumes, mapping of recurrences).
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Clinique de L'Europe, Amiens, , France
ICO Paul Papin, Angers, , France
Clinique Générale d'Annecy, Annecy, , France
Institut Bergonie, Bordeaux, , France
Clinique Pasteur Cfro, Brest, , France
Centre Francois Baclesse, Caen, , France
Centre Jean Perrin, Clermont-Ferrand, , France
Hopital Henri Mondor, Créteil, , France
Centre Georges-Francois Leclerc, Dijon, , France
Chu Grenoble, Grenoble, , France
Centre Oscar Lambret, Lille, , France
Hôpital Universitaire Dupuytren, Limoges, , France
Groupe Hospitalier Bretagne Sud, Lorient, , France
Centre Léon Bérard, Lyon, , France
CHU La Timone, Marseille, , France
Institut Regional Du Cancer Montpellier, Montpellier, , France
Saint Louis, Paris, , France
Hopital Europeen Georges Pompidou, Paris, , France
Aphp Pitie-Salpetriere, Paris, , France
CH Lyon Sud, Pierre-Bénite, , France
Centre Eugene Marquis, Rennes, , France
Chp Saint-Gregoire, Saint Gregoire, , France
ICO - site René Gauducheau, Saint-Herblain, , France
Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, , France
Institut Claudius Regaud, Toulouse, , France
Clinique Pasteur, Toulouse, , France
Gustave Roussy Cancer Campus Grand Paris, Villejuif, , France
Name: Paul SARGOS, MD
Affiliation: Institut Bergonié
Role: PRINCIPAL_INVESTIGATOR
Name: Stéphane LARRE, Prof
Affiliation: CHU Robert Debré
Role: PRINCIPAL_INVESTIGATOR
Name: Géraldine PIGNOT, MD
Affiliation: Institut Paoli-Calmettes
Role: PRINCIPAL_INVESTIGATOR