A Phase III Protocol of Androgen Suppression (AS) and 3DCTR/IMRT Vs AS and 3DCTR/IMRT Followed by Chemotherapy With Docetaxel and Prednisone for Localized, High-Risk, Prostate Cancer

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed prostate cancer at high-risk for recurrence within the past
180 days as determined by 1 of the following combinations (risk groups):

- Gleason score ≥ 9, prostate-specific antigen (PSA) ≤ 150 ng/mL, and any T stage

- Gleason score 8, PSA < 20 ng/mL, and stage ≥ T2

- Gleason score 8, PSA 20-150 ng/mL, and any T stage

- Gleason score 7, PSA 20-150 ng/mL, and any T stage

- Clinically negative lymph nodes by imaging (pelvic CT scan or pelvic MRI), nodal
sampling, or dissection within 90 days prior to study entry

- Equivocal or questionable lymph nodes ≤ 1.5 cm by imaging allowed

- Positive lymph nodes by capromab pendetide (ProstaScint^®) scan with a
corresponding lymph node ≤ 1.5 cm by CT scan or MRI allowed

- PSA ≤ 150 ng/mL

- Cannot have been obtained during any of the following time points:

- 10-day period after prostate biopsy

- After initiation of hormonal therapy

- Within 30 days after discontinuation of finasteride

- Within 90 days after discontinuation of dutasteride

- No distant metastases by physical exam and bone scan

- Equivocal bone scan findings allowed if plain films are negative

PATIENT CHARACTERISTICS:

- Zubrod performance status 0-1

- Platelet count ≥ 100,000/mm^3

- Absolute neutrophil count ≥ 1,800/mm^3

- Hemoglobin ≥ 8 g/dL (transfusion or other intervention allowed)

- ALT and AST ≤ 1.5 times upper limit of normal (ULN)

- Alkaline phosphatase ≤ 2.5 times ULN

- Bilirubin ≤ 1.5 times ULN

- Fertile patients must use effective contraception during and for at least 3 months
after completion of study treatment

- No prior invasive malignancy, except nonmelanomatous skin cancer or other malignancy,
unless disease-free for ≥ 3 years (e.g., carcinoma in situ of the oral cavity or
bladder are allowed)

- No unstable angina and/or congestive heart failure requiring hospitalization within
the past 6 months

- No transmural myocardial infarction within the past 6 months

- No acute bacterial or fungal infection requiring intravenous antibiotics

- No AIDS

- No prior allergic reaction to any study drugs or other drugs formulated with
polysorbate 80

- No existing peripheral neuropathy ≥ grade 2

PRIOR CONCURRENT THERAPY:

- At least 60 days since prior 5-alpha reductase inhibitor (e.g., finasteride) for
prostatic hypertrophy

- At least 90 days since prior testosterone

- Prior pharmacologic androgen ablation for prostate cancer allowed provided androgen
ablation was initiated no more than 50 days prior to study entry

- No prior radical prostatectomy, cryosurgery for prostate cancer, or bilateral
orchiectomy

- No prior systemic chemotherapy for prostate cancer

- Prior chemotherapy for a different cancer is allowed

- No prior radiotherapy, including brachytherapy, to the region of prostate cancer that
would result in overlap of radiotherapy fields

- Intensity modulated radiotherapy allowed