Radiation Therapy, Docetaxel, and Hormone Therapy in High-Risk Locally Advanced Metastasized Prostate Cancer

OBJECTIVES: Primary * Determine, preliminarily, the grade III or IV toxicity rate of concurrent extended-field intensity-modulated radiotherapy (IMRT), docetaxel, and androgen deprivation therapy in patients with high-risk, locally advanced prostate cancer with pelvic lymph node metastasis. Secondary * Determine, preliminarily, the progression-free survival of patients treated with this regimen. * Determine the maximum tolerated dose of docetaxel when administered with concurrent IMRT in this patients. OUTLINE: This is a dose-escalation study of docetaxel. Patients receive combined androgen deprivation therapy (if not already on combined hormonal therapy) comprising goserelin acetate\* subcutaneously once every 3 months for up to 2 years and oral bicalutamide once daily beginning on day 1 and continuing until the completion of radiotherapy. Beginning at approximately week 9 of androgen deprivation therapy, patients receive docetaxel IV over 1 hour once weekly for up to 9 weeks. Concurrently with chemotherapy, patients undergo intensity-modulated radiotherapy 5 days a week for up to 45 fractions (9 weeks). Cohorts of 3-6 patients receive escalating doses of docetaxel until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Note: \*Not required for patients who have undergone bilateral orchiectomy After completion of study therapy, patients are followed periodically for 5 years.