• Rate of prostate-specific antigen (PSA) decline [ Designated as safety issue: No ]
  

• Progression-free survival based on PSA progression [ Designated as safety issue: No ]
  
• Overall survival [ Designated as safety issue: No ]
  
• Correlation between velocity of subsequent PSA failure and survival [ Designated as safety issue: No ]
  

OBJECTIVES:

Primary

• Determine the rate of prostate-specific antigen (PSA) decline and the number of patients reaching a PSA nadir of zero after treatment with chemoradiotherapy comprising docetaxel and external-beam radiotherapy followed by docetaxel and prednisone in patients with hormone-naive prostate cancer who have a rising PSA after radical prostatectomy.

Secondary

• Determine the tolerability of this regimen in these patients.
• Determine the progression-free survival, based on PSA progression, of these patients.
• Determine the overall survival of patients treated with chemoradiotherapy for rising PSA after radical prostatectomy.
• Determine if the velocity of subsequent PSA failure impacts survival of these patients.

Tertiary

• Document subsequent therapy for patients whose previous treatment has failed and if there is a response to that therapy.

OUTLINE: Patients receive docetaxel IV over 1 hour on days 1, 8, 15, 22, 29, 36, and 43 and undergo external-beam radiotherapy on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47.

Beginning within 6 weeks after completion of chemoradiotherapy, patients receive docetaxel IV over 1 hour on day 1 and oral prednisone twice daily on days 1-21. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 1 month, every 4 months for 2 years, and then every 6 months for 3 years.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Histologically confirmed prostate cancer
• Prostate-specific antigen (PSA) level > 0.2 ng/mL after radical prostatectomy performed ≥ 6 weeks ago
• No lymph node-positive prostate cancer

• No documented metastatic disease

  • CT scan of the abdomen and pelvis negative (within the past 6 months)
  • No bone pain OR negative bone scan (within the past 6 months)

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Absolute neutrophil count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 9 g/dL
• Bilirubin normal
• ALT and AST ≤ 1.5 times upper limit of normal
• Alkaline phosphatase normal
• Fertile patients must use effective contraception
• No peripheral neuropathy > grade 1
• No other malignancy within the last 5 years that could affect the diagnosis or assessment of prostate cancer
• No serious illness with a life expectancy of < 5 years
• No concurrent medical, psychological, or social circumstance that would preclude study compliance
• No history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior orchiectomy
• No prior chemotherapy regimen for this disease
• No prior pelvic radiotherapy

• No pre- or postoperative androgen manipulation, such as luteinizing hormone-releasing hormone agonists, antiandrogens (flutamide, bicalutamide, or nilutamide), or finasteride

  • Preoperative androgen manipulation for a duration of ≤ 3 months allowed
• No prior immunotherapy
• No prior strontium chloride Sr 89, samarium Sm 153 lexidronam pentasodium, or other systemic radioisotopes
• No concurrent filgrastim (G-CSF) or sargramostim (GM-CSF)

• No concurrent herbal or alternative regimens including, but not limited to, any of the following:

  • Saw palmetto
  • PC-SPES
  • Shark cartilage
• No other concurrent investigational agents
• No other concurrent chemotherapy, immunotherapy, or hormonal therapy (except for replacement steroids)