Radiation Therapy in Combination With Brachytherapy for Clinically Localized, Intermediate Risk Prostate Cancer

Ultra-hypofractionated, Image-guided, Intensity-modulated Radiation Therapy in Combination With Brachytherapy for Clinically Localized, Intermediate Risk Prostate Cancer

The purpose of this study is to test the safety and side effects "of "ultra-hypofractionated" radiation therapy when used after brachytherapy (radiation implants). This treatment delivers a higher radiation dose with each treatment over a shorter period of time.

Inclusion Criteria:

• Intermediate risk prostate cancer patients will be eligible for this study. Intermediate risk grouping will be assessed per NCCN guidelines as:
• Pathologically-proven diagnosis of prostate adenocarcinoma
• PSA 10-20ng/mL or
• Gleason =7 or
• Clinical stage T2b/c
• Clinical stage T2b/c Additionally, patients will be required to meet the following criteria
• Age ≥18
• KPS≥70
• Prostate volume ≤ 60cc (cytoreductive androgen deprivation therapy prior to brachytherapy of ≤ 6 months duration will be allowed to achieve this goal). For patients with a prostate volume between 50-60ccs, hormone therapy will be at the discretion of the physician.
• International Prostate Symptom Score ≤15

Exclusion Criteria:

• Prior prostate surgery (including TURP)
• Prior history of chronic prostatitis or urethral stricture
• Inflammatory bowel disease
• Prior history of pelvic radiotherapy
• Unable to give informed consent
• Metastatic disease.