A Study of Shorter Course Hormone Therapy and Radiation for High-risk Prostate Cancer

Phase II Trial of Short Course Androgen Deprivation, Hypofractionated Pelvic Radiation and a Brachytherapy Boost for NCCN High-Risk Prostate Cancer With Low-Intermediate Risk Decipher Genomic Score

The purpose of this study is to find out whether combining a shorter than standard course of ADT with standard prostate brachytherapy and hypofractionated external beam radiation therapy is a safe and effective way to prevent high-risk prostate cancer from coming back and/or spreading to other parts of the body.

Inclusion Criteria:

• Pathologically-proven diagnosis of prostate adenocarcinoma

• Clinical stage T3-4 or Gleason score 8-10 or PSA >20 ng/ml

  °If radiographic T3-T4 is the only high-risk factor, it must be "consistent with" or >90% probability of having T3-T4 disease determined by the reading radiologist.

• Decipher genomic score ≤0.6

• Willing and able to provide written informed consent and Authorization for Use and Release of Health and Research Study Information (HIPAA authorization)

• Age ≥18

• KPS ≥70 or ECOG 0-2

• Estimated life expectancy >5 years

• Baseline prostate volume ≤90 cc

• Baseline IPSS ≤20

• No contraindications to ADT, brachytherapy, or pelvic external beam radiation therapy as determined by the treating radiation oncologist per standard practice

• Patients who have already started ADT consisting of bicalutamide 50 mg PO daily with leuprolide or an equivalent GnRH analogue are eligible if given for ≤ 60 days prior to registration

Exclusion Criteria:

• Regional lymph node or metastatic disease
• Prior pelvic radiation
• Prior prostate surgery (including TURP or cryosurgery)
• Prior history of inflammatory bowel disease
• Unable to undergo anesthesia or brachytherapy
• Active second malignancy or past history of malignancies diagnosed within the last 2 years that requires active therapy and/or in remission, with the exception of resected non-melanoma skin cancers, non-muscle invasive bladder cancer, stage I head and neck cancer, or stage I colorectal cancer