Dose Escalation Study of Preoperative SBRT for High Risk Prostate Cancer

Inclusion Criteria

• •Histologically-proven prostate adenocarcinoma.
• •Clinical stage ≤T3a based on digital rectal exam and/or ≤T3a based on MRI (if done); N0-Nx; M0-Mx (AJCC 7th Edition)
• •Prostate-specific antigen (PSA) ≤ 80 ng/ml, obtained within 3 months.
• •Patients belonging in the National Comprehensive Cancer Network (NCCN) high recurrence risk group. High risk: Clinical stage T3a, or Gleason score = 8-10, or PSA \>20 ng/mL.
• •Prostate volume: ≤ 80 cc on transrectal ultrasound
• •IPSS score ≤15
• •Zubrod performance status 0-2 or equivalent
• •No prior total prostatectomy or cryotherapy of the prostate. Prior transurethral resection or laser ablation is permitted.
• •No prior radiotherapy to the prostate or lower pelvis
• •No implanted hardware or other material that would prohibit appropriate treatment planning or treatment delivery, in the investigator's opinion
• •No history of an invasive malignancy (other than this prostate cancer, or non-metastatic basal or squamous skin cancers) in the last 5 years
• •No androgen deprivation therapy (ADT) can be prescribed prior to or during radiation therapy
• •Must be able to have gold fiducial markers placed in the prostate or, if patient already has fiducial markers placed, they must be in accordance with the protocol specifications
• •Ability to understand and the willingness to sign a written informed consent document
• •Willingness to fill out IPSS, SHIM, and EPIC quality of life forms
• •Age ≥18 years
• •IPSS (AUA) score ≤15