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

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