Daily Adaptive Radiation Therapy Using an Individualized Approach for Prostate Cancer

Inclusion criteria

• Patient has NCCN low or intermediate risk prostate cancer that is biopsy proven.
• Prostate volume is ≤80cc as assessed by MRI prior to radiotherapy.
• AUA/IPSS score is ≤ 15.
• ECOG performance status is ≤2 (or Karnofsky score is ≥60%).
• Patient has no PIRADS 4 or 5 lesion on prostate MRI contacting the urethra (determined at physician discretion).
• Patient has the ability to complete required patient questionnaires.
• Patient age ≥ 18 years (or greater than the local age of majority).
• Patient has the ability to understand and the willingness to sign a written informed consent document.

Exclusion criteria

• Patient has baseline grade ≥3 GI or GU toxicity
• Patient has had prior overlapping pelvic radiotherapy.
• Patient has had prior transurethral resection of the prostate, prostate HIFU, or cryoablation.
• Patient has node positive prostate cancer.
• Patient has extracapsular extension (capsular abutment is permitted).
• Patient has active inflammatory bowel disease or active collagen vascular disease.
• Patient cannot undergo prostate MRI.
• Patient cannot undergo prostate fiducial marker placement.
• Patient has ongoing receipt of cytotoxic chemotherapy (androgen deprivation therapy is allowed).