PSMA-PET Guided Radiotherapy

Inclusion criteria

• Enrolled in PERA (CHUM CER 17.0.32) and consented to contact for investigational trials.
• Histological diagnosis of prostate cancer planned for curative-intent radiotherapy.
• ECOG 0-1
• Charlson Cormobidity Index ≤ 4
• High-risk of distant metastases as defined by any of:

• Oligometastases (≤5) (regional or distant) identified on conventional staging, with ≤ 3 metastasis in any non-bone organ. For a spine metastasis, direct involvement of adjacent spinal segments would still be considered as "one" tumour. For nodal metastases, more than one involved lymph node in the same ipsilateral nodal region/chain would still count as "one" tumour. Defined nodal regions for this protocol include inguinal, external iliac, internal iliac, common iliac, retroperitoneal, hilar/mediastinal, anterior cervical, posterior cervical, and axillary. Metastases in all other organs that are within 1cm of each other will be considered as "one" tumour.
• Subjects with newly diagnosed high-risk (NCCN) localized prostate cancer and CAPRA score 6-10.
• Subjects with a prior history of treated prostate cancer (RP or RT), and biochemical failure (Phoenix-RT or>0.2ng/ml-RP)
• Standard staging (bone scan, CT pelvis) within 12 weeks of consent.

Exclusion criteria

• Prior androgen deprivation therapy terminated < 12 months prior to enrollment.
• Prior or planned PET scan.