Study Evaluating the Efficacy and the Tolerance of Pelvic-prostatic Hypo-fractionated Radiotherapy Followed by Boost in Patients With Prostate Adenocarcinoma Adverse Intermediate Risk or High Localized Risk

Inclusion criteria

• Adenocarcinoma of the prostate
• Patient with one of the following cases:

• Gleason 7 - 10 + T1c - T2b + PSA < 50 ng/mL or
• Gleason 6 + T2c - T4 ou envahissement ≥ 50% sur les biopsies + PSA < 50 ng/mL or
• Gleason 6 + T1c - T2b + PSA > 20 ng/mL
• Risk of lymph node involvement> 15%
• Patient N0, or Nx
• Prostate volume estimated on MRI or ultrasound less than 60 cc.
• Absence of pelvic lymphadenopathy ≥ 15 mm on CT or MRI extension assessment
• Lack of bone and / or visceral metastasis on CT scan and bone scintigraphy
• Hormonal treatment started maximum 90 days before the beginning of the irradiation,
• IPSS score <12 without alpha blocker treatment
• Absence of prior pelvic radiotherapy,
• Lack of surgical treatment for prostate cancer except transurethral resection performed within 6 months before radiotherapy,
• Age ≥ 18 years and ≤ 85 years,
• WHO performance index ≤ 1,
• Estimated life expectancy> 5 years,
• Indication of treatment with radiotherapy and validated hormone therapy in a multidisciplinary consultation meeting
• Affiliation to a social security scheme,
• Signed informed consent.

Exclusion criteria

• Prostate cancer of histology other than adenocarcinoma,
• Patient diagnosed with N1 during imaging or pN1,
• serum PSA level> 100 ng / ml,
• IPSS score ≥ 12 or alpha blocker treatment,
• Prostate volume estimated on MRI or ultrasound> 60 cc
• History of cancer in the 5 years prior to entry into the trial,
• History of trans-urethral resection of prostate less than 6 months old,
• History of rectal surgery,
• History of pelvic irradiation,
• Patient with severe hypertension not controlled by appropriate treatment,
• Contraindication to pelvic irradiation,
• Patient not eligible for brachytherapy

• Prostate volume> 60cc
• Urine flow measurement with max flow <12 mL / s
• Or curative anticoagulant treatment
• Or contraindication to general anesthesia
• Patient treated with antineoplastic or drug may include methotrexate,
• Hormone therapy started> 90 days before the first irradiation,
• Patient on immunosuppressant therapy
• Contraindication to agonists or antagonists of LHRH,
• Bilateral hip prosthesis,
• Patient already included in another therapeutic trial with an experimental molecule,
• Patient unable to cooperate during treatment,
• Persons deprived of their liberty or guardianship,
• Inability to undergo medical follow-up of the test.