Study on PSMA-Directed Radiation Therapy for Recurrent Prostate Cancer

Inclusion Criteria

• Men aged 18 or older with confirmed prostate cancer.
• Cancer that has returned in a limited area below the diaphragm, possibly involving pelvic lymph nodes.
  • No more than 5 cancer spots on a PSMA PET/CT scan.
  • Cancer must be confined to pelvic and para-aortic lymph nodes below the diaphragm.
  • At least one cancer spot in the para-aortic lymph nodes below the diaphragm.
  • Tumors must be smaller than 5 cm.
• Previous pelvic radiation treatment with a positive response.
  • Radiation to the prostate, with or without pelvic lymph nodes, or
  • Radiation to the prostate bed after surgery, with or without pelvic lymph nodes.
• Cancer must be sensitive to hormone therapy.
• General health status allowing normal activities or some restrictions (ECOG score 0-2).
• Ability to understand the study and willingness to sign consent forms.
• Willingness to complete quality of life and psychosocial questionnaires.
• Willingness to participate in the Prostate Cancer Database Protocol.

Exclusion Criteria

• No confirmed diagnosis of prostate cancer.
• More than 5 cancer spots.
• History of cancer spread to bones or organs.
• No cancer in the para-aortic lymph nodes.
• No PSMA PET/CT scan for staging.
• Previous radiation outside the pelvis for prostate cancer.
• Tumors larger than 5 cm.
• Recent hormone or chemotherapy treatment before staging scan or study enrollment.
• Suspicious cancer in the prostate without a negative biopsy.
• Medical implants that interfere with treatment.
• Prostate cancer that does not respond to hormone therapy.
• Poor general health status (ECOG score greater than 2).
• History of inflammatory bowel disease.
• History of other cancers, except non-melanoma skin cancer.
• Inability to consent or being a prisoner.
• Unwillingness to complete quality of life and psychosocial questionnaires.
• Impaired decision-making ability.