Study on Short-Term Hormone Therapy and Radiation for High-Risk Prostate Cancer with Low/Intermediate ARTERA Scores

Inclusion Criteria

• Must be able to understand and sign a consent form.
• Male participants aged 18 or older.
• Diagnosed with prostate cancer that meets at least one high-risk criteria, such as a Gleason score of 8-10, a PSA level over 20 up to 40 ng/ml, or MRI stage T1-T3 without nodal involvement.
• No signs of cancer spread to lymph nodes on initial scans.
• Low or intermediate ARTERA AI scores.
• Serum testosterone level of at least 120 ng/dL before starting ADT.
• At least 4 weeks since any major surgery.
• Good overall health with a Karnofsky Performance Status over 80.
• Prostate size less than 90 cc.
• MRI may show some cancer spread beyond the prostate capsule.
• International Prostate Symptom Score (IPSS) less than 22.
• Must meet all MRI screening criteria and agree to complete the MRI screening form.

Exclusion Criteria

• Gleason score of 6 or 7 without a PSA over 20 ng/mL.
• PSA level over 40 ng/mL.
• Previous or ongoing hormone therapy for prostate cancer lasting more than 3 months.
• High-risk ARTERA scores.
• MRI shows suspicious lymph node involvement.
• Evidence of cancer spread to lymph nodes or other areas on scans.
• Metal implants in the pelvis that could affect MRI quality.
• Cannot receive gadolinium contrast.
• Karnofsky Performance Status below 80.
• MRI or CT shows advanced cancer spread (T4, N1, or bone disease).
• Previous prostate cancer treatments, except for certain prostate surgeries.
• History of another cancer within the last 2 years, except for certain skin cancers or cancers in remission.
• IPSS score over 22.
• Currently taking certain prostate cancer medications (e.g., enzalutamide, apalutamide).
• Previous hormone therapy for prostate cancer is allowed if it was less than 3 months total.