CT-guided Stereotactic Body Radiation Therapy and MRI-guided Stereotactic Body Radiation Therapy for Prostate Cancer, MIRAGE Study

Prior treatment

• Prior cryosurgery, high intensity focused ultrasound (HIFU) or brachytherapy of the prostate
• Prior pelvic radiotherapy
• Contraindications to MRI, including:
  • Electronic devices such as pacemakers, defibrillators, deep brain stimulators, cochlear implants;
  • Metallic foreign body in the eye or aneurysm clips in the brain;
  • Severe claustrophobia

Other illness

• History of Crohn's disease, ulcerative colitis, or ataxia telangiectasia

Other

• Patients with neuroendocrine or small cell carcinoma of the prostate
• Patients with any evidence of distant metastases. Note, evidence of lymphadenopathy below the level of the renal arteries can be deemed loco regional per the discretion of the investigator

• Histologically confirmed, clinical localized adenocarcinoma of the prostate
• No evidence of disease beyond the prostate and/or seminal vesicles (i.e., no suspicious pelvic lymph nodes or presence of metastatic disease outside the pelvis)
• Staging workup as recommended by the National Comprehensive Cancer Network (NCCN) on the basis of risk grouping:
  • Low risk: No staging workup required
  • Favorable intermediate-risk: CT abdomen/pelvis if Memorial Sloan Kettering Cancer Center (MSKCC) nomogram predicts \>10% probability of lymph node involvement
  • Unfavorable intermediate-risk: technetium bone scan, CT abdomen/pelvis if MSKCC nomogram predicts \>10% probability of lymph node involvement
  • High-risk: technetium bone scan, CT abdomen/pelvis if MSKCC nomogram predicts \>10% probability of lymph node involvement
  • Advanced imaging studies (i.e. prostate-specific membrane antigen positron emission tomography \[PSMA PET\] and axumin scan) can supplant a bone scan if performed first
• Ability to understand, and willingness to sign, the written informed consent