SURPASS: Stereotactic Ultra-hypofractionated Radiotherapy for Post-prostatectomy Patients: Adaptive Salvage SBRT

Prior treatment

• Prior pelvic radiotherapy which in the opinion of the treating radiation oncologist precludes safe radiation therapy.

Other illness

• Distant metastatic disease
• Has a diagnosis of inflammatory bowel disease, active scleroderma, lupus, or other rheumatologic disease which in the opinion of the treating radiation oncologist precludes safe radiation therapy.
• Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.

Other

• Neuroendocrine or small cell histology

• Patients at or over 18 years old.
• Have a histologically confirmed diagnosis of prostate adenocarcinoma status post radical prostatectomy who are candidates for salvage postoperative radiotherapy. This includes patients whose Prostate-Specific Antigen (PSA) does not fall to undetectable levels after prostatectomy or that have undetectable PSA after prostatectomy with a subsequent detectable PSA that increases on \> 2 determinations or increases to PSA \> 0.1 ng/ml. It also includes patients with adverse pathologic features at the time of prostatectomy (e.g. positive surgical margin, pathologic T-stage 3-4 disease, pathologic Gleason score 8-10 disease, presence of tertiary Gleason grade 5 disease) or an intermediate- or high-risk Decipher genomic classifier score.
• No evidence of metastatic disease
• Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• Can complete EPIC-26/IPSS assessments and provide informed consent