PSMA-Directed Para-Aortic Radiation Therapy for Oligorecurrent Prostate Cancer

About This Trial

This study is testing whether using targeted radiation therapy alongside hormone therapy can help control cancer that has returned, while also protecting your quality of life.
Doctors will use specialized imaging scans to precisely find and deliver radiation to lymph nodes in the lower belly and pelvis.
The trial is for men whose prostate cancer has come back in only a few lymph nodes (up to five spots) after prior radiation, with no spread to the bones or other organs.
Before considering this study, you should know that you cannot have received recent chemotherapy or hormone therapy, and you will be asked to complete regular questionnaires about your daily well-being.

The purpose of this prostate cancer research study is to learn about: 1.
Improving control of prostate cancer using radiation therapy, delivered to the para-aortic and pelvic lymph nodes, in addition to systemic androgen suppression therapy; 2.
Preserving quality of life after radiation therapy; 3.
Leveraging imaging results from prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) scans to evaluate and manage disease progression.

Age Range: 18 years and older
Gender: Male
Who This Trial is For: This study is testing whether using targeted radiation therapy alongside hormone therapy can help control cancer that has returned, while also protecting your quality of life.

Full Eligibility Criteria

Inclusion Criteria

Histologically proven prostate adenocarcinoma
Male, ≥ 18 years old
Oligorecurrent disease limited to the sub-diaphragmatic region with or without pelvic lymph nodes
- a. No more than a total of 5 lesions on PSMA PET/CT scan (each lesion defined as positive with standardized uptake value (SUV) > liver uptake and CT scan correlate)
- b. No disease outside of the pelvic and sub-diaphragmatic para-aortic lymph nodes
- c. At least one lesion in the sub-diaphragmatic pelvic or para-aortic lymph nodes
- d. Non-bulky nodal disease (ie, tumor 5 cm in tumor size
Androgen deprivation therapy (ADT) or chemotherapy in the three months prior to staging PSMA PET/CT scan (suggesting oligoprogressive disease, rather than true oligorecurrent disease) or at time of study enrollment
Suspicious radiologic evidence of disease in the prostate on staging PSMA PET/CT scan without confirmatory negative prostate biopsy
Implanted hardware which limits treatment planning or delivery (determined by treating physician)
Castration-resistant prostate cancer (history of rising PSA with serum testosterone level 2
History of inflammatory bowel disease
History of malignancy other than prostate cancer except for non-melanoma skin cancer
Patients unable to consent or are prisoners
Unwilling to fill out quality of life and psychosocial forms
Participants with impaired decision-making capacity