Dose Escalation Study Using Ultra-Hypofractionated, Image-Guided, Intensity-Modulated Radiotherapy in Prostate Cancer

Inclusion Criteria:

Eligibility is not restricted to MSKCC to confirm biopsy/diagnosis. Participating institution testing is sufficient.

Low and intermediate risk prostate cancer patients will be eligible for this study. Risk groups will be assigned as per NCCN guidelines.

Low risk patients will be defined as:

PSA < or = to 10 ng/ml and
Gleason score = 6 and
Clinical Stage < or = to T2a

Intermediate risk patients will be defined as:

PSA 10-20 ng/ml or
Gleason score = 7 or
Clinical stage T2b/T2c

Additionally, patients will be required to meet the following criteria:

Age > or = to 18
KPS > or = to 70
Pre-treatment endorectal coil MRI or CT (MRI preferred) at MSKCC showing no definite evidence of radiographic T3, T4, or N1 disease
Prostate size < or = to 60 cc
International Prostate Symptom Score < or = to 15

Exclusion Criteria:

Prior androgen deprivation therapy for prostate cancer

Elective pelvic lymph node irradiation
KPS < 70
Pelvic MRI or CT (MRI preferred) evidence of radiographic T3, T4 or N1 disease

Presence of distant metastasis as determined by:

o alkaline phosphatase > or = to ULN or

whole body bone scan positive for osseous metastases
Prior history of transurethral resection of the prostate
Prior history of chronic prostatitis
Prior history of urethral stricture
Prior history of pelvic irradiation
History of inflammatory bowel disease
Unable to give informed consent

Unable to complete quality of life questionnaires Abnormal complete blood count. Any of the following

Platelet count less than 75,000/ml
Hb level less than 10 gm/dl
WBC less than 3.5/ml
Abnormal renal function tests (creatinine > 1.5)