Stereotactic Body Radiation Therapy in Treating Patients With Localized Prostate Cancer That Have Undergone Surgery

Inclusion Criteria:

History of histologically confirmed, clinical localized adenocarcinoma of the prostate treated with radical prostatectomy with definitive intent
Presence of adverse pathologic features at the time of prostatectomy (positive surgical margin, pathologic T-stage 3-4 disease, pathologic Gleason score 8-10 disease, presence of tertiary Gleason grade 5 disease) OR documentation of rising prostate-specific antigen on at least two consecutive draws, with the magnitude of prostate-specific antigen exceeding 0.03 ng/mL
Computed tomography (CT) scan and MRI of the pelvis within 120 days prior to enrollment (note: [a] if patient has medical contraindication to MRI, an exemption will be granted and enrollment can proceed [b] for patients with PSA < 1.0 ng/mL, the treatment planning CT can substitute for a diagnostic CT scan)
Bone scan within 120 days prior to enrollment; if the bone scan is suspicious, a plain x-ray and/or MRI must be obtained to rule out metastasis, and advanced imaging (e.g., 18NaF positron emission tomography [PET]/CT) is strongly recommended
Karnofsky performance score (KPS) >= 70
Ability to understand, and willingness to sign, the written informed consent

Exclusion Criteria:

Patients with any evidence of distant metastases
Patients with pathologically-confirmed N1 prostate cancer
Patients with neuroendocrine or small cell carcinoma of the prostate
Prior cryosurgery, high-intensity focused ultrasound ablation (HIFU) or brachytherapy of the prostate
Prior pelvic radiotherapy
History of Crohn's disease, ulcerative colitis, or ataxia telangiectasia