Extended-Field Lymph Node Proton Irradiation for High Risk Prostate Cancer
This phase II trial investigates whether proton radiation therapy directed to the prostate tumor, pelvic, and para-aortic lymph nodes, is an effective way to treat patients with high-risk or lymph node positive prostate cancer who are receiving radiation therapy, and if it will result in fewer gastrointestinal and genitourinary side effects. Proton beam therapy is a new type of radiotherapy that directs multiple beams of protons (positively charged subatomic particles) at the tumor target, where they deposit the bulk of their energy with essentially no residual radiation beyond the tumor. By reducing the exposure of the healthy tissues and organs to radiation in the treatment of prostate cancer, proton therapy has the potential to better spare healthy tissue and reduce the side effects of radiation therapy.
• Pathologically confirmed high-risk prostate cancer fulfilling any one of the following criteria:
‣ Gleason grade 8 or higher
⁃ cT3b (seminal vesicle involvement) or cT4
⁃ Prostate specific antigen \[PSA\] \> 20 (or PSA \>10 if on finasteride)
⁃ Clinically or pathologically positive regional lymph nodes within the inguinal, external iliac, internal iliac, obturator, peri-rectal, pre-sacral, common iliac, or lower para-oaortc (inferior to the L2-L3 interspace) basins
• Zubrod performance status 0-2
• Complete blood cell (CBC)/differential obtained within 90 days prior to registration on study
• Absolute neutrophil count (ANC) \>= 1,500 cells/mm\^3
• Platelets \>= 100,000 cells/mm\^3
• Hemoglobin \>= 8.0 g/dl (Note: The use of transfusion or other intervention to achieve hemoglobin \[Hgb\] \>= 8.0 g/dl is acceptable)
• Patient must be able to provide study specific informed consent