High-risk prostate cancer, defined as at least one of: T3, OR Gleason 8-10, OR PSA \> 20 ng/mL
Willing to give informed consent to participate in this clinical trial
Able and willing to complete Expanded Prostate Index Composite (EPIC) questionnaire
You may not be if
Prior pelvic radiotherapy
Contra-indication to radical prostate radiotherapy e.g. connective tissue disease or inflammatory bowel disease
Contraindication to prostate MRI
Anticoagulation medication (if unsafe to discontinue for gold seed insertion)
Diagnosis of bleeding diathesis
Large prostate with significant arch interference on TRUS after 3 months of neoadjuvant ADT.
Previous TURP
Poor baseline urinary function defined as International Prostate Symptom Score (IPSS) \>20
Significant medical co-morbidity rendering patient unsuitable for general anesthetic
No evidence of castrate resistance (defined as PSA \< 3 ng/ml while testosterone is \< 0.7nmol/l. Patients could have been on combined androgen blockade but are excluded if this was started due to PSA progression.
Definitive extrapelvic nodal or distant metastatic disease on staging investigations.
Clareo Health | 5 Fractions of Pelvic SABR With Intra Prostatic SABR
