This prospective, single-arm feasibility study will include patients with prostate cancer that have controlled local disease diagnosed with oligorecurrent para-aortic nodal disease and/or common iliac nodal disease detected by PSMA PET or conventional CT/MRI imaging, and these patients will undergo CT-guided online adaptive SBRT to the tumor and elective SBRT to adjacent at-risk nodal regions.
Histologically confirmed prostate adenocarcinoma.
Oligorecurrent para-aortic +/- common iliac nodal disease planned for SBRT.
≤10 involved para-aortic (defined as between L1/L2 interface and L4/L5 interface) +/- common iliac LN on PSMA PET imaging.
ECOG performance status 0-2.
Prior radiotherapy to the nodal echelon (PA +/- common iliac).
Active secondary malignancy, except for adequately treated non-melanoma skin cancer.
Presence of significant comorbidities or medical conditions that may compromise the ability to undergo radiotherapy or participate in the study.
Contraindication to radiation.