PSMA-PET Guided Radiotherapy

Inclusion Criteria:

1. Enrolled in PERA (CHUM CER 17.0.32) and consented to contact for investigationaltrials.

2. Histological diagnosis of prostate cancer planned for curative-intent radiotherapy.

3. ECOG 0-1

4. Charlson Cormobidity Index ≤ 4

5. High-risk of distant metastases as defined by any of:

6. Oligometastases (≤5) (regional or distant) identified on conventional staging,with ≤ 3 metastasis in any non-bone organ. For a spine metastasis, directinvolvement of adjacent spinal segments would still be considered as "one"tumour. For nodal metastases, more than one involved lymph node in the sameipsilateral nodal region/chain would still count as "one" tumour. Defined nodalregions for this protocol include inguinal, external iliac, internal iliac,common iliac, retroperitoneal, hilar/mediastinal, anterior cervical, posteriorcervical, and axillary. Metastases in all other organs that are within 1cm ofeach other will be considered as "one" tumour.

7. Subjects with newly diagnosed high-risk (NCCN) localized prostate cancer andCAPRA score 6-10.

8. Subjects with a prior history of treated prostate cancer (RP or RT), andbiochemical failure (Phoenix-RT or>0.2ng/ml-RP)

9. Standard staging (bone scan, CT pelvis) within 12 weeks of consent.

Exclusion Criteria:

1. Prior androgen deprivation therapy terminated < 12 months prior to enrollment.

2. Prior or planned PET scan.