Multicenter Study of Hypofractionated Postoperative Radiotherapy in Patients Diagnosed With Prostate Carcinoma

Inclusion Criteria:

* Age ≥ 18 years.
* ECOG 0-1 status.
* Previous radical prostatectomy (any modality will be allowed) with or without lymphadenectomy.
* Histological confirmation of prostate adenocarcinoma in the prostatectomy specimen.
* pT2-T3 Version 2.0, March 27, 2019
* pN0-Nx
* Indication of postoperative RT:

  * Adjuvant RT: pT3 and / or positive margins with PSA \<0.2 ng / ml. Delayed RT is considered (\> 6 months from the date of surgery but PSA \<0.2 ng / ml).
  * Rescue RT: exclusive biochemical recurrence, without evidence of macroscopic local, regional or distant disease, after surgery. Biochemical recurrence is considered PSA ≥ 0.2 ng / ml after undetectable levels, confirmed with a subsequent determination.
* PSA levels ≤ 2 ng / ml after, at least 45 days after surgery and 30 days before inclusion in the study.
* No clinical evidence of lymph node disease. The presence will be admitted by imaging tests of pelvic nodes ≤ 1 cm in its shortest axis.
* No evidence of disease in the prostatic fossa. If you doubt by digital rectal examination or CT, an MRI will be performed.
* No evidence of distant disease after performing a thoraco-abdominal-pelvic CT scan and bone scan.
* Reasonable follow-up possibilities.
* Ability to complete the EPIC-26 questionnaire.
* Written informed consent prior to inclusion in the study.

Exclusion Criteria:

* \- Previous pelvic radiation therapy.
* Distant metastasis.
* Macroscopic residual tumor.
* PSA\> 2 ng / ml.
* Pathological stage T4.
* Lymph node involvement.
* Pelvic or para-aortic nodules in the reevaluation images after surgery, except pelvic nodes ≤ 1 cm in their shortest axis.
* Indication of pelvic nodal RT. Version 2.0, March 27, 2019
* Severe urinary incontinence at the time of indication for radiotherapy.
* Uni / bilateral hip prosthesis
* Previous tumors, except non-melanoma skin carcinoma, and which are not free of disease for at least 3 years from the end of the treatment of said neoplasms. Bladder tumors are excluded in all cases.
* Genetic hyper-radio-sensitivity syndromes.
* Chronic inflammatory bowel disease or partial or radical cystectomy for any reason.
* Previously treated with androgen deprivation therapy for a period greater than 3 months.
* Previously treated with chemotherapy for prostate cancer.
* Life expectancy \<5 years or severe comorbidity: unstable angina, congestive heart failure, transmural myocardial infarction requiring admission in the last 6 months, active infectious process, respiratory disease requiring hospitalization, liver failure (Child-Pugh Class B or C), HIV with a CD4 count \<200 cells / ml, kidney failure requiring dialysis and immunosuppressed by other causes.