EBRT + Lu-PSMA for N1M0 Prostate Cancer

Inclusion Criteria:

* Histologically proven prostate cancer;
* cT2-4, partly determined by MRI;
* N1, determined by LND/SNP and/or PSMA PET/CT;
* iM0, determined by PSMA PET/CT;
* Accepted for curative intent treatment with EBRT of the prostate and regional nodes + 3y ADT;
* Visually PSMA-positive primary tumor and nodes, largest lesion ≥ average liver uptake;
* WHO performance score 0-1;
* Age \> 18 years;
* For patients who have partners of childbearing potential: Willingness to use a method of birth control with adequate barrier protection during the study and for 6 months after the study drug administration; and
* Signed written informed consen

Exclusion Criteria:

* Inability to comply to study procedures;
* Inability to adhere to radiation safety measures in hospital or at home;
* Inability to undergo the required biodistribution scans;
* Prior or current malignant disease with potential impact on treatment outcome or survival;
* Prior treatment with EBRT;
* Prior treatment with ADT, already initiated \>1 month before the start of EBRT;
* Prior treatment with radionuclide therapies, 177Lu-PSMA-617 or other;
* Reduced bone marrow reserve (Hb\<6 mmol/L, Leukocytes\<2.5 10E9/L, or Platelets\<100 10E9/L not older than 1 month before start of EBRT);
* Reduced renal function (GFR \< 60 not older than 1 month before start of EBRT);
* Reduced salivary gland function (history of prior salivary gland disease); or
* Miction problems requiring pre-treatment with ADT.