For a patient with localized, high-risk prostate cancer (Gleason >8, staged with PSMA PET), is prostate SBRT a reasonable treatment choice, and if so, what duration of ADT would you utilize in this setting?

Yes, I offer SBRT as a reasonable option for high-risk prostate cancer. This is admittedly an extrapolation from PACE-B, which studied treatment of intermediate-risk cancer, but it seems justified in my view. Safety is well established. Efficacy is supported by PACE-B, with an asterisk coming from N...

I agree with the other answers. SBRT seems a reasonable choice. There is no direct randomized study that validates this choice, but sufficient data from non-randomized studies to justify the choice. I would offer the opportunity to enroll the patient in the NRG-GU013 study, which is randomizing high...

I agree with Drs. @Dr. First Last and @Dr. First Last comments.

I would just add that in HYPO-RT-PC, 11% of the patients were high-risk, and if anything, subgroup analysis (with all the caveats) showed a favorable HR of 0.51 (CI: 0.29-0.89) for SBRT (albeit not the most popular dose/fractionation). ...