Ultra-hypofractionated Stereotactic Body Radiation Therapy with or without Short Course Degarelix in Treating Patients with Intermediate-Risk Prostate Cancer

Inclusion Criteria

• Biopsy proven intermediate risk prostate cancer, which includes patients with any one of the following variables: * Gleason 7 disease * Prostate-specific antigen (PSA) 10-20 ng/ml * Clinical T2b-T2c disease * Note: Patients who only have radiographic evidence of T3 disease (i.e. extracapsular extension, or seminal vesical invasion radiographically) will not be excluded
• Serum testosterone >= 240 ng/dL determined within 2 months prior to enrollment
• At least 4 weeks must have elapsed from major surgery
• Karnofsky performance status (KPS) >= 80%
• Prostate size as determined on magnetic resonance imaging (MRI) to be < 90 cc; prostate size can be determined on computed tomography (CT) scan if MRI is not available
• IPSS =< 20
• Patient must be available for follow-up; after 2 years of follow-up following post-treatment biopsy, telephone-based follow-up will be acceptable
• Serum bilirubin =< 1.5 times the upper institutional limits of normal (ULN); patients with a history of Gilbert’s syndrome may be enrolled if the total bilirubin is < 3 mg/dL with a predominance of indirect bilirubin (within 8 weeks of randomization)
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 2.5 x ULN (within 8 weeks of randomization)
• Serum creatinine =< 1.5 x ULN (within 8 weeks of randomization)
• Absolute neutrophil counts >= 1,500 cell/mm^3 (within 8 weeks of randomization)
• Platelets >= 100,000 cells/mm^3 (within 8 weeks of randomization)
• Hemoglobin value >= 9 g/dL (Note: patients whose anemia has been corrected to a hemoglobin value >= 9 g/dL with blood transfusions are allowed) (within 8 weeks of randomization)

Exclusion Criteria

• CT or MRI evidence of metastatic disease to the bone
• Patients with one or more positive lymph nodes considered suspicious as determined by clinical assessment on MRI or CT
• Prior treatment for prostate cancer, including history of chemotherapy, hormonal therapy within 30 days of enrollment or surgery for prostate cancer (except for prior transurethral prostatic resection [TURP] or greenlight photoselective vaporization of the prostate [PVP] which would be allowed)
• History of another malignancy within the previous 3 years except for the following: adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, currently in complete remission, or any other cancer that has been in complete remission for at least 3 years
• Patients with Crohn’s disease or ulcerative colitis