Conventional or Hypofractionated Radiation Therapy in Treating Patients with Prostate Cancer

Inclusion Criteria

• Men age 18 or older
• Patient has diagnosis of pathologically confirmed prostate cancer, treated with radical prostatectomy. Any type of radical prostatectomy will be permitted, including retropubic, perineal, laparoscopic, or robotically assisted
• Patient has pathologic T2-T3M0 stage. Patients can have 5 or less metastatic pelvic lymph nodes confirmed by pathology
• For patients radiated in the post-operative salvage setting: pathology can demonstrate any of the following features but not required, positive margin, extracapsular extension, or seminal vesicle involvement with detectable prostate-specific antigen (PSA) of >= 0.1. PSA >= 0.1 after radical prostatectomy: most recent PSA value within 12 months of registration and prior to initiating any androgen deprivation therapy (ADT)
• Patient diagnosed with Gleason score of 6-10
• Eastern Cooperative Oncology Group (ECOG) performance 0-2
• Patients may receive 6 months and up to 24 months of androgen deprivation therapy. Patients may have received androgen deprivation therapy up to 12 months prior to postoperative radiotherapy
• If the patient has a prior history of any cancer other than prostate cancer, he must have completed treatment within 1 year of study registration and the patient must have no evidence of disease of this prior non-prostate cancer

Exclusion Criteria

• Prior radiation therapy to prostate/seminal vesicle fossa or postoperative region
• Neoadjuvant chemotherapy before or after prostatectomy
• History of lupus, scleroderma, or calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome
• History of severe active co-morbidity or uncontrolled diabetes
• Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
• Transmural myocardial infarction within the last 6 months
• Severe hepatic disease, defined as a diagnosis of Child-Pugh class B or C hepatic disease
• End-stage renal disease (i.e., on dialysis or dialysis has been recommended)