Clinical Research Directory

Inclusion Criteria: * Male; age \>= 18 years * Histological confirmation of prostate adenocarcinoma * Recurrent prostate cancer after prior receipt of primary radiotherapy to the prostate (can also include treatment of splenic vessels \[SVs\] and lymph nodes \[LNs\]) or salvage RT to the prostate fossa (can also include prior pelvic RT) * Oligometastatic extent of disease * Recurrent disease involving lymph nodes as diagnosed with choline positron emission tomography (PET)/computed tomography (CT) or other advanced PET imaging (prostate-specific membrane antigen \[PSMA\] or flucyclovine) * Limited to pelvic and/or retroperitoneal/para-aortic lymph nodes * Zubrod performance score (PS) =\< 1 * Signed informed consent Exclusion Criteria: * Bone or visceral metastases present * Lymph node metastases beyond the pelvis and/or retroperitoneum * Contraindications to RT (e.g., uncontrolled inflammatory bowel disease) * Contraindications to androgen suppression * Concurrent antineoplastic agents (chemotherapy) * Previous or concurrent malignancy other than non-melanoma skin cancer within 5 years of diagnosis of prostate cancer * Inability to start the radiation portion of the protocol treatment within 6 months after study enrollment * Medical or psychiatric conditions that preclude informed decision-making or compliance with the protocol treatment or follow-up