Clinical Research Directory

Inclusion criteria: 1. Histologically proven initial diagnosis of adenocarcinoma of the Prostate. 2. Biochemical recurrence of prostate cancer following primary local prostate treatment (radical prostatectomy, primary radiotherapy or radical prostatectomy +/- prostate bed adjuvant salvage radiotherapy) according to the EAU guidelines 2018. BCR after surgery: PSA \> 0.1ng/ml. BCR after radiotherapy: PSA nadir +2 ng/ml or 3 consequent rises in PSA level (after exclusion of possible bounce effect). 3. Minimal 1 lesion and maximum 4 lesions (bone + lymph nodes) in total, without evidence of visceral metastases. 1. Nodal relapse (N1) in the pelvis on PSMA-PET/CT with a maximum of 4 positive lymph nodes. The upper limit of the pelvis is defined as the aortic bifurcation. 2. Nodal relapse (M1a) on PSMA-PET/CT above the aortic bifurcation with a maximum of 3 positive lymph nodes. 3. Bone relapse on PSMA-PET/CT with a maximum of 3 lesions. 4. Combination of a, b, c with a maximum of 4 metastases. 4. Age \> 18 years. 5. Recent PSMA-PET/CT scan within 60 days prior to randomization. 6. PSA \< 10 ng/ml. 7. In case of chronic use of finasteride the PSA value should be \< 5 ng/ml. 8. WHO performance state 0-2. 9. Signed informed consent prior to registration/randomization. Exclusion criteria 1. Visceral metastases. 2. PSA ≥ 10 ng/ml. 3. PSA-doubling time ≤ 3 months. 4. ADT or chemotherapy for recurrent PCa. 5. Testosterone \< 1.7 nmol/l 6. Painful metastases needed pain medication (\> level 1 pain medication) . 7. Invasive active cancers other than superficial non-melanoma skin cancers. 8. Inability or unwillingness to understand the information on trial-related topics, to give informed consent or to fill out QoL questionnaires.