MR-linac Guided Ultra-hypofractionated RT for Prostate Cancer (SMART-P01 and SMART-P02)

This study is testing a precise radiation technique called ultra-hypofractionated stereotactic body radiation therapy (SBRT), guided by an MRI-equipped radiation machine (MR-Linac), to treat localized or oligometastatic prostate cancer in fewer, higher-dose sessions than conventional radiation. **You may be eligible if:** - You are 18 years or older - You have been diagnosed with prostate cancer confirmed by biopsy - Your cancer is low, intermediate, or selected high-risk localized prostate cancer, or has spread to a limited number of sites that can all be safely treated with radiation - Your prostate gland is not too large (under 100cc) and your urinary symptoms are mild (IPSS score below 18) - You are in reasonably good health (ECOG 0–2) **You may NOT be eligible if:** - You have a contraindication to MRI - You had a TURP (prostate scraping procedure) within the past 6 months - You have inflammatory bowel disease (ulcerative colitis or Crohn's disease) - You have had prior pelvic radiation - You have certain rare connective tissue disorders (like ataxia telangiectasia or lupus) Talk to your doctor to see if this trial is right for you.