PEACE V: Salvage Treatment of OligoRecurrent Nodal Prostate Cancer Metastases

Inclusion Criteria: * Histologically proven initial diagnosis of adenocarcinoma of the prostate * Biochemical relapse of prostate cancer following radical local prostate treatment (radical prostatectomy, primary radiotherapy or radical prostatectomy +/- prostate bed adjuvant/ salvage radiotherapy) according to the EAU guidelines 2016. * Following radical prostatectomy, patients with a biochemical relapse are eligible in case a nodal relapse is detected in the pelvis even in the absence of prior postoperative prostate bed radiotherapy (adjuvant or salvage). * In case of a suspected local recurrence following primary radiotherapy, a biopsy should confirm local recurrence and patients with a confirmed local recurrence are eligible in case they also undergo a local salvage therapy. If imaging rules out local relapse, patients are eligible. * Nodal relapse in the pelvis on choline, PSMA or FACBC PET-CT with a maximum of 3 positive nodal lymph nodes. The upper limit of the pelvis is defined as the aortic bifurcation. * WHO performance state 0-1 * Age \>18 years * Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial * Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations. Exclusion Criteria: * Bone or visceral metastases * Para-aortic lymph node metastases (above the aortic bifurcation) * Local relapse in the prostate gland or prostate bed not suitable for a curative treatment * Previous irradiation of the pelvic and or para-aortic nodes * Serum testosterone level \<50ng/dl or 1.7 nmol/L at time of randomization * Symptomatic metastases * Lymph node metastases in previously irradiated areas resulting in dose constraint violation * Contraindications to pelvic radiotherapy (chronic pelvic inflammatory bowel disease) * Contraindications to androgen deprivation therapy * PSA rise while on active treatment with (LHRH-agonist, LHRH-antagonist, anti-androgen, estrogen * Previous treatment with cytotoxic agent for PCa * Treatment during the past month with products known to influence PSA levels (e.g. fluconazole, finasteride, corticosteroids,…) * Other active malignancy, except non-melanoma skin cancer or other malignancies with a documented disease-free survival for a minimum of 3 years before randomization.