The Gleason 4+3 in several cores plus cribriform architecture and the Decipher score translates to high risk. I would want aggressive treatment. 24 months of ADT is reasonable unless you have really severe side effects. Most people can deal with the side effects of Lupron. I believe IMRT is often recommended for higher risk patients and can have fewer side effects than SBRT. Both are painless, so I don't see any compelling reason to resist IMRT. (I have similar biopsy results and had 24 months of Lupron as four six-month doses plus IMRT with SpaceOAR. Perhaps lucky to have the standard side effects, but nothing that was all that hard to deal with).