Related Experiment Video
Updated: Oct 26, 2025
07:30
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
3.5K
Elective nodal radiotherapy in prostate cancer
Gert De Meerleer1, Charlien Berghen1, Alberto Briganti2
1Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.
The Lancet. Oncology
|August 2, 2021
Summary
Elective whole pelvis radiotherapy benefits select prostate cancer patients with high lymph node invasion risk. Modern techniques minimize toxicity, making it a viable option for improved survival outcomes.
Area of Science:
- Oncology
- Radiation Oncology
Background:
- The role of elective whole pelvis radiotherapy (WPRT) in prostate cancer with high risk of pelvic nodal disease remains controversial.
- Previous trials like RTOG 9413 and GETUG-01 did not demonstrate a survival benefit for WPRT over prostate-only radiotherapy.
- Recent studies, including POP-RT, highlight the importance of patient selection, particularly for those with >35% lymph node invasion risk.
Purpose of the Study:
- To evaluate the efficacy and safety of elective whole pelvis radiotherapy in specific prostate cancer patient cohorts.
- To determine the impact of WPRT on survival outcomes in node-positive prostate cancer patients.
- To assess the role of WPRT in the salvage setting and its potential benefits with modern imaging and radiotherapy techniques.
Main Methods:
- Review of randomized controlled trials (RTOG 9413, GETUG-01, POP-RT) and retrospective studies.
- Analysis of outcomes in patients with clinically node-positive (cN1) or pathologically node-positive (pN1) disease treated with WPRT and androgen deprivation therapy.
- Consideration of data from the SPORTT trial regarding biochemical recurrence-free survival in the salvage setting.
Main Results:
- WPRT demonstrated a significant survival benefit when added to androgen deprivation therapy in patients with cN1 or pN1 disease.
- The POP-RT trial established WPRT's role for patients with >35% risk of lymph node invasion (Roach formula).
- WPRT may improve biochemical recurrence-free survival in the salvage setting, with proper upper field border definition being crucial.
Conclusions:
- Elective whole pelvis radiotherapy is beneficial for carefully selected prostate cancer patients, especially those with node-positive disease or high lymph node invasion risk.
- Advances in imaging (e.g., PSMA PET-CT) may increase the identification of patients who would benefit from WPRT.
- Modern radiotherapy technology has rendered severe late toxicities rare, comparable to prostate-only radiotherapy.
