Salvage prostate bed plus elective pelvic node radiation without androgen deprivation therapy

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Limited data exists on the effectiveness of adding elective pelvic nodal radiation (EPNI) to salvage prostate bed radiation therapy (PBRT) without androgen deprivation therapy (ADT) for men with biochemical recurrence (BCR) of prostate cancer (PCA) post-radical prostatectomy (RP).

Purpose of the Study:

• To evaluate the effectiveness of salvage PBRT with EPNI without ADT in men with BCR of PCA.
• To compare outcomes of salvage PBRT with EPNI without ADT versus with ADT.

Main Methods:

• Retrospective chart review of 326 patients with BCR of PCA treated at a single institution.
• Data collected included pre-operative PSA, pathology, post-operative PSA, radiation details (PBRT and EPNI), ADT use, and subsequent outcomes (PSA failure, metastasis).

Main Results:

• 326 patients received PBRT; 78% did not receive ADT. 90% received EPNI with salvage PBRT.
• Of patients not receiving ADT, 83% achieved undetectable PSA post-treatment.
• At a median follow-up of 87 months, 53% were without rising PSA, and 15% developed metastatic disease.

Conclusions:

• Salvage PBRT plus EPNI without ADT demonstrated comparable outcomes to salvage PBRT plus EPNI with ADT in this cohort.
• These findings require validation through randomized controlled trials.