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Soumyajit Roy¹, Angela Y Jia¹, Nicholas G Zaorsky¹

¹Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.

International Journal of Radiation Oncology, Biology, Physics

|May 23, 2026

Summary

This summary is machine-generated.

Whole-pelvic radiotherapy (WPRT) did not improve outcomes for localized prostate cancer patients. Further research is needed to identify potential subgroups that may benefit from WPRT.

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Area of Science:

Oncology
Radiation Oncology
Prostate Cancer Research

Background:

Localized prostate cancer treatment often involves radiotherapy.
Whole-pelvic radiotherapy (WPRT) aims to improve outcomes by encompassing a larger radiation field.
The benefit of WPRT in localized prostate cancer remains a subject of investigation.

Purpose of the Study:

To conduct an aggregate meta-analysis of all phase III randomized trials evaluating the impact of WPRT on oncologic outcomes in localized prostate cancer.
To determine if WPRT offers a significant benefit over prostate-only radiotherapy.

Main Methods:

Systematic search of PubMed, clinicaltrials.gov, and conference proceedings for relevant randomized trials (1980-2025).
Utilized random-effects models to pool hazard ratios (HR) and 95% confidence intervals (CI).
Assessed heterogeneity using I² statistics and performed sensitivity analyses and meta-regression.

Main Results:

Four trials (n=4,465) were included in the meta-analysis.
WPRT did not significantly improve overall survival (OS), biochemical recurrence (BCR), or distant metastasis (DM).
Excluding one trial (POP-RT) eliminated heterogeneity and showed no significant benefit for BCR or DM.

Conclusions:

This meta-analysis found no meaningful benefit of WPRT over prostate-only radiotherapy in unselected localized prostate cancer patients.
Individual patient data meta-analysis is recommended to identify potential subgroups that may benefit from WPRT.