Do you treat pelvic lymph nodes in patients with high-risk prostate cancer who refuse ADT?

The treatment of pelvic lymph nodes for prostate cancer indeed is a controversial issue. I do treat pelvic lymph nodes in high-risk patients in the absence of ADT even though I do not have a phase III study to support its use. My rationale for treatment of pelvic nodes comes from RTOG 75-06. This st...

I assume the rationale for the question is that perhaps ADT is treating microscopic nodal disease and if it is not being given, perhaps pelvic RT should replace it. While I appreciate the theoretical concern, I do not think the data supports it. Although I believe the weight of evidence is against t...