Do you use nomograms to decide whether to treat pelvic nodes in high-intermediate to high risk prostate cancer?

Rather than using risk estimate, my practice is to treat nodes for all high risk patients unless there is a contraindication. The nodal group I treat is distal common iliac, external, internal iliac, obturator and presacral region. The contouring principal is same for all pelvic malignancies and is illustrated in RTOG atlas also. Recent nodal location studies based on surgery and SNLN have shown drainage into above nodal region as primary eschelon and forms basis of our practice

Interesting--I am in the group who do not give elective nodal irradiation in this setting unless proven regional node positivity.

Elective pelvic nodal treatment has remained controversial for my entire 20 year career thus far, and I predict it will remain controversial for another 20 years!