For persistent PSA elevation after prostatectomy, would you recommend salvage radiation if pathologically negative nodes, but regional and non-regional lymphadenopathy on PSMA PET?  

Specifically, would you offer salvage radiation to a patient who underwent a prostatectomy with PLND and had a post-op PSA of 12 with pathology revealing adenocarcinoma 4+3+5, pT3a N0, and positive margins? PSMA PET revealed regional and non-regional nodes up to the cervical chain. 

Answer from: Radiation Oncologist at Academic Institution

Answer from: Medical Oncologist at Academic Institution