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For prostate cancer patients with N+ disease, is there evidence demonstrating improved outcomes with the addition of nodal RT, as opposed to prostate RT alone plus ADT?

NCCN guidelines recommend pelvic RT for N+, but what is the hard evidence for this?
2 Answers
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

There is no direct evidence. In the STAMPEDE trial, which showed benefit of RT in node positive patients, RT involved prostate and nodes in a majority of patients (>80%).

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Radiation Oncology · UC San Diego
Answered on

I agree with @Dr. First Last that the evidence is indirect. Parker et al. STAMPEDE M1|R0 stratified by N0/N1, noting that those patients also all had metastatic disease.

We 'interpolate' from the evidence for T3-T4N0M0 and Tany Nany M1 that RT to the prostate is worthwhile for N1M0 patients. And we e...

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