What are your typical dose and fractionaton schedules for post-prostatectomy radiotherapy for a patient with involved pelvic lymph nodes?

I'm just going to tell you what I do. :)

I do sequential planning at 2 Gy per fraction - 46 Gy to the whole pelvis, and then a sequential conedown to treat the prostate bed to 20 Gy, 66 Gy cumulative. If nodes are pN+ but none are visible on CT imaging, that's my dose. If there are nodes on a post-op...

My current approach:

64-70 Gy in 2 Gy/fx to the fossa (depending on baseline function and clinical risk of local recurrence or presence of gross disease).

50.4 Gy/28 fx to the pelvic nodal region with SIB up to 70 Gy/28 fx to the involved nodes as long as normal tissue goals are met.

Small bowel: We...

I typically use conventional fractionation for post-prostatectomy RT. The recently published experience from Wisconsin showing a continuous development of significant late effects with longer term follow-up for moderate hypofractionation in this setting, I believe, is cause for concern, so I have no...

7,200 cGy in 40 fractions total: 5,040 cGy in 28 fractions to pelvis/nodes first, then boost prostate bed. Positive lymph node(s) max dose theoretically as high as 7,200 cGy, but typically impossible due to bowel constraint, with Dmax 6,000 cGy. Attention to the sacral plexus and ureter as well.

45 to 47.6 Gy in 25 fractions to the elective nodes with 57.5 to 60 Gy SIB to the GTV node with a 5 mm PTV margin, keeping V55 small bowel to <1 cc.

Prostate fossa dose range of 60 to 62.5 Gy.