The cost of elective nodal coverage in prostate cancer: Late quality of life outcomes and dosimetric analysis with 0, 45 or 54 Gy to the pelvis

Jensen, G.L.; Jhavar, Sameer; Ha, Chul S.; Hammonds, Kendall; Swanson, Gregory P.

doi:10.1016/j.ctro.2022.06.008

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…It remains to be proven whether that results in a bene t as seen with pelvic bed dose escalation. We previously reported a modest increase in toxicity with 54Gy EPNI dose [Jensen 2022].…”

Section: Resultsmentioning

confidence: 99%

Salvage prostate bed plus elective pelvic node radiation without androgen deprivation therapy

Swanson

Hammonds

Jhavar

2023

Preprint

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Background and purpose: In men with biochemical recurrence (BCR) of prostate cancer (PCA) after radical prostatectomy (RP), there is limited data on effectiveness of adding elective pelvic nodal radiation (EPNI) to salvage prostate bed radiation (PBRT) without androgen deprivation therapy (ADT) to prevent progression. Materials and Methods: Retrospective chart review of 326 patients treated for BCR of PCA from a single institution was performed to capture baseline pre-operative PSA, pathologic details, post-operative PSA, treatment details (radiation and ADT), subsequent failure (rising PSA), response to radiation, and subsequent outcomes after radiation. Results: Between 2004 through 2017, 326 patients received PBRT. Majority (n = 253; 78%) did not receive ADT. Majority received EPNI (n = 227; 90%) with salvage PBRT (n = 213; 94%). The median pre-PBRT PSA was 0.50 ng/ml (0.10–75.60 ng/ml). Of the patients that did not receive ADT, 83% (210/253) achieved an undetectable (< 0.2 ng/ml) PSA after salvage PBRT. After a median follow up of 87 months, 172 (53%) patients were without a rising PSA and 50 (15%) developed metastatic disease. Conclusion: Outcomes with salvage PBRT plus EPNI without ADT appear comparable to salvage PBRT plus EPNI plus ADT. These results need confirmation in a randomized setting.

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“…It remains to be proven whether that results in a bene t as seen with pelvic bed dose escalation. We previously reported a modest increase in toxicity with 54Gy EPNI dose [Jensen 2022].…”

Section: Resultsmentioning

confidence: 99%