- Whole-pelvis radiotherapy (WPRT) improved biochemical recurrence-free survival (bRFS) in patients with high-Gleason-grade prostate cancer who received external beam radiotherapy (EBRT) plus brachytherapy (BT), but not in those treated with EBRT alone.
- WPRT did not improve distant metastasis-free survival (DMFS) and prostate cancer (PCa)-specific survival (PCSS).
Why this matters
- Further studies to optimize WPRT are warranted, including with the use of more potent radiosensitizing androgen deprivation therapy agents and/or with advanced imaging to identify occult nodal disease.
- Study of 1170 patients with Gleason grade group 5 PCa received EBRT (n=734) or EBRT+BT (n=436) between 2000 and 2013.
- Funding: None.
- 41% of patients in the EBRT group and 73% in EBRT+BT group received WPRT.
- Median follow-up was 5.6 years.
- WPRT significantly improved bRFS in patients treated with EBRT+BT (HR, 0.5; P=.02), but not those treated with EBRT (HR, 0.8; P=.4).
- No significant difference was observed in DMFS or PCSS in patients who received WPRT:
- EBRT group: HR, 1.1 (P=.8) and 0.7 (P=.1), respectively.
- EBRT+BT group: HR, 0.6 (P=.2) and 0.5 (P=.1), respectively.
- Retrospective design.