- In patients with high-risk localized or locally advanced prostate cancer, including pelvic lymph node (PLN) in radiation field does not increase the risk for gastrointestinal or genitourinary toxicity vs prostate-only intensity-modulated radiation therapy (IMRT) at 3 years.
Why this matters
- UK NICE guidelines recommend PLN irradiation in high-risk patients; extending the treatment field to include the PLN can prevent relapse without increasing gastrointestinal or genitourinary toxicity.
- 3845 patients with high-risk localized or locally advanced prostate cancer treated with IMRT.
- Funding: None disclosed.
- Median follow-up was 2.7 years.
- 20% of patients received PLN irradiation.
- In patients who underwent prostate and PLN-IMRT vs prostate-only IMRT:
- 3-year cumulative incidence of gastrointestinal complications was 14% for both.
- 3-year cumulative incidence of genitourinary toxicity was 9% vs 8%.
- 4.9 vs 5.1 gastrointestinal complications per 100 person-years and 3.2 vs 2.7 genitourinary complications per 100 person-years were observed.
- Men with ≥1 comorbidity had higher risk for genitourinary toxicity vs those without (subdistribution HR, 1.39; P=.01).
- Patients in the highest vs lowest quintile of socioeconomic deprivation had lower gastrointestinal toxicity (subdistribution HR, 0.68; P=.01).
- Retrospective design.
- Short follow-up time.