- In patients with hormone-sensitive nodal oligorecurrent prostate cancer, elective nodal radiotherapy (ENRT) reduces nodal recurrences but is associated with higher toxicity vs stereotactic body radiotherapy (SBRT).
Why this matters
- Both strategies as potential treatment option in these patients are endorsed in expert consensus statements.
- Multicenter study of 506 patients with hormone-sensitive nodal oligorecurrent prostate cancer who received SBRT (n=309) or ENRT (n=197) after local treatment with radical prostatectomy, radiotherapy, or both.
- Funding: National Institute for Health Research.
- Median follow-up was 36 months.
- 3-year metastasis-free survival (MFS) was significantly higher with ENRT vs SBRT (77% vs 68%; P=.01).
- ENRT significantly prolonged adjusted MFS in patients with 1 node at recurrence (HR, 0.50; P=.009), but not in those with >1 lymph node (HR, 0.92; P=.8).
- SBRT was associated with significantly higher incidences of progression vs ENRT (177 vs 74 patients; P<.001 style="list-style-type:circle;">
- local progression (50 vs 9 patients; P<.001>
- lymph node progression (P<.001 and>
- pelvic lymph node progression (P<.001>
- grade ≥3 toxicity (5 vs 0; P=.009);
- early toxicity (12 vs 3; P=.002); and
- late toxicity (31 vs 16; P<.001>
- Retrospective design.