For prostate cancer patients with N+ disease, is there evidence demonstrating improved outcomes with the addition of nodal RT, as opposed to prostate RT alone plus ADT?

NCCN guidelines recommend pelvic RT for N+, but what is the hard evidence for this?

Answer from: Radiation Oncologist at Community Practice

There is no direct evidence. In the STAMPEDE trial, which showed benefit of RT in node positive patients, RT involved prostate and nodes in a majority of patients (>80%).

Comments

Radiation Oncologist at UC San Diego
Thank you. Can you point to where STAMPEDE reporte...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
Here is the link to one with high risk M0 subset. ...

Radiation Oncologist at UC San Diego
Thanks! I think I misread your response the first ...

Answer from: Radiation Oncologist at Academic Institution

I agree with @Sushil Beriwal that the evidence is indirect. Parker et al. STAMPEDE M1|R0 stratified by N0/N1, noting that those patients also all had metastatic disease.We 'interpolate' from the evidence for T3-T4N0M0 and Tany Nany M1 that RT to the prostate is worthwhile for N1M0 patients. And...

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Radiation Oncologist at The Oregon Clinic-Radiation Oncology West
I agree with all comments above. The Australian an...

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For prostate cancer patients with N+ disease, is there evidence demonstrating improved outcomes with the addition of nodal RT, as opposed to prostate RT alone plus ADT?

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