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Topics:
Radiation Oncology • Genitourinary Cancers
When do you consider lymphadenectomy vs pelvic lymph node RT in a lymph node recurrence after prior prostatectomy or prostate-only RT?
Assume a young, fit patient who has not had prior pelvic RT before, and has been fully staged with molecular imaging (e.g., PSMA) with no evidence of disease beyond the one recurrent lymph node.
Answer from: Radiation Oncologist at Community Practice
This is subject to ongoing study (surgery SBRT vs. regional RT) De Bruycker et al., PMID 32398040 We usually favor regional nodal RT with SIB boost to node unless there are contraindications.
Comments
Radiation Oncologist at Stony Brook University School of Medicine
Thanks. In the trial, only 6 months ADT is used. D...
Thanks. In the trial, only 6 months ADT is used. D...
Radiation Oncologist at Varian Medical Systems/Allegheny health network
We prefer long term ADT.
We prefer long term ADT.
Radiation Oncologist at Kansas City VA Medical Center
We generally cover bilateral pelvic nodes to 50 Gy...
We generally cover bilateral pelvic nodes to 50 Gy...
Answer from: Radiation Oncologist at Academic Institution
If he has had a prostatectomy, would do salvage to prostate fossa + LNs with SIB to gross LN. If he had prostate RT with no suspicion for in-prostate recurrence, would salvage LN basins with SIB to gross LN.I know some are doing SBRT alone in regionally recurrent patients, but retrospective dat...
Second malignancy from RT would not be a concern f...