Would you ever omit or reduce prostate bed radiation in a post-prostatectomy patient who develops recurrence in pelvic LNs?

Which criteria/factors would you use to decide whether to de-intensify prostate bed/fossa treatment? For instance, surgical margin status or biochemical failure free interval?

Answer from: Radiation Oncologist at Academic Institution

In STORM, which is a phase 2 study looking at elective nodal RT vs SBRT for nodal recurrence presented at ESTRO, local recurrence was 5% in the group that got prostate bed plus nodal RT vs. 14% in the group that received only SBRT to node suggesting benefit of treating prostate bed for nodal relapse...

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Radiation Oncologist at Corewell Health
In limited and specific cases, yes. I had a patien...

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Would you ever omit or reduce prostate bed radiation in a post-prostatectomy patient who develops recurrence in pelvic LNs?

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