Would you recommend definitive XRT with extensive lymph node involvement of prostate cancer?

Is there an extent of nodal involvement in prostate cancer above which you would not offer definitive XRT? With PSMA/PET we see some patients with increased pelvic nodal disease. Alternatively, do you manage similar to STAMPEDE and treat with prostate directed therapy alone with hormone therapy/abiraterone?

Answer from: Radiation Oncologist at Academic Institution

In cases of lymph node positive disease, I favor RT to the prostate and lymph nodes (with long termADT ± abiraterone) if I believe all the gross disease can be encompassed in a tolerable radiation treatment plan. In STAMPEDE, RT was mandated in all N0 cases and encouraged in N+ cases, wh...

Comments

Radiation Oncologist at Levine Cancer Institute
Agree with the above. As mentioned, when retroperi...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
This retrospective data gives some data for CI nod...

Radiation Oncologist at Lafayette Radiation Center
Agree with the above. Will offer "extended" to par...

Radiation Oncologist at Stony Brook University School of Medicine
When would you electively cover PA chain in prosta...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
I extrapolate from my personal management of cervi...

Radiation Oncologist at West Virginia University
I'm not sure one could extrapolate treating the ab...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Elective coverage of the para-aortic LNs (not gros...

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Would you recommend definitive XRT with extensive lymph node involvement of prostate cancer?

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