Evolving Paradigm of Radiotherapy for High-Risk Prostate Cancer: Current Consensus and Continuing Controversies

Table 5

Pelvic nodal radiation in high-risk patients.

Study	Study cohort	Median; follow-up	Trial arms	Outcomes
RTOG 94-13 [29–31]	1275 patients, 73% Gleason 7–10	12 years	PRT; NA/C ADT + pelvic RT; NA/C ADT + prostate RT; Adjuvant ADT + pelvic RT; Adjuvant ADT + prostate RT	Significant improvement in biochemical control, trend for; improved progression-free survival with use of NA/C ADT + pelvic RT
GETUG-01 [32]	444 patients, T1b-T3N0; (75% high-risk)	3.5 years	PRT; Prostate RT versus pelvic RT prostate boost; 46 Gy to the pelvis, 66–70 Gy to the prostate	No difference in PFS or OS with use of pelvic node radiation; No significant difference in toxicity or QOL measures
Yale; Aizer et al. [33]	277 patients with ≥15% LN involvement per Roach formula [34]	2.5 years	Retrospective review: Whole pelvic RT/prostate boost versus prostate RT alone; ≥90% received ADT; Mean RT dose: 75.6 Gy	4-year biochemical-free survival improved with pelvic RT (86% versus 70%, ) in multivariate analysis; OS not reported; Increased acute GI toxicity with pelvic RT, no difference in late toxicity

PFS: progression-free survival, OS: overall survival, PRT: prospective randomized trial, and NA/C: neoadjuvant/concurrent.