- About 26% of patients with low-risk localized prostate cancer (PCa) and 34% of those with favorable intermediate-risk disease received pelvic lymph node irradiation (PLN-RT) while undergoing external beam radiotherapy (EBRT) during 2005-2015.
- Use of PLN-RT increased in patients with high-/very high-risk disease.
Why this matters
- National Comprehensive Cancer Network guidelines do not recommend PLN-RT in low- and favorable intermediate-risk patients.
- Study of 197,378 men with localized prostate cancer from the National Cancer Database who received EBRT±brachytherapy and androgen deprivation therapy during 2005-2015.
- Funding: NIH; Prostate Cancer Foundation.
- 36.7% of patients received PLN-RT.
- During 2005-2015, PLN-RT use
- increased in men with high-risk (44.6% to 50.3%; P<.001 and very high-risk to p disease.>
- remained stable in low-risk (27.3% to 25.6%; P=.170) favorable intermediate-risk (33.2% to 33.7%; P=.6), and unfavorable intermediate-risk (36.5% to 36.8%; P=.8) disease.
- very high risk disease (OR, 1.34; P=.013),
- higher Gleason grade group (OR for group 5 vs 1, 2.08; P<.001>
- increasing pretreatment PSA (OR, 1.09; P<.001>
- Hispanic ethnicity (vs white men; OR, 1.29; P=.033),
- treatment at an academic facility (vs community; OR, 0.75; P=.036).
- Retrospective design.