The efficacy of radical radiotherapy for patients with primarily diagnosed prostate cancer with metastases to regional lymph nodes

Objectives. Retrospective analysis of 22 patients with high risk prostate cancer and clinical regional lymph node involvement treated with radical radiotherapy and ADT. Material and methods. The mean pre-treatment PSA level was 69 ng/ml. Median age — 65 years. Lymph nodes involvement was determined by radiological imaging. Duration of ADT was 2–3 years. All patients underwent conventional radiotherapy. Dose to the prostate ranged from 75.6 to 78 Gy, to elective lymph nodes — 44 to 50 Gy, boost dose to involved lymph nodes — 60 to 75,6 Gy. Median follow-up was 40 months. Results. The 3-year and prognosed 5-year bCR in studied group was 78% and 65%. The 3-years and 5-years prognosed OS was 88% and 73%. We observed 5 failures. No relapse in a nodal boost region was observed. No dose-effect relationship was observed for bCR nor OS. Only T stage proved prognostic for bCR. Conclusions. The results showed good outcome for node positive prostate cancer patients treated with radical intent. No dose-effect relationship suggest that metastatic pelvic lymph nodes may not require such dose escalation as primary tumor.