The standard of treatment for men who have a localized recurrence in lymph nodes (LN) after surgery is intensity modulated radiation therapy (IMRT) as well as with men who have high-risk prostate cancer which includes cancer in both the prostate and seminal vesicles (SV). As with all treatments the use of IMRT comes with many additional risks for comorbidity problems.
In an attempt to better understand these additional risks 1,160 men who were identified has having high risk prostate cancer or failed primary surgical treatment of their prostate cancer were treated with IMRT. All the subject men had simulation with both CT, MRI, and utilized daily image guidance. The researchers obtained toxicity data from chart reviews.
The researchers found that the delivery of 56 Gy to the pelvic lymph nodes resulted in a significant increase in grade 2 or higher late GI toxicity (with a HR of 2.0). They concluded that a decision to treat the pelvic lymph nodes should be weighed against the increase in late GI toxicity.
J Clin Oncol 32, 2014 (suppl 4; abstr 41): Matthew E. Johnson, Tianyu Li, Alexander Kutikov, Mark K. Buyyounouski, Mark L. Sobczak, Rosalia Viterbo, Eric M. Horwitz.
Joel T Nowak, M.A., M.S.W.