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In-body radiation therapy combined with androgen deprivation therapy (ADT) is the recommended cure for non-metastatic local advanced prostate cancer.
this paper reports a randomized trial comparing the clinical prognostics of preventive whole pelvic lymph node radiotherapy (WPPT) and simple prostate radiotherapy (PORT) for the treatment of high-risk prostate cancer.
phase III, single-center, randomized controlled trial, patients with lymph node-negative prostate cancer who had received cured radiotherapy were recruited with an estimated 20 percent risk of lymph nodes ≥ 20 percent.
is randomly divided into two groups at 1:1.
all patients received imaging guidance, stress radiotherapy, and androgen deprivation for at least 2 years.
end point is 5 years bio-chemical failure-free lifetime (BFFS), the secondary endpoint is disease-free lifetime (DFS) and total lifetime (OS).
November 2011-August 2017, a total of 224 patients were randomly divided into two groups: PORT-114, WPRT-110.
68 months of follow-up, a total of 36 bio-chemical failures (25 cases in PORT group, 7 cases in WPRT group) and 24 deaths (13 cases in PORT group and 11 cases in WPRT group) were recorded.
5-year BFFS in the WPRT group was 95.0% (95% CI, 88.4 to 97.9), while the PORT group was 81.2% (95% CI, 71 .6 to 87.8), unojusted hazard ratio (HR) 0.23 (95% CI, 0.10 to 0.52; p.lt;0.0001).
WPRT group also showed higher five-year DFS (89.5% vs 77.2%; HR 0.40; 95% CI, 0.22-0.73; p-0. 002), but five-year OS doesn't seem to make any difference (92.5% vs. 90.8%; HR 0.92; 95% CI, 0.41-2.05; p.83).
the WPRT group also had a higher survival rate of no distance transfer (95.9% vs 89.2%; HR 0.35; 95% CI, 0.15-0.82; p=0.01).
, preventive pelvic radiation therapy for high-risk localized advanced prostate cancer improved BFFS and DFS in patients compared to PORT, but did not appear to have a significant effect on OS.
