Including Pelvic Lymph Nodes in Radiation Fields for Advanced Prostate Cancer: Update on Toxicity
Posted: Monday, August 12, 2019
According to the results of a UK national population-based study presented in the Journal of Clinical Oncology, including pelvic lymph nodes in radiation fields for patients diagnosed with high-risk or locally advanced prostate cancer does not seem to be linked to an increase in gastrointestinal or genitourinary toxicity. Ajay Aggarwal, PhD, of the Guy’s and St. Thomas’ National Health Service Foundation Trust and King’s College, London, and colleagues determined that prostate-only and prostate and pelvic lymph node intensity-modulated radiation had “virtually no difference” in terms of toxicity.
“[A] follow-up beyond 3 years is required to answer questions about its impact on late [genitourinary] toxicity,” the authors concluded. “Definitive evidence in favor of better cancer control with [prostate and the pelvic lymph nodes radiation therapy] is needed to fully define its role.”
The investigators used data from the Cancer Registry, the National Radiotherapy Dataset, and the Hospital Episode Statistics database to identify patients with high-risk localized or locally advanced prostate cancer who were treated with intensity-modulated radiation therapy. Of the patients identified, 780 had been treated with prostate and pelvic lymph node radiation therapy, and 3,065 received prostate-only intensity-modulated radiation therapy.
The results showed a 3-year cumulative incidence rate for gastrointestinal toxicity of 14% among both arms of patients. The 3-year incidence rate for genitourinary toxicity among the patients in the prostate and pelvic lymph node cohort was 9%, and it was 8% in the prostate-only radiation group. Additionally, patients displayed similar levels of severe gastrointestinal and genitourinary toxicity rates regardless of whether pelvic lymph nodes were included in the radiation field.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.