Elective pelvic lymph node radiation and risk of death in patients with unfavorable-risk prostate cancer

There are no long-term data evaluating the mortality impact of whole-pelvic radiation therapy (WPRT) among men with unfavorable-risk prostate cancer. A clinical trial randomized such patients to ADT plus RT plus docetaxel or ADT plus RT alone. Treatment of the pelvic nodes was at the discretion of the treating physician. Among the randomized patients, 25.14% received WPRT. The median duration of follow-up was 10.20 years. In the group of men younger than 65 years at randomization, WPRT was associated with a significantly lower risk of all-cause mortality (aHR 0.33; p=0.04) and a numerically lower risk of prostate cancer-specific mortality (aHR 0,17; p=0,09). These associations were not seen in the group of men aged 65 years or older at randomization.