Combined modality radiotherapy increases the efficacy of treatment in patients with high-risk prostate cancer (PCa). The benefits of the elective inclusion of regional lymphatic collectors in the area of irradiation are unclear, since dose escalation, as well as an increase in the volume of irradiation, are associated with a high risk of treatment complications, which significantly affect the quality of patient live.
OBJECTIVE
To study the impact of elective pelvic lymph node irradiation on early results of the treatment and on quality of life in patients with high-risk prostate cancer.
MATERIAL AND METHODS
Combined modality radiotherapy with hormone therapy was performed in 60 patients with prostate cancer in MRRC, in the period from November, 2019 to January, 2021. The patients were randomized into 2 groups: with regional lymph node irradiation (n=32) and without irradiation (n=28). At the first stage of treatment, a course of conformal external beam radiotherapy (EBRT) was carried out in a total dose of 46 Gy. At the second stage of the treatment one session of high-dose-rate brachytherapy (192Ir) at a single dose of 15 Gy was performed.
RESULTS
Acute, grade 1 genitourinary (GU) toxicities occurred in 11 (34.4%) patients in the group with regional lymph node irradiation and in 8 (28.6%) patients in the group without additional irradiation (p .83). In group 2, one (3.6%) patient had GU toxicity of grade 2. Acute, grade 1 lower gastrointestinal (GI) toxicities were observed in 13 (40.6%) patients in the group with regional lymph node irradiation and in 3 (10.7%) patients in the group without additional irradiation (p=0.01).
CONCLUSIONS
The preliminary analysis showed an increase in the incidence of lower GI and GU toxicities in the group with elective regional lymph node irradiation.