Table 4.
Pelvic CTV lymph node volume and outcomes of Non-RP studies.
| First Author | Institution | Area of Pelvic CTV Lymph Node | Key Findings |
|---|---|---|---|
| Blanchard | GETUG | The upper limit of the pelvis could be either S1-S2 (small pelvis) or L5-S1 (large pelvis) | There was no association between biochemical PFS and the use of WPRT |
| Braunstein | Harvard | Beginning at the bifurcation of the aorta to the common iliac arteries (approximating vertebral levels L4 and L5) and included internal and external iliac chains | A decreased risk of ACM was noted with the use of WPRT versus PORT. However, a combination of WPRT and ADT did not further improve ACM compared with PORT with ADT |
| Dearnaley | CRUK | Lower border L5 on sagittal CT | WPRT had a modest side effect profile. |
| Ishii | Tane General Hospital, Japan | Obturator vessels, the common, external and internal iliac vessels | WPRT resulted in no significant increase in acute GU toxicity when compared with PORT |
| Mantini | Catholic University, Italy | Presacral, obturator, internal iliac, and external iliac chains | No significant differences were seen in acute and late GI and GU toxicity among the patients treated with WPRT or PORT |
| McDonald | University of Alabama, USA | Starting at L5-S1 junction | WPRT increases the rates of acute and late GI toxicity |
| Murthy | Tata Memorial Centre, India | Starting at L4-5 junction to include bilateral common iliac, external iliac, internal iliac, presacral | WPRT improved BFFS and DFS as compared with PORT, but OS did not appear to differ. WPRT resulted in increased G2+ late GU toxicity as compared to PORT |
| Pommier | GETUG | Routine radiation field coverage to the S1/2 interspace | WPRT was well tolerated but did not improve PFS. |
| Roach | RTOG | The pelvic CTV lymph node volumes at the L5/S1 interspace (the level of the distal common iliac and proximal presacral lymph nodes) | NHT plus WPRT improved PFS compared with NHT plus PORT albeit increased risk of grade 3 or worse intestinal toxicity |
GETUG, French Genitourinary Study Group; CRUK, Cancer Research UK; RTOG, Radiation Therapy Oncology Group; WPRT, whole-pelvic radiotherapy; PORT, prostate-only radiotherapy; PFS, progression-free survival; ACM, all-cause mortality; ADT, androgen deprivation therapy; NR, not reported; GU, genitourinary; GI, gastrointestinal; BFFS, biochemical failure-free survival; DFS, disease-free survival; OS, overall survival; G2+, grade 2 or worse; NHT, neoadjuvant hormonal therapy.