ESTRO 2024 - Abstract Book

S2609

Clinical - Urology

ESTRO 2024

With a median follow up of 103.3 months [interquartile range, IQR 57.5;142.4] for the ENRT group and 35.6 months [IQR 25.4;77.1] for the MDT group, 58.8% of the ENRT group presented a biochemical relapse, vs 69.7% in the MDT group. Five-year biochemical relapse-free survival was 39.8% in the ENRT group, vs 16.3% in the MDT group (p=0.019) (See Fig.1). A clinical recurrence was registered in 44.2% of ENRT patients and 48.5% of MDT patients. Five year clinical recurrence-free survival was 60% for the ENRT group and 36.9% for the MDT group (p=0.09) (see Fig.2)

Conclusion:

This preliminary analysis is undermined by the presence of two poorly balanced groups, in terms of total number of patients, median follow-up, and disease burden, with up to 32 positive lymph nodes, determined mainly with Choline PET/CTfor the ENRT group and up to 4 lymph nodes (oligometastatic disease), determined with PSMA PET/CT, for the MDT group. As for radical and salvage treatments [1,2], we observed a better biochemical relapse free survival in patients treated with ENRT. Despite the aforementioned greater disease burden and less sensitive examination (Choline PET/CT) used, the extensive treatment manages to compensate for, and clinical recurrence is not lower than in oligometastatic disease treated with MDT.

Keywords: ENRT vs MDT, prostate cancer lymph node metastasis

References:

1. Murthy V, et al. Prostate-only versus whole-pelvic radiation therapy in high-risk and very high-risk prostate cancer (POP-RT): Outcomes from phase III Randomized Controlled Trial. J Clin Oncol 2021; 39 (11): 1234-42

2. Pollack A, et al. The addition of androgen deprivation therapy and pelvic lymph node treatment to prostate bed salvage radiotherapy (NRG Oncology/RTOG0534 SPPORT): an international, multicentre, randomised phase 3 trial. Lancet 2022; 399 (10338): 1886-1901