Radiation Therapy of Patients with Regional Risk Group of Prostate Cancer

Abstract

Relevance: Radiation therapy is one of the main local method of treatment for patients with prostate
 cancer and regional metastases of pelvic lymph nodes. However, unfortunately, some patients can be
 subject to development progression of disease as emergence regional lymph node’s metastasis of
 retroperitoneal space.
 Purpose: To develop a new more effective radical method of radiation therapy for patients with metastases in the regional lymph nodes.
 Material and methods: The radiotherapy department has developed a new method of radiation therapy
 for patients with prostate cancer and metastases in the regional lymph nodes, which includes prophylactic irradiation of retroperitoneal lymph nodes.
 Results: 20 patients with prostate cancer and metastases to the regional lymph nodes were treated
 from June 2020 to December 2022. The median follow-up was 17 months. In all patients, radiation
 therapy was carried out in combination with neoadjuvant, concomitant and adjuvant hormone therapy
 with analogues of luteinizing hormone releasing hormone. All patients received a course of radiation
 therapy without interruption. At the time of analysis, all patients are alive and stay by under active surveillance with no signs of progression. At the end of radiation therapy, all patients noted manifestations
 of toxicity of the I-II degree genitourinary and gastrointestinal systems. There is a gradual recovery of
 patients in the form of a decrease and relief of radiation reactions in 3-6 months after the end of radiation therapy.
 Conclusion: The first data evaluating the safety of the new developed method of radiation therapy by
 hypofraction mode with additional prophylactic irradiation of the retroperitoneal lymph nodes demonstrate good tolerability. However, further study and conducting the 3rd phase of randomized trial are required to determine clinical efficacy.