S1217
Clinical - Urology
ESTRO 2026
based on a representative patient and agreed nodal subregions. Results: A total of 63 men were studied, with median PSA 24.6ng/ml, 55.6% had T3b/T4 disease and 58.1% had ISUP grade 4 or 5. 42.9% had a single node, 44.4% between 2 and 4 and 9.5% 5 or over. More patients in the PETN1M0 cohort had involved nodes above the bottom of the sacroiliac joint. 30.6% CONVN1M0 cohort received additional SACT (25% docetaxel) in addition to PPNRT and ADT compared to 88.9% of the PETN1M0 cohort (100% androgen receptor pathway inhibitors). Radiotherapy was mainly delivered in 20 fractions, with a total prostate dose of 60Gy and pelvic nodal dose of 44- 45Gy, following our departmental protocol; 65.1% of patients had a nodal boost dose. Median follow-up for the PETN1M0 was 31 months and no patients have relapsed. Median follow-up for the non-relapsed CONVN1M0 cohort was 88 months and 15 patients have relapsed, at a median of 55 months; the 5-year relapse-free survival and overall survival was 70% and 86%, respectively. Updated results will be presented. Conclusion: Our results reflect the limited international literature and support the use of radical intent treatment such as PPNRT, ADT and additional SACT for men with N1M0 prostate cancer. The imaging used for staging is critical when defining N1 status. In our department, the use of PSMA PET staging has coincided with the use of novel hormonal therapy as an adjuvant to ADT and prostate pelvic nodal radiotherapy. References: [1] Cancer Research UK. Prostate Cancer Statistics 2024. https://www.cancerresearchuk.org/health- professional/cancer-statistics/statistics-by-cancer- type/prostate-cancer#heading-Five.[2] Hofman MS, Lawrentschuk N, Francis RJ, et al. Prostate-specific membrane antigen PET-CT in patients 21with high-risk prostate cancer before curative-intent surgery or radiotherapy: a prospective, randomised, multicentre study. Lancet. 2020 Apr 11;395(10231):1208-1216. doi: 10.1016/S0140-6736(20)30314-7.[3] Elewaily MI, Maniam A, Tree A, Banna GL. Investigating the latest evidence from phase III trials supporting treatment options for de novo clinically lymph node-positive hormone-sensitive prostate cancer. Curr Oncol Rep. 2025 May;27(5):572-583. Keywords: node positive prostate cancer
References: Kirchheiner2020 Int J Radiat Oncol Biol Phys
2020;106(2):300Defraene2012 Int J Radiat Oncol Biol Phys 2012;82(3):1233Brand2022 Int J Radiat Oncol Biol Phys 2023;115(2):327Rancati2022 Radiother Oncol 2022; 170(S1):S485 Keywords: prostate cancer,late side effects,predictive model
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Real-world outcomes after curative approach combined hormonal and radiotherapy for node positive prostate cancer john staffurth 1,2 , Ali Hussnain 3 , Justin Varghese 4 , Owain Woodley 5 , Jim Barber 3 , Loretta Sweeney 3 , Jacob Tanguay 3 , Nachi Palaniappan 3 1 Research, Velindre Cancer Centre, Cardiff, United Kingdom. 2 Division of Cancer and Genetics, Cardiff University, Cardiff, United Kingdom. 3 Urology, Velindre Cancer Centre, Cardiff, United Kingdom. 4 Centre for Medical Education, Cardiff University, Cardiff, United Kingdom. 5 Physics, Velindre Cancer Centre, Cardiff, United Kingdom Purpose/Objective: Men with lymph node positive prostate cancer without distant metastases (N1M0 PCa) are under-represented in clinical trials. They were included in the STAMPEDE trial, which showed improved outcome from additional systemic anti-cancer therapy (SACT), but did not address the optimal treatment approach, which includes radical prostate and pelvic nodal radiotherapy (PPNRT) with androgen deprivation therapy (ADT). Material/Methods: We have studied two cohorts of men with N1M0 PCa treated with PPNRT, prolonged ADT +/- SACT. The CONVN1M0 cohort was staged with conventional imaging and the PETN1M0 cohort was staged with PSMA PET scanning after a change in protocol. We report presenting features, treatment details and early disease control endpoints. We will present the anatomical position of each node for each patient,
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