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Table 3 Treatment specifications

From: Radiotherapy for pelvic nodal recurrences after radical prostatectomy: patient selection in clinical practice

Factor Recommendations
Recommended Imaging before therapeutic decision 93% PSMA PET/CT
64% pelvic multiparametric MRI
further: bone scan, PSMA-PET MRI, choline PET (1 center each)
Dose to elective pelvic lymph nodes (ENRT) Median dose 50 Gy (range, 45–54 Gy) in 1.8–2 Gy/fraction
No pelvic RT recommended by 14%
Prostate bed RT Always included by 58% of the centers using pelvic RT
Median dose 66 Gy (range, 64–70 Gy)
Dose for lymph node boost for pelvic RT SIB in 75%, median dose 66 Gy (range 57.5–70 Gy, single dose 2–2.5 Gy)
SBRT boost in 25% (2 × 5 Gy)
SBRT* 29% 3-fraction course (SD 10–15 Gy)
43% 5-fraction course (SD 6–8 Gy)
14% > 10 fraction course (SD 3.5 Gy)
36% no primary SBRT
Margins SBRT CTV, median 0 mm (range, 0–5 mm)
PTV, median 5 mm (range, 3–5 mm)
Recommendation for concomitant ADT standard duration 57% six months, 7% nine months
21% in the presence of risk factors 6–24 months
29% no concomitant ADT (in addition to SBRT)
  1. * for SBRT, some center provided more than one fractionation schedule
  2. CTV, clinical target volume; PSMA, prostate specific membrane antigen; PTV, planning target volume; RT, radiotherapy; SIB, simultaneous integrated boost; SBRT, stereotactic body radiotherapy; SD, single dose.