Beyond Treatment Volume: When Pelvic Radiotherapy May Still Matter in High-Risk Localised Prostate Cancer

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The management of high-risk localized prostate cancer has evolved with advances in radiotherapy, androgen deprivation therapy, and systemic intensification.
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Elective pelvic radiotherapy remains debated, with evidence suggesting that systemic therapy is a more significant driver of patient outcomes than treatment volume.
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Recent trials indicate that pelvic radiotherapy should not be universally applied but rather tailored to patients with high nodal involvement risk.
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Advanced delivery techniques like IMRT are crucial for maximizing oncological benefits while minimizing toxicity in selected patients.
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Ongoing studies are exploring the role of pelvic nodal treatment in various contexts, reinforcing the importance of patient selection and systemic control.

Frontiers In Oncology

by Henriquez, Ivan , Abuchaibe, Oscar , Malave-Chacon, Barbara , Arenas, Meritxell
April 27, 2026

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