Necessity of Pelvic Lymph Node Irradiation in Patients with Recurrent Prostate Cancer after Radical Prostatectomy in the PSMA PET/CT Era: A Narrative Review

Biomedicines. 2022 Dec 24;11(1):38. doi: 10.3390/biomedicines11010038.

Abstract

The main prostate cancer (PCa) treatments include surgery or radiotherapy (with or without ADT). However, none of the suggested treatments eliminates the risk of lymph node metastases. Conventional imaging methods, including MRI and CT scanning, are not sensitive enough for the diagnosis of lymph node metastases; however, the novel imaging method, PSMA PET/CT scanning, has provided valuable information about the pelvic LN involvement in patients with recurrent PCa (RPCa) after radical prostatectomy. The high sensitivity and negative predictive value enable accurate N staging in PCa patients. In this narrative review, we summarize the evidence on the treatment and extent of radiation in prostate-only or whole-pelvis radiation in patients with positive and negative LN involvement on PSMA PET/CT scans.

Keywords: PSMA PET/CT; gallium 68 PSMA-11; lymph nodes; pelvic LN; prostate cancer; prostatic neoplasms; radiation therapy/radiotherapy; recurrence.

Publication types

  • Review

Grants and funding

This research received no external funding.