This protocol addresses male patients with locally advanced prostate cancer who have clinically positive pelvic lymph nodes (cN1) detected on conventional imaging — such as CT or bone scan — with no evidence of distant metastasis (M0). Approximately 5–10% of newly diagnosed prostate cancer patients present at this stage.
Suspected pelvic nodal involvement on conventional imaging, in the absence of bone or visceral spread, defines a clinical subset where locoregional control alone is insufficient. Both the primary tumour site and the regional nodal disease must be addressed concurrently within the treatment plan.
Current guidelines recommend a combination of image-guided radiation therapy covering both the prostate and the pelvis, alongside long-term systemic hormonal therapy augmented by an additional agent for a defined course. The complete regimen — including specific agents, sequence, and duration — is available in the full structured protocol.
The principal endpoints are achieving an undetectable or nadir serum PSA, preventing biochemical recurrence, and halting metastatic progression.