Elective Nodal Irradiation: Old Game, New SPORT

The debate about the risks and benefits of elective nodal irradiation (ENI) in prostate cancer has resurfaced with the recent publication of the SPORT trial, a feasibility study looking at the possibility of starting a randomized controlled trial (RCT) comparing irradiation of the prostate versus prostate plus ENI for high-risk prostate cancer in the stereotactic body radiation therapy (SBRT) era. 1 Houlihan OA, Redmond K, Fairmichael C, et al. A randomized feasibility trial of stereotactic prostate radiotherapy with or without elective nodal irradiation in high-risk localised prostate cancer (SPORT trial) [e-pub ahead of print]. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2023.02.054, accessed April 20, 2023. Google Scholar The question has been around for decades, yet it still remains unanswered: Is the added risk of toxicity with ENI worth the benefit? A Randomized Feasibility Trial of Stereotactic Prostate Radiation Therapy With or Without Elective Nodal Irradiation in High-Risk Localized Prostate Cancer (SPORT Trial)International Journal of Radiation Oncology, Biology, PhysicsVol. 117Issue 3PreviewThe aim of this study was to establish the feasibility of a randomized clinical trial comparing SABR with prostate-only (P-SABR) or with prostate plus pelvic lymph nodes (PPN-SABR) in patients with unfavorable intermediate- or high-risk localized prostate cancer and to explore potential toxicity biomarkers. Full-Text PDF