PEARLS is an international randomised phase II/III clinical trial which aims to provide definitive randomised evidence that para-aortic radiation therapy with prostate and pelvic radiotherapy (extended field radiation therapy) is safe and improves failure free survival in prostate cancer patients with involved lymph nodes at presentation.
PEARLS aims to improve patient outcomes by treating patients whose cancer has spread to the lymph nodes with radiotherapy to an extended area than is currently used. The hypothesis is that by extending radiation to cover a wider area where recurrences can often occur may improve control of the cancer. There is currently no standard management for prostate cancer patients who present at diagnosis with cancer having spread to the lymph nodes in the abdomen. Previous studies have indicated that it is safe to treat the prostate and pelvic areas with radiotherapy. There have been no recent studies using modern radiotherapy technology to treat larger areas within the abdomen. PEARLS will assess to see if the extended radiotherapy treatment helps to control the cancer better.