摘要前列腺癌是老年男性常见的恶性肿瘤，放射治疗是其重要的根治手段。对于已出现盆腔淋巴结转移的前列腺癌患者，推荐进行盆腔淋巴结区域照射；而对于盆腔淋巴结阴性的患者，是否应进行盆腔淋巴结预防性照射尚无定论。现有的几项随机研究（如GETUG-01、RTOG-9413、POP-RT和EORTC 22863）在纳入人群、治疗方法和随访时间等方面存在明显差异，结论方面也各有侧重，未能形成具有强参考价值的一致性结论。因此，本文综述了根治性放疗和术后放疗中盆腔淋巴结预防照射的相关研究，并对其进行了比较，希望进一步讨论盆腔预防照射在盆腔淋巴结阴性患者中的作用和适应人群，帮助临床做出决策。同时，随着磁共振淋巴造影和前列腺特异性膜抗原（prostate-specific membrane antigen，PSMA）正电子发射计算机断层扫描（positron emission tomography/computed tomography，PET-CT）等新型检查技术在临床中应用，这些兼具高特异性和高灵敏度的影像学方法更准确地筛选出了盆腔淋巴结阴性患者，进而显著改变临床研究的结果，如POP-RT研究的阳性结论就可能与PSMA PET-CT的应用密切相关。鉴于此，本文对常用影像技术在该领域的应用情况进行了汇总，旨在为放疗医生提供有益参考。

abstractsProstate cancer is a common malignancy in elderly men, and radiotherapy is one of the important radical methods. For patients with prostate cancer who exhibit pelvic lymph node metastasis, it is recommended to undergo pelvic lymph nodes irradiation; However, for those with negative pelvic lymph nodes, there is no consensus on prophylactic pelvic lymph node irradiation. Several published researches (such as GETUG-01, RTOG-9413, POP-RT, and EORTC 22863) have shown significant differences in the included populations, treatment methods, and follow-up time, and these researches fail to form a consensus with strong reference value because of different focuses on conclusion. Therefore, this article reviews studies on radical and post-operative radiotherapy, with a comparative analysis. We further discuss the therapeutic role and appropriate population for pelvic irradiation in patients with negative pelvic lymph nodes, aiming to provide more precise guidance for clinical practice. Meanwhile, with the increasing application of advanced imaging techniques such as magnetic resonance lymphography and prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET-CT), these high-specificity and high-sensitivity imaging technologies can more accurately screen out patients with negative pelvic lymph nodes. Furthermore, the application of these imaging technologies in assessing whether pelvic lymph nodes have metastases will provide important influences on research outcomes, such as the positive conclusion of the POP-RT may be closely associated with the implementation of PSMA PET-CT. In view of this, this review summarizes recent progress of common imaging techniques in this field, aiming to provide useful references for radiation oncologists.