Due to its rarity and lack of prospective studies, clinical evidence for the management of the inguinal lymphatic nodal basin with radiation therapy in penile cancer (PeCa) has been limited. In this report, we review the current literature and further investigated the landscape of radiation sensitivity in nodal metastases of PeCa utilizing our well-established genome-based radiosensitivity index (RSI) platform. We hypothesized that optimal therapeutic gain could be achieved in PeCa stratified by the combination of clinicopathological parameters, genomic heterogeneity, and RSI-based radiation dose prescription (RxRSI). Similar to primary PeCa lesions, we found that the majority of PeCa nodal metastases are genomically radioresistant with significant heterogeneity. RxRSI should be considered to inform and optimize the radiation therapy dose prescription to the individual tumor biology.

由于其罕见且缺乏前瞻性研究，阴茎癌（PeCa）放射治疗腹股沟淋巴结盆的临床证据有限。在本报告中，我们回顾了当前的文献，并利用我们完善的基于基因组的放射敏感性指数 (RSI) 平台进一步研究了 PeCa 淋巴结转移的放射敏感性情况。我们假设通过临床病理学参数、基因组异质性和基于 RSI 的辐射剂量处方 (RxRSI) 的组合，可以在 PeCa 中实现最佳治疗增益。与原发性 PeCa 病变相似，我们发现大多数 PeCa 淋巴结转移在基因组上具有抗辐射性，具有显着的异质性。