Adjuvant RT Better for Locally Advanced PCa

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WASHINGTON, D.C.—Adjuvant radiotherapy (RT) may be associated with better disease-specific survival than salvage RT among men who have undergone radical prostatectomy (RP) for locally advanced prostate cancer (PCa), data show.

Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database from 1995-2005, investigators at Brigham and Women's Hospital in Boston identified 1,692 men undergoing RP who received adjuvant RT (772 patients) or salvage RT (920 patients) for pT3 disease or greater. They defined adjuvant RT as RT within six months post-RP and salvage RT as RT administered 12 months or more after surgery. The median follow-up was 5.4 years.

The disease-specific mortality rate was 0.29 per 100 person-years in the adjuvant group compared with 1.0 per 100 person-years in the salvage group, a significant difference between the groups, the researchers, led by Jim C. Hu, MD, MPH, reported at the American Urological Association annual meeting. Adjuvant treatment was associated with fewer bone-related events compared with salvage treatment (14.1% vs. 21.3%), but adjuvant treatment was associated with significantly increased use of salvage hormonal therapy (1.74 vs. 1.08 events per 100 person-years).

The adjuvant group was significantly more likely than the salvage group to have poorly differentiated tumors (60.9% vs. 48.6%).

Dr. Hu's group concluded that their study characterized expected outcomes from adjuvant and salvage RT and this could help counsel men contemplating these treatment approaches.

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