Radiotherapy After Prostate Cancer Surgery Improves Outcomes

It is associated with a decreased risk of progression compared with a wait-and-see approach.
It is associated with a decreased risk of progression compared with a wait-and-see approach.

Adjuvant radiotherapy (ART) for prostate cancer decreases the risk of biochemical progression compared with a wait-and-see approach following radical prostatectomy (RP), new findings suggest.

The findings are from a study of 307 men with pT3 pN0 PCa randomized to wait-and-see (159 patients) or 3D conformal ART (148 patients). The median follow-up was 111 months and 113 months for the ART and wait-and-see groups, respectively.

At 10 years, the progression-free survival (PFS) rate was 56% for the ART group compared with 35% for the wait-and-see group, which translated into a significant 49% decreased risk of disease progression, the researchers reported online ahead of print in European Urology.

The investigators defined disease progression as biochemical recurrence, clinical recurrence, or death. ART did not significantly improve metastasis-free or overall survival, but the study was not adequately powered for these endpoints.

The benefit of ART was especially pronounced in men with positive surgical margins. In this group, the 10-year PFS was 57% for ART recipients and 27% for the wait-and-see patients.

In the ART group, the worse late sequelae were 1 grade 3 and 3 grade 2 cases of bladder toxicity and 2 grade 2 cases of rectum toxicity. The researchers observed no grade 4 events.

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