RADICALS-RT (NCT00541047) is the largest ever trial of postoperative radiotherapy in prostate cancer. Results published in late Fall 2019.
It found no difference in disease recurrence at 5 years between men who routinely had radiotherapy shortly after surgery and men who had radiotherapy later, if the cancer came back.The trial enrolled 1,396 patients after surgery for prostate cancer from the UK, Denmark, Canada, and Ireland. Men were randomly allocated to postoperative radiotherapy or the standard approach of observation only, with radiotherapy kept as an option if the disease recurred.
At a median follow-up of 5 years, progression-free survival was 85% in the radiotherapy group and 88% in the standard care group (hazard ratio [HR] = 1.10; That means men who DID NOT choose SRT or eSRT had a higher progression-free survival at five-years than those who did choose early RT.
The results of the ARTISTIC meta-analysis confirmed those of RADICALS, further supporting the routine use of observation and early salvage radiotherapy. This study combined RADICALS, RAVES, and GET-AFU17 data to compare ART to eSRT. 2,151 men randomized to eSRT or SRT at a higher PSA level.
The analysis found no evidence that adjuvant radiotherapy improves event-free survival compared to early salvage radiotherapy (HR = 1.09). Based on these results, the difference in 5-year event-free survival is likely only to be around 1%. Study first author Chris Parker, MD, of The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, said, “The results suggest that radiotherapy is equally effective whether it is given to all men shortly after surgery or given later to those men with recurrent disease. There is a strong case now that observation should be the standard approach after surgery and radiotherapy should only be used if the cancer comes back.”
“The good news is that in future, many men will avoid the side effects of radiotherapy,” added Dr. Parker.
Post Edited (OldTiredSailor) : 1/27/2020 1:40:56 PM (GMT-7)