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Despite the ability of prostate cancer screening to identify patients with clinically organ-confined (T1c) prostate cancer, a troubling number of men still present with locally advanced — high-grade, high-stage, high–prostate-specific antigen (PSA) — disease. During the past 10 to 15 years, randomized trials have shown that optimal management of these patients requires a multimodality treatment, such as radiotherapy (RT) plus androgen-deprivation therapy (ADT) or radical prostatectomy plus adjuvant RT.
To further test the benefits of adding RT to ADT in men with locally advanced prostate cancer, international investigators conducted a randomized, phase III trial involving 1205 men with stage T3 or T4 (N0, NX, M0) disease or clinical T2 tumor…