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The goal of adjuvant radiotherapy after radical prostatectomy is to sterilize the prostatic bed and, in selected settings, regional nodes to decrease the potential for local recurrence and, ultimately, reduce the systemic spread of the disease and improve survival. Recent randomized trials have shown that in patients with T3 disease or positive surgical margins, postoperative radiotherapy to the surgical bed improves local control and biochemical (prostate-specific antigen) progression-free survival (PFS).
One of these trials, by the Southwest Oncology Group (SWOG), demonstrated that adjuvant radiotherapy versus observation significantly reduced risk for distant metastases and improved overall survival (J Urol 2009; 181:956). However, anothe…