Adjuvant vs. Salvage Radiotherapy for High-Risk Prostate Cancer

Prior studies have shown that adjuvant radiotherapy (RT) for patients with prostate cancer delays time to prostate-specific antigen (PSA) progression after radical prostatectomy. However, the optimal timing of adjuvant RT is unclear.

Now, investigators conducted an international, randomized, phase III trial of adjuvant radiotherapy versus salvage radiotherapy at PSA progression in 1396 prostate cancer patients who had undergone radical prostatectomy (median preoperative PSA, 7.9). Patients had at least one of the following high-risk factors for PSA progression: T3 or T4 disease, a Gleason score of 7 to 10, positive margins, and preoperative PSA of ≥10.

At a median follow-up of 4.9 years, 5-year PSA progression–free survival was similar with a…