Salvage Radiotherapy for Prostate Cancer: The Role of Androgen Deprivation Therapy

Following radical prostatectomy, 20% to 50% of men experience a detectable prostate-specific antigen (PSA) level, frequently referred to as biochemical recurrence. Prostate bed radiotherapy (PBRT) administered in either the adjuvant or “salvage” setting has variably been shown to improve disease control rates, with recent data suggesting improved outcomes with early salvage therapy.

Investigators conducted an international phase 3 trial to test the role of adding androgen deprivation therapy (ADT) to PBRT alone or with pelvic lymph node radiotherapy (PLNRT). Over a 7-year period, 1792 patients with PSA values between 0.1 and 2.0 ng/mL after radical prostatectomy were randomized to receive PBRT alone, PBRT plus 4 to 6 months of ADT, or PBRT p…