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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Thursday, November 2, 2023
For patients with prostate carcinoma who were treated with radical prostatectomy, an observation policy with salvage radiotherapy should remain the standard of care, since the use of adjuvant radiotherapy did not significantly improve clinical outcomes, according to the results of the RADICALS-RT study presented at the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract 1764O). In fact, the use of adjuvant radiotherapy increased the risk of urinary and bowel complications, suggested Noel Clarke, MBBS, FRCS, ChM, of the Christie at Salford Royal Hospital, Manchester, United Kingdom, and colleagues.
From 2007 to 2016, a total of 1,396 patients with prostate carcinoma who had a radical prostatectomy were recruited for the study. Participants were randomly assigned to receive either adjuvant radiotherapy (n = 697) or an observation policy with salvage radiotherapy (n = 699). Prostate-specific antigen levels were measured regularly to assess for increases of 0.1 ng/mL or higher. Patients were further stratified based on their Gleason score, margin status, planned radiotherapy volume, and radiotherapy schedule.
The study authors reported an overall survival rate of 88% and 87%, respectively, in patients who received adjuvant radiotherapy or an observation policy with salvage radiotherapy (hazard ratio [HR] = 0.98). In addition, the calculated rate of freedom from distant metastases at 10 years was 93% for those who received adjuvant radiotherapy and 90% for those who underwent an observation policy with salvage radiotherapy (HR = 0.68). Moreover, patients who received adjuvant radiotherapy reported increased rates of urinary and fecal incontinence at the 1-year interval.
Disclosure: For full disclosures of the study authors, visit cslide.ctimeetingtech.com.
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