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MEDTECH The final results of the RADICALS-RT trial have spoken.
A recent phase 3 trial has provided new insights into the effectiveness of adjuvant radiotherapy following radical prostatectomy in prostate cancer patients. Conducted by Noel Clarke, MD, from The University of Manchester, and presented at the 2023 European Society for Medical Oncology Annual Congress, this study critically examines the long-held practice of administering radiotherapy post-surgery, shedding light on its benefits and potential risks.
Key Points:
- Study Overview: A phase 3 trial evaluated the benefit of adjuvant radiotherapy following radical prostatectomy in prostate cancer patients.
- Participants: 1396 prostate cancer patients post-radical prostatectomy were randomized into two groups: 697 for adjuvant radiotherapy and 699 for observation with salvage radiotherapy upon PSA failure.
- Primary Outcome: The main focus was on freedom from distant metastases (FFDM).
- Secondary Outcomes: These included overall survival, safety, and patient-reported outcome measures at 1, 5, and 10 years.
- Duration and Results: After a median follow-up of 8 years, FFDM at 10 years was 93% in the radiotherapy group versus 90% in the observation group (HR 0.98; 95% CI, 0.67-1.44; P = .92).
- Radiotherapy in Observation Arm: 39% of patients in the observation group eventually received radiotherapy.
- Increased Morbidity: Adjuvant radiotherapy was linked to higher urinary and bowel morbidity.
- Recommendation: Dr. Clarke suggests an observation policy with salvage radiotherapy for PSA failure as the standard post-radical prostatectomy.
According to the American Cancer Society, about 1 in 8 men will be diagnosed with prostate cancer during their lifetime. However, the survival rate is high, with 98% surviving more than 10 years after diagnosis.
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