Prostate Cancer Patients May Safely Skip Radiation Therapy After Surgery, Phase 3 Trial Shows

Prostate Cancer Patients May Safely Skip Radiation Therapy After Surgery, Phase 3 Trial Shows
Men with prostate cancer who undergo surgery have similar long-term outcomes whether they receive radiation therapy shortly after the surgery or only when signs of disease recurrence appear, suggesting that some may be spared the radiation treatment, a Phase 3 clinical trial shows. Findings from the trial were shared in an oral presentation, titled “Timing of Radiotherapy (RT) After Radical Prostatectomy (RP): First Results from the RADICALS RT Randomised Controlled Trial (RCT) [NCT00541047],” at the European Society for Medical Oncology (ESMO) 2019 Congress, held recently in Barcelona, Spain. These are the late breaking results of the Phase 3 RADICALS-RT (NCT00541047) trial, designed to investigate if the addition of radiation therapy to androgen deprivation therapy (ADT) after prostate removal surgery improves the clinical outcomes of men with prostate cancer. The study enrolled 1,396 men who had undergone surgery to remove their prostate at several clinical centers across Canada, the U.K., Denmark, and Ireland. All participants were randomly assigned to receive one of two post-operative treatment regimens: either adjuvant radiotherapy, or observation only, with the option to resort to radiotherapy if the cancer returned (standard care). Data from RADICALS-RT presented at the ESMO Congress showed that at a median follow-up of five years, 85% of men receiving adjuvant radiotherapy and 88% of those who had been kept on observation continued to show no signs of disease worsening, suggesting that routine radiotherapy was not superior to standard care at preventing disease recurrence. Patient-reported outcomes also indicated that urinary incontinence after one year of treatment was worse in 5.3% of the men receiving adjuvant radiotherapy compared with
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