Adjuvant radiotherapy no better for localized prostate cancer
Adjuvant radiotherapy does not improve event-free survival in men with localized or locally advanced prostate cancer treated with radical prostatectomy, according to a review and meta-analysis published online Sept. 28 in The Lancet.
Claire L. Vale, Ph.D., from University College London, and colleagues used a prospective framework for an adaptive meta-analysis to compare adjuvant and early salvage radiotherapy following radical prostatectomy in men aged ≥18 years with intermediate- or high-risk localized or locally advanced prostate cancer. Three eligible trials were identified, and results for event-free survival were obtained for 2,153 patients recruited between November 2007 and December 2016 (1,075 randomly assigned to receive adjuvant radiotherapy and 1,078 to early salvage radiotherapy).
The researchers found that the meta-analysis showed no evidence for improved event-free survival with adjuvant radiotherapy versus early salvage radiotherapy based on 270 events (hazard ratio, 0.95; 95 percent confidence interval, 0.75 to 1.21; P = 0.70), with a 1 percent change in five-year event-free survival (89 versus 88 percent). Across trials, the results were consistent.
“Our results show that salvage radiotherapy could spare men from receiving radiotherapy and its associated toxic effects,” the authors write. “Thus, questions over the best postoperative policy to propose after radical prostatectomy and which patients could still benefit from adjuvant radiotherapy remain valid.”
Several authors disclosed financial ties to the biopharmaceutical industry.