# SPCG-7/SFUO-3

Source: https://onco.cc/trials/spcg-7/  
OnCo record `spcg-7` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding radiotherapy to hormone therapy for locally advanced prostate cancer halves the chance of dying of it, and the side effects are modest.

## Summary

SPCG-7 asked the mirror image of EORTC 22863: not whether to add hormones to radiotherapy, but whether to add radiotherapy to hormones. It randomised 875 men with locally advanced prostate cancer (T3 in 78 percent, PSA below 70, N0 M0) to endocrine treatment alone (439) or the same endocrine treatment with local radiotherapy (436).

At a median 7.6 years, 79 men in the endocrine-alone group and 37 in the combined group had died of prostate cancer. Cumulative 10-year prostate cancer mortality was 23.9 percent with endocrine treatment alone and 11.9 percent with the combination, a difference of 12.0 percentage points (95 percent confidence interval 4.9 to 19.1) and a relative risk of 0.44 (0.30 to 0.66). Ten-year overall mortality was 39.4 against 29.6 percent, a difference of 9.8 points (0.8 to 18.8), relative risk 0.68 (0.52 to 0.89). Cumulative 10-year PSA recurrence was 74.7 against 25.9 percent (p<0.0001, hazard ratio 0.16, 0.12 to 0.20).

After 5 years, urinary, rectal and sexual problems were slightly more frequent in the combined group. The authors concluded that endocrine treatment plus radiotherapy should be the new standard, and it is.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-25
- Also known as: SPCG-7; SPCG-7/SFUO-3
- Registry id: ISRCTN01534787
- Phase: 3
- Setting: Locally advanced prostate cancer, 78 percent T3, PSA below 70, N0 M0: endocrine treatment alone, being 3 months of total androgen blockade then continuous flutamide, against the same endocrine treatment with local radiotherapy, with prostate cancer specific survival as the primary endpoint
- Sponsor: Scandinavian Prostate Cancer Group and the Swedish Association for Urological Oncology
- Enrolled: 875
- Result: Ten-year prostate cancer mortality 11.9 percent with hormones plus radiotherapy against 23.9 percent with hormones alone (relative risk 0.44, 95 percent confidence interval 0.30 to 0.66); overall mortality 29.6 against 39.4 percent (0.68, 0.52 to 0.89).
- Outcomes: Prostate cancer mortality at 10 years: Endocrine treatment with radiotherapy 11.9% vs Endocrine treatment alone 23.9%; Overall mortality at 10 years: Endocrine treatment with radiotherapy 29.6% vs Endocrine treatment alone 39.4%
- Replication: The NCIC CTG PR.3/MRC PR07 intergroup trial (1,205 men) found the same, with an overall survival hazard ratio of 0.70 at a median 8 years.

## Sources

- ISRCTN registry ISRCTN01534787: https://www.isrctn.com/ISRCTN01534787
- SPCG-7/SFUO-3 (Lancet 2009): https://doi.org/10.1016/S0140-6736(08)61815-2

## Connected records

- cancers: [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Androgen deprivation & AR pathway inhibitors](https://onco.cc/technologies/androgen-deprivation/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- drugs: [Flutamide](https://onco.cc/drugs/flutamide/)
- terms: [Androgen deprivation therapy (ADT)](https://onco.cc/terms/adt/), [Curative intent vs palliative intent](https://onco.cc/terms/curative-intent/), [Hormone therapy](https://onco.cc/terms/hormone-therapy/)
- trials: [EORTC 22863](https://onco.cc/trials/eortc-22863/), [Hormone Therapy With or Without Surgery or Radiation Therapy in Treating Patients With Prostate Cancer](https://onco.cc/trials/nct00002633/)

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