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The trial that first showed radiotherapy soon after prostate surgery reduces the risk of the cancer spreading and helps men live longer, in an era before PSA was used to trigger treatment.
SWOG 8794 randomised 431 men with pT3N0M0 prostate cancer after radical prostatectomy to 60 to 64 Gy adjuvant radiotherapy or observation; 425 were eligible, 211 observed and 214 irradiated. Seventy men under observation eventually received radiotherapy anyway.
Metastasis-free survival was significantly better with adjuvant radiotherapy: 93 of 214 events against 114 of 211, hazard ratio 0.71 (95 percent confidence interval 0.54 to 0.94, p=0.016). Overall survival also improved: 88 deaths of 214 against 110 of 211, hazard ratio 0.72 (0.55 to 0.96, p=0.023).
SWOG 8794 and EORTC 22911 together made adjuvant radiotherapy standard after an adverse-pathology prostatectomy for more than a decade. What they did not test is the comparison that matters now, adjuvant radiotherapy against early salvage radiotherapy triggered by a rising PSA, and when RADICALS-RT, RAVES and GETUG-AFU 17 did test it, early salvage won on toxicity without losing control. Their result stands; the question moved.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
431 randomised.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Metastasis-free survivalprimary | Adjuvant radiotherapy | 214 | 93 events | 0.71 (0.54 to 0.94) | 0.016 | link |
| Observation | 211 | 114 events | ||||
| Overall survival | Adjuvant radiotherapy | 214 | 88 deaths | 0.72 (0.55 to 0.96) | 0.023 | link |
| Observation | 211 | 110 deaths |
Shares ARTISTIC meta-analysis, Salvage therapy, RADICALS-RT, Biochemical recurrence (BCR).
Shares ARTISTIC meta-analysis, Salvage therapy, RADICALS-RT, Biochemical recurrence (BCR).
Shares Salvage therapy, RADICALS-RT, Radical prostatectomy, Biochemical recurrence of prostate cancer.
Shares Salvage therapy, Biochemical recurrence (BCR), Radical prostatectomy, Biochemical recurrence of prostate cancer.
Shares Biochemical recurrence (BCR), Radical prostatectomy, Biochemical recurrence of prostate cancer, Localised prostate cancer, high and very high risk.
Shares Biochemical recurrence (BCR), Radical prostatectomy, Localised prostate cancer, high and very high risk, Prostate cancer.
Shares Biochemical recurrence (BCR), Localised prostate cancer, high and very high risk, IMRT / IGRT (modern external beam), Prostate cancer.
Shares Biochemical recurrence (BCR), Localised prostate cancer, high and very high risk, IMRT / IGRT (modern external beam), Prostate cancer.