Improving postoperative radiotherapy following radical prostatectomy

Figures & data

Table 1. Comparison of the five randomized clinical trials concerning postoperative radiotherapy following radical prostatectomy.

	SWOG 8794 N = 425	EORTC 22911 N = 1005	ARO 96-02 N = 307	GETUG-16 N = 743	RTOG 9601 N = 840
Year	1988–1997	1992–2001	1997–2004	2006–2010	1998–2003
Inclusion	pT3R1/R0 (any PSA)	pT2 R1 or pT3R1/R0	pT3 R0/R1 (undetectable PSA)	pT2, pT3, pT4 with PSA rise 0.2–2.0 -g/ml	pT2 R1, pT3 R0/R1 detectable PSA 0.2–4.0 -g/ml > 8 weeks RP
Treatment	Radiotherapy vs. wait-and-see	Radiotherapy vs. wait-and-see	Radiotherapy vs. wait-and-see	Radiotherapy with goserolin (6 months) vs. radiotherapy	Radiotherapy with bicalutamide (24 months) vs. radiotherapy
Dose	60–64 Gy	60 Gy	60 Gy	66 Gy	64.8 Gy
Median FU	12.6 years	10.6 years	10 years	5.3 years	12 years
Timing of radiotherapy	<17.5 weeks after RP	<16 weeks after RP	6–12 weeks after RP	with PSA rise 0.2–2.0 -g/ml	with PSA rise 0.2–4.0 -g/ml
Relapse	>0.4 ug/ml PSA after undetectable	Increase PSA > 0.2 ug/ml two times	2 increases in PSA after undetectable	0.5 -g/ml increase from lowest PSA	0.3 -g/ml increase from lowest PSA
BR	10.3 years (RT) 3.1 years (WS) Median (p < 0.001)	13.2 years (RT) 6.12 years (WS) Median (p < 0.0001)	NA	NA	44% (RT + HT) 67.9% (RT) At 12 years
PFS	NA	60.6% (RT) 41.1% (WS) 10 years (p < 0.0001)	56% (RT) 35% (WS) 10 years (p < 0.0001)	80% (RT+ Go) 62% (RT) 5 years (p < 0.001)	NA
Overall survival	74% (RT) 66% (WS) 10 years (p = 0.023)	76.9% (RT) 80.7% (WS) 10 years (NS)	82% (RT) 85% (WS) 10 years (NS)	96% (RT + Go) 95% (RT) 5 years NS	76.3% (RT + Bi) 71.3% At 12 years (p = 0.04)
MFS	71% (RT) 61% (WS) 10 years (p = 0.016)	76.5% (RT) 71.3% (WS) 10 years (NS)	80% (RT) 84% (RT) 10 years (NS)	NA	14.5%(RT + Bi) 23% (RT) (p = 0.005) Incidence of a distant recurrences

Go: gosereline; Bi: bicalutamide; MFS: metastatic-free survival; PFS: progression-free survival; BR: biochemical relapse; WS: wait and see.