Given results of the RADICALS trials, is LT-ADT standard of care for salvage prostate RT?

Given the results of RADICALS-HD and RADICALS-RT trials, it seems as though there was no benefit to adding ST-ADT to RT, but a DFMS benefit for LT-ADT over ST-ADT. I’m not sure I’m ready to routinely rx LT-ADT in all settings, especially in light of the other positive ST-ADT trials (GETUG, SPPORT) and known risks of LT-ADT (per 9601).

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3 Answers

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Radiation Oncology · Cleveland Clinic

Answered on

I do not think long-term ADT is established as standard of care for salvage prostate radiation, as this would require a demonstration of improved overall survival in at least specific subgroups of patients. RADICALS-HD demonstrates improvement in freedom from metastasis as well as freedom from non-p...

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Radiation Oncology

Answered on · Updated on

I don’t think I could add much to Dr. @Dr. First Last and Dr. @Dr. First Last comprehensive analyses. However, since I was asked for an update, I thought the addition of a paper that has been published since the filing of those responses may be helpful.

DADSPORT (Burdett et al., PMID 40571441) was a ...

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Radiation Oncology · University Hospital Basel

Answered on

One important thing to note about RADICALS-HD is that the distribution of patients in the different comparison arms is not uniform.

This has to do with the fact that physicians were able to advise and let the patients choose which randomization they would prefer. We can safely assume that physicians ...

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