Has the recent presentation of RADICALS-HD changed your ADT duration recommendations for patients receiving post operative radiation therapy for prostate cancer after radical prostatectomy?

The way I interpret RADICALS is that for adverse pathology meaning GS 8 and above, T3 disease or node positive who benefit from ADT would favor 24 over 6 months and probably these are patients who benefit from nodal RT also. For a favorable type prostate fossa only RT with unclear if any additional help from ADT.

2 years of ADT is warranted and what I routinely did as a trainee prior to the results. High risk, in my opinion, is similar to biochemical relapse with any risk up front - it implies involvement beyond the prostate that surgery missed - given recurrences are, by definition, at the margin of the prostate or beyond (occult high risk or metastatic). But of course, some select high risk cases can be managed surgically with success. It’s a “do over” of surgery with curative intent. In patients with ...