Is antiandrogen monotherapy a reasonable option for a patient with high-risk disease getting IMRT (+/- BT boost) who refuses GNRH modulators?

I do use anti-androgen monotherapy as a compromise for patients who refuse LHRH agonists. Many patients walk out the door when LHRH agonists are mentioned. The PSA nadir is not as low with biclutamide as with LHRH agonists. There is experience with biclutamide at 150 mg both in non randomized report...

Trials show that adding hormonal therapy to radiation (64 to 78 Gy EBRT) shifts the tumor response curve to the left (Figure below; https://www.ncbi.nlm.nih.gov/pubmed/28589396). These trials mostly offered dual agent, injectable LHRH agonists with an oral anti-androgen concurrent with RT. To my kno...