Is long term ADT now the standard of care with salvage prostate bed RT?
The dreaded hormone question...After 40 years of embarking on extremely well designed randomized trials, we still are confused about the who, what, when of ADT. Will RTOG 9601 create a new care standard? As @Dr. First Last said, I think we will see increased utilization. I have been using bicalutami...
@Dr. First Last presented at the 2015 ASTRO Plenary the results of RTOG 9601 and showed that 2 years of bicalutamide 150 mg improved OS for men undergoing post-op, salvage RT for prostate cancer. Does this report change practice? In my view and in my practice, it will.
Of course, one would like to ...
I have been asked to add my 2 cents since RTOG 9601 has now been published, and this will serve as an update to my original post above.
I feel that both RTOG 9601 as well as GETUG 16 basically prove that adding ADT to salvage radiotherapy improves biochemical free survival, metastasis free survival, ...
Robert Lee is spot on.
Soon to be online will be a paper I wrote answering this very question in depth in IJROBP.
Briefly, salvage RT plus ADT should be the standard of care for patients with PSAs above 0.7 ng/mL. I would argue this should be long-term hormone therapy until we have data from RADICALS...
I am keen to hear what people think about the "unplanned" subgroup analysis in 9601. For me this is the most interesting element of this landmark study. The Duke residents will roll their eyes but this is now my favorite example of statistical interaction. The format is not conducive to an academic ...
Well, now that RTOG 9601 is published, can we provide more insight into the type and duration of ADT? We also have GETUG 16 to consider, a study smaller than 9601 that showed an improvement in PFS with 6 months of LHRH agonist. @Dr. First Last has a nice commentary on GETUG 16 and RTOG 9601: https:/...
I remain unconvinced that concurrent/adjuvant hormonal therapy increases the cure rate of salvage radiotherapy. I think hormonal therapy merely delays manifestation of recurrences that salvage radiotherapy could not eradicate. This is a difficult hypothesis to statistically prove.
If biochemical rel...