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Radiation Oncology • Genitourinary Cancers
In which prostate cancer patients, if any, do you consider adding ADT to adjuvant radiation therapy following prostatectomy?
Specifically, in patients who have an undetectable PSA post-op, with high risk features such as seminal vesicle invasion, positive margins, or extraprostatic extension, plus high Gleason score 8, 9, or 10, and/or an intraductal carcinoma of the prostate, would you offer short term ADT with adjuvant radiation?
Answer from: Radiation Oncologist at Academic Institution
Two trials (RTOG 9601 and GETUG-AFU 16) have demonstrated a benefit to adding ADT to salvage radiotherapy, and both required a minimum PSA of 0.2 ng/ml or higher. In RTOG 9601, the subgroup of patients who appeared to benefit most from ADT were those with PSA >0.7 ng/ml, suggesting that concurren...
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Answer from: Radiation Oncologist at Academic Institution
There are no right answers to this question yet. However, I would imagine that if one is even seeing an "adjuvant" radiation consult, it is because they have adverse features that are already worrying the urologist. The patterns of care data I am familiar with put the rate of adjuvant therapy use in...
Answer from: Radiation Oncologist at Community Practice
As others have mentioned, there is no level 1 data to support the use of ADT with adjuvant RT. Lack of data does not mean there is no benefit, but it also doesn't mean there is benefit.As with all prostate cancers, risk stratification is used to determine appropriate treatment to compliment RCT data...