(HealthDay News) — For men with high-risk prostate cancer, postoperative radiation after radical prostatectomy is associated with improved biochemical progression-free survival over a median of 10.6 years of follow-up, compared with a wait-and-see policy, according to a study published online Oct. 19 in The Lancet.
Michel Bolla, M.D., from the Centre Hospitalier Universitaire A Michallon in Grenoble, France, and colleagues conducted a phase 3 trial to examine the long-term results of immediate postoperative irradiation versus a wait-and-see approach for patients, aged 75 years or younger, with prostate cancer extending beyond the prostate. One thousand five participants from 37 institutions were randomized to receive postoperative radiation (502 patients) or a wait-and-see policy (503 patients) until biochemical progression and were followed for a median of 10.6 years.
The researchers found that patients receiving postoperative irradiation had significantly improved biochemical progression-free survival, with a lower rate of biochemical progression, clinical progression, or death (39.4 percent), compared with the wait-and-see policy (61.8 percent; hazard ratio, 0.49). The postoperative radiation group had significantly more late adverse events than the wait-and-see group (10-year cumulative incidence, 70.8 versus 59.7 percent).
“Our results suggest that postoperative irradiation significantly improves biochemical progression-free survival and local control, and might improve clinical progression-free survival in patients younger than 70 years and those with positive surgical margins, although it might have a possible detrimental effect in patients aged 70 years or older,” the authors write.