Three randomized trials and a meta-analysis of the trials failed to show a significant effect of adjuvant radiotherapy on biochemical progression or combined clinical events after radical prostatectomy for early, high-risk prostate cancer.
In the largest of the three trials, salvage radiotherapy was associated with a 3% absolute advantage for biochemical progression-free survival (bPFS) at 5 years, although the difference did not reach statistical significance. One of the smaller trials showed absolute difference in bPFS of 1% at 6 years in favor of salvage therapy, whereas the other showed a nonsignificant 2% higher event-free survival (EFS) with salvage radiotherapy.
The meta-analysis, which included 2,153 randomized patients, yielded a 5-year EFS of 89% with adjuvant radiotherapy and 88% with salvage therapy, also not significant.
The largest of the trials and the meta-analysis were published simultaneously in the Lancet, and the two smaller trials in the Lancet Oncology.