Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: We agree with Dr Sherr that the radiotherapy dose for this protocol, which was designed in 1987, was lower than that which would be used today. Because most studies to date have demonstrated a greater efficacy for a higher dose of radiotherapy, we too might expect a greater difference in outcomes if the study were initiated today. While the effect on metastasis-free survival was close to the criterion for statistical significance, the lower than expected event rate had a major effect on the study's ability to reach statistical significance.
Thompson IM, Tangen CM. Advanced Prostate Cancer and Postoperative Radiotherapy—Reply. JAMA. 2007;297(9):950-951. doi:10.1001/jama.297.9.951-a