In Reply We agree with Dr Voog and colleagues that combining external beam RT with ADT remains the standard of care for men with intermediate or high-risk1 prostate cancer. We also wish to highlight that across our entire study cohort there was no increase in the risk of cardiac death in men randomized to receive RT compared with RT and ADT (hazard ratio, 0.74 [95% CI, 0.40-1.39]; P = .36). This result is consistent with the study of more than 1900 men2 mentioned by Voog and colleagues and the meta-analysis3 evaluating this association.
D’Amico AV, Chen M, Kantoff PW. Radiation With or Without Androgen Deprivation Therapy for Localized Prostate Cancer—Reply. JAMA. 2016;315(10):1055-1056. doi:10.1001/jama.2015.17570