To the Editor: The randomized clinical trial by Dr Thompson and colleagues1 of adjuvant postoperative radiotherapy for patients with advanced prostate cancer validated the results of a European study that included more patients but had shorter follow-up.2 Because of lower than expected event rates, it was improbable that the primary endpoint of improved metastasis-free survival would be observed unless radiotherapy was particularly effective at preventing spread of residual prostatic fossa cancer, salvage radiotherapy for a detectable prostate-specific antigen level or hormonal therapy did not prevent metastasis, and death from causes other than prostate cancer did not reduce metastasis-free survival.
Pisansky TM, Pollack A, Sandler HM, Valicenti RK. Advanced Prostate Cancer and Postoperative Radiotherapy. JAMA. 2007;297(9):950–951. doi:10.1001/jama.297.9.950-b
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