Outcomes of adding ADT and pelvic lymph node treatment to prostate bed salvage radiotherapy for prostate cancer

After radical prostatectomy, in men with still detectable PSA levels, administering salvage
radiation therapy to the prostate bed results in about 70% of patients being free of progression
at 5 years. A three-group randomized trial was designed to determine whether gains in patient
outcomes can be achieved by adding either 4-6 months of short-term androgen deprivation
therapy (ADT) to prostate bed radiotherapy or both short-term ADT and pelvic lymph node
radiotherapy to prostate bed radiotherapy.

The results demonstrated that adding short-term ADT to prostate bed radiation is beneficial
and suggests that the extension of standard postprostatectomy salvage prostate bed radiation
by including radiation to the pelvic lymph nodes with short-term ADT aids in the prevention
prostate cancer progression. Long-term follow-up is continuing.
Lancet 2022 May 14;399(10338)1886-1901