Prostate

Question 1

Studies investigating adjuvant prostate bed radiation or observation after prostatectomy

Answer 1

1. SWOG 8794 (Thompson)
2. EORTC 22911 (Bolla)
3. ARO 96-02 (Wiegel)

Question 2

Which adjuvant study demonstrated survival benefit

Answer 2

SWOG 8794

Question 3

Design of SWOG 8794

Answer 3

431 patients pT3N0 +/- pos margins to obs vs. radiation (60-64 Gy).

Question 4

Results of SWOG 8794

Answer 4

15 year OS benefit (37 vs 47%)
DMFS benefit (38 vs. 46%)
10 year biochemical and local failure advantages with RT
Worse GU/GI tox (but bowel differences disappeared by 2 years)

Question 5

Design of EORTC 22911

Answer 5

RCT of 1005 pts randomized to obs vs. RT (60 Gy), included pN0 with ECE, +margin or SVI

Question 6

Results of EORTC 22911

Answer 6

Improvement in PSA RFS, LRF, PFS all better but NO DIFF in OS

Question 7

Strongest predictor of benefit to adjuvant RT in EORTC 22911

Answer 7

+margin

Question 8

Design of ARO 96-02

Answer 8

RCT of 385 pts with pT3 disease +/- +margin and undetectable PSA to obs vs. RT (60 Gy). 5 year biochemical free survival was improved