Prostate Cancer After Surgery

Happy New Year.

Now is as good a time as ever to reflect on the past¹, appreciate its lessons, and find gratitude in its challenges. With the end of a tumultuous 2020, our 2021 provides a chance to welcome a fresher start.  We, including our patients have seen how newer digital technologies such as social media changed landscapes at work and at home. As we make resolutions that look to the future, let us reinvigorate our enthusiasm for chasing goals, dreams, and shared successes. Let us drive the change we want to see, including using social media to better learn, share, and collaborate beyond barriers both new and old…

This year’s first #RadOnc #JC club will go back to our journal club basics² by focusing on a multicentre prostate cancer RCT: RADICALS-RT.

Parker et al. Timing of radiotherapy after radical prostatectomy (RADICALS-RT): A randomized, controlled phase 3 trial. Lancet 2020.
     

This article is free to access thanks to the authors and The Lancet [link]. We will be joined by lead author Prof. Parker (@PCaParker), Prof. Sydes (@mattsydes), and other special guests as we discuss the timing of radiation and other treatments after prostatectomy.

As rates of prostate cancer climb especially in developing countries and men live longer after prostate surgery, radiation and hormone treatment becomes more important. For breast cancer, these are often recommended after surgery. However, for prostate cancer the indications are less clear.  RADICALS-RT, is one of the largest randomized clinical trials for men in this setting. It recruited nearly 1400 men across Europe and North America over nine years and sheds light on the optimal treatment for men with prostate cancer.  

Our chat will begin 8 AM Central Standard Time on Saturday January 16th and carry through into Sunday. We will have a “live ho ur” on 2 PM Central Standard Time on Sunday January 17^th with the study authors.  

Guiding topics include:

T1.  Background: What is the rationale behind this trial? Where did immediate & salvage RT come from?
T2.  Methods: How were the endpoints, arms, & other treatment details chosen for validity?

T3.  Results: What were they, how big, and how precise?

T4. Discussion: What is the take home message? What is your local practice and does this help? Are the benefits in your setting worth all the costs?

T5. Next Steps: Is there a subset of patients including other practice settings where these results may not apply? Are more trials needed and how should they be designed? How can our findings be used to help more?

Some tips to participate:

• Guidelines on how to sign up and participate
• A Disclaimer for ways to keep us rewarding and professional. If you’re not ready, just lurk and tune in to the conversation.

Suggestions? Leave a comment or tweet one @Rad_Nation. We look forward to engaging with you!

Selected References:
[1] Reflections may including continued progress for our field over #125YrsRadOnc

2 (Archived) M Katz, 2014. #radonc Journal Club: Global Learning on Twitter. [Link]

³ Tilki, D. and A. V. D’Amico (2020). “Timing of radiotherapy after radical prostatectomy.” The Lancet 396(10260): 1374-1375. [Link]

⁴ Vale et al. (2020). “Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data.” The Lancet 396(10260): 1422-1431. [Link]