Salvage radiotherapy with or without hormone therapy: for whom and when?

Abstract

We thank Dr. Williams for their comments (1) on the recent published results of the GETUG 16 trial (2) and the potential impact that could have these results on daily practice. First, as it was underlined in the publication, it is truth that 5 years is a too short time for determining an impact on overall survival but the disease-free survival was the primary end point of the trial and by increasing the biological relapse free survival (BRFS) we avoid secondary treatments such as chemotherapy or second line of hormone therapy for one third of patients compare to salvage radiotherapy alone arm. I agree also with Williams: in a next future, a probably dramatic improvement to identified subclinical metastases would avoid for some patients an inappropriate radiotherapy treatment, but that means also that selected patients with pure pelvic or prostate bed relapse would have a higher benefit of salvage radiotherapy combined with short term hormone therapy.