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POSEIDON IPD (n=6057): adding HT to postop RT misses OS (HR 0.87, 0.76-1.01, p=0.06); benefit concentrates at pre-RT PSA >0.5 (interaction p=0.02).
Prostate carried the day, and both readings push RT decisions toward patient selection over blanket intensification: POSEIDON says HT with salvage RT earns its OS case only at higher pre-RT PSA (NNT 125 at ≤0.2 vs 25 at >1.0), while GÖTEBORG-1 shows 25yr PC-specific survival of 94% on AS against 68% failure-free at 22yr. Elsewhere the signal is planning-level: MIBC dose escalation cut invasive local recurrence (SHR 0.20) with no added G2+ toxicity, and immune-sparing lung SBRT spared 13.4% of ALC reduction.
read the full digest →Studies · 116
- IROCK Contouring GuidelinesFirst international consensus contouring guideline for RCC SABR; median DSC 0.85 across 4 cases, 16 radiation oncologists.
- Dose-Escalated RT for MIBC (TMT)SHR 0.20 (0.05-0.89) for invasive local recurrence with SIB dose escalation in TMT; no OS or MFS difference.
- Immune Cell Sparing RTALC reduction improved 13.4% (95% CI 2.8-24.0, p=0.01) with immune-sparing SBRT planning vs standard, 29.5% in central tumors.
- GÖTEBORG-1PC-specific survival 94% at 25yr on active surveillance, but failure-free survival fell to 68% at 22yr.
- POSEIDONOS HR 0.87 (0.76-1.01), p=0.06 adding hormone therapy to postop RT; 0.7% absolute at 10y, PSA-dependent interaction p=0.02.
- DBCG Skagen Trial 13y arm lymphedema 8.0% (40Gy/15fx) vs 9.4% (50Gy/25fx), OR 0.84, noninferior; LRR, distant recurrence, and mortality all equivalent.
- PACE-B5yr PROMs comparable for SBRT vs conventional RT: pad-free 91% vs 90%, mod/big urinary leak 6% vs 4%, bowel bother 5% both arms.
- ESTRO Prostate SBRT Consensus Recommendations15-expert ESTRO Delphi consensus on optimising primary prostate SBRT: patient selection, contouring, dose/fractionation, follow-up, and delivery technique.
- ProtecT (secondary analysis: cribriform morphology)Cribriform-negative pts (87%): radical Rx gave no significant 15yr metastasis reduction vs active monitoring; cribriform-negative GG2 matched GG1 risk.
- NRG Oncology/RTOG 0848OS primary EP not met (HR 0.96, 90% CI 0.79-1.18) adding adjuvant CXRT to gemcitabine; node-negative subgroup OS benefit on interaction (P=.0063).
- TROG 08.03 RAVES QOL SubstudyAt 5yr, 16% vs 2% severe urinary leakage aRT vs no RT (p=0.01); sRT timing had no QOL effect.
- STAMPEDE (abiraterone ± enzalutamide, high-risk non-metastatic)MFS HR 0.53 (6yr 82% vs 69%) and OS HR 0.60 adding 2yr abiraterone to ADT in high-risk M0 prostate (85% also had RT).