This longer term follow-up provide updated data, at a median follow-up of 9.33 years as compared to 5.25 years for the first analysis of the GETUG-AFU 16 trial.
A commentary suggests that although the near halving of the risk of progression lends support to adding 6 months of an LHRH agonist to radiotherapy, the reduction in metastasis-free survival in the dual therapy group should be considered hypothesis-generating, since the study did not require annual or systematic scans during follow-up and since patients who reported pain could be scanned with a CT and bone scan. Without assurance of consistent scanning between the two randomised treatment groups, the metastasis-free survival endpoint is potentially subject to ascertainment bias. It discusses reasons why there was an overall survival benefit in the RTOG 9601 trial, but not in the GETUG-AFU 16 trial. It suggests that while awaiting the results of studies that will enable health-care providers who care for men with prostate cancer to personalise the use of androgen deprivation therapy in the salvage setting, on the basis of the results of the GETUG-AFU 16 trial, it would be prudent to consider adding a 6 month course of an LHRH agonist to salvage radiotherapy in men with no or minimal comorbidity given the near halving of progression and the possible reduction in mortality due to prostate cancer.