The role of radiation therapy in prostate cancer after radical prostatectomy: when and why?
Bibliographic record
Abstract
PURPOSE OF REVIEW: Recent data support postoperative radiotherapy in the management of selected patients with localized prostate cancer; however, optimal patient selection and timing of additional treatment are uncertain. Data describing selection factors for treatment and literature supporting immediate or delayed radiotherapy are reviewed and the limitations of current knowledge are discussed. RECENT FINDINGS: Three randomized controlled trials showed an advantage of combined surgery-radiotherapy when compared with surgery alone for biochemical relapse-free survival, local control and, in one trial, overall survival for those with pT3 disease and/or positive surgical margin. These trials only compared early postoperative radiotherapy with no radiotherapy. Toxicity of combined therapy is worse than that of surgery alone, so a preferable strategy might be to limit treatment to those who demonstrate postoperative biochemical progression. Only retrospective evidence exists to support this approach. SUMMARY: Optimal timing and selection of patients for postoperative radiotherapy will only be determined from the results of important randomized controlled trials such as Medical Research Council/National Cancer Institute of Canada Clinical Trials Group Radiotherapy and Androgen Deprivation In Combination After Local Surgery (RADICALS), and these should be strongly supported. In the absence of new data, immediate postoperative radiotherapy for men with adverse pathology should be the standard of care, and these men should be referred to a radiation oncologist soon after surgery to discuss the relative merits of immediate or delayed postoperative therapy or entry into a clinical trial.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".