Kamran on the Shift Towards Early Salvage Radiation After Prostatectomy
The approach to radiation therapy after prostate surgery has largely shifted away from immediate adjuvant treatment towards early salvage radiation therapy, according to Sophia Kamran, MD, Harvard Medical School and Mass General Cancer Center, who discusses this in an interview with Targeted OncologyTM at the 2025 AUA Annual Conference.
This transition was primarily driven by 3 significant trials, collectively analyzed in the ARTISTIC meta-analysis. This analysis demonstrated no detriment to cancer outcomes with early salvage therapy compared to adjuvant therapy. Importantly, early salvage allows patients more time to recover urinary continence and sexual function before potentially needing radiation. This has positively impacted their overall quality of life, according to Kamran.
However, adjuvant therapy isn't obsolete. There's substantial ongoing research investigating its role in patients with very high-risk features or younger age at diagnosis, who were often excluded from the ARTISTIC trials. Some retrospective studies suggest that patients with high-risk characteristics, such as node-positive disease, might still benefit from upfront adjuvant radiation. Therefore, this remains an active area of investigation, and Kamran urges physicians to stay tuned for further research.
