The Lancet reports a long term study (median 10.6 years) of 1005 men after radical prostatectomy surgery. These men were judged at "high risk". Half were randomly assigned immediate (Adjunct) radiation therapy. The other half were placed in a wait and see category. This second group received Salvage Radiation (SRT) only when judged necessary by subsequent clinical or biochemical evidence. This study was done by the European Organization for Research and Treatment of Cancer (EORTC) 22911 study, and was published online October 19 in the Lancet.
Five year Progression Free Survival was significantly higher in the Adjunct group (61.8% vs 39.4%), and the Adjunct group was less likely to need hormone therapy. However, overall survival (about 80%), after 10 years was about the same in both groups. Maybe that has something to do with the age of us guys who get this disease.
As far as I know this is the most thorough long term study of the benefits of Adjunct vs Salvage Radiation for men at high risk. (I would assert men at Gleason 8 or above are at high risk).
Here is the connect to the Lancet article. More complete summary. You would have to subscribe to read the full report.
DaVinci surgery 11/09. Clean margins, clean seminal vessels.
Rising PSA noted 06/11
Time to recurrrence 18 months
Three month doubling time (summer 2011).
PSA rose from .07 on 06/11 to .17 on 11/11.
MRIs and bone scans negative so far.
Started hormone therapy (Lupron/Casodex) 12/11
Began radiation (SRT) 02/20/12.
Finished SRT 04/16/12
Last Lupron shot 03/12
PSA and testostorone "undetectable" 07/12
Next PSA and testostorone test early January