Radiotherapy dose intensification for high-risk prostate cancer - what is gained?
Mené en France sur 505 patients atteints d'un cancer de la prostate à haut risque (durée médiane de suivi : 9,5 ans), cet essai randomisé multicentrique de phase III évalue l'efficacité, du point de vue de la survie sans progression à 5 ans, d'une augmentation de la dose de radiothérapie (passant de 70 Gy à 80 Gy) en combinaison avec un traitement anti-androgénique
Can a modest increase in radiotherapy dose make a difference for a patient with high-risk prostate cancer? In The Lancet Oncology, Christophe Hennequin and colleagues present results from the GETUG-AFU 18 trial,1 which enrolled 505 patients across 25 centres in France to answer this important and relevant question. Participants were randomly assigned (1:1) to receive 70 Gy or 80 Gy to the prostate, along with 3 years of androgen deprivation therapy (ADT). The higher radiotherapy dose improved biochemical or clinical progression-free survival (the primary outcome) from 88·1% to 91·4% at 5 years and from 72·2% to 83·6% at 10 years (stratified hazard ratio 0·56, 95% CI 0·40–0·78). The trial provides convincing evidence of a progression-free survival benefit for high-dose radiotherapy, even when combined with very long-term ADT.
The Lancet Oncology , commentaire en libre accès, 2026