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To the Editor: In their study of the effect of adjuvant postoperative radiotherapy on the clinical outcome for men with stage T3 prostate cancers, Dr Thompson and colleagues¹ demonstrated that external beam radiation therapy in the range of 60 to 64 Gy resulted in a statistically significant reduction in the risk of prostate-specific antigen relapse and disease recurrence, while improvement in disease-free-survival was close to statistical significance. Overall survival did not appear to be affected by postoperative radiation therapy.

There are 2 points to consider when drawing clinically relevant conclusions from this article. First, the radiation dose used in this study may have been suboptimal to control microscopic disease. Valicenti et al² concluded that postoperative radiation doses of 64.8 Gy or higher were significantly more effective than lower doses in men with stage T3 prostate cancers. Consequently, use of higher doses of radiation by Thompson et al might have led . . . [Full Text of this Article]

David L. Sherr, MD
dls9003@med.cornell.edu
Department of Radiation Oncology
Weill Medical College of Cornell University
New York, NY

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