[Comment] Impact of adding hormone therapy to postoperative radiotherapy in prostate cancer

Impact of adding hormone therapy to postoperative radiotherapy in prostate cancer Affiliations & Notes Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA Article Info Publication History: Published February 26, 2026 DOI: 10.1016/S0140-6736(26)00368-5 External LinkAlso available on ScienceDirect External Link Copyright: © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Linked Articles Download started OkThe addition of hormone therapy to radiotherapy improves overall survival in men with high-risk prostate cancer, over radiotherapy alone.1 Mechanisms proposed to explain this effect include cytoreduction, the androgen receptor's regulation of key DNA damage response pathways, and suppression of micrometastases.2,3 However, randomised trials evaluating the benefit of adding hormone therapy to postoperative radiotherapy (PORT) have yielded conflicting results.4–9 References 1. Kishan, AU ∙ Sun, Y ∙ Hartman, H ∙ et al., the MARCAP Consortium group Androgen deprivation therapy use and duration with definitive radiotherapy for localised prostate cancer: an individual patient data meta-analysis Lancet Oncol. 2022; 23:304-316 2. Pilié, PG ∙ Tang, C ∙ Mills, GB ∙ et al. State-of-the-art strategies for targeting the DNA damage response in cancer Nat Rev Clin Oncol. 2019; 16:81-104 3. Shore, ND ∙ Luz, MA ∙ De Giorgi, U ∙ et al. Improved survival with enzalutamide in biochemically recurrent prostate cancer N Engl J Med. 2025; 394:563-575 4. Shipley, WU ∙ Seiferheld, W ∙ Lukka, HR ∙ et al., the NRG Oncology RTOG Radiation with or without antiandrogen therapy in recurrent prostate cancer N Engl J Med. 2017; 376:417-428 5. Carrie, C ∙ Magné, N ∙ Burban-Provost, P ∙ et al. Short-term androgen deprivation therapy combined with radiotherapy as salvage treatment after radical prostatectomy for prostate cancer (GETUG-AFU 16): a 112-month follow-up of a phase 3, randomised trial Lancet Oncol. 2019; 20:1740-1749 6. Pollack, A ∙ Karrison, TG ∙ Balogh, AG ∙ et al. The addition of androgen deprivation therapy and pelvic lymph node treatment to prostate bed salvage radiotherapy (NRG Oncology/RTOG 0534 SPPORT): an international, multicentre, randomised phase 3 trial Lancet. 2022; 399:1886-1901 7. Parker, CC ∙ Clarke, NW ∙ Cook, AD ∙ et al., the RADICALS Investigators Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial Lancet. 2024; 403:2405-2415 8. Parker, CC ∙ Clarke, NW ∙ Cook, AD ∙ et al., the RADICALS Investigators Randomised trial of no, short-term, or long-term androgen deprivation therapy with postoperative radiotherapy after radical prostatectomy: results from the three-way comparison of RADICALS-HD (NCT00541047) Eur Urol. 2024; 86:422-430 9. Parker, CC ∙ Kynaston, H ∙ Cook, AD ∙ et al., the RADICALS Investigators Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial Lancet. 2024; 403:2416-2425 10. Kishan, AU ∙ Sun, Y ∙ Parker, CC ∙ et al. Hormone therapy use and duration with postoperative radiotherapy for recurrent prostate cancer: an individual patient data meta-analysis Lancet. 2026; published online Feb 26. https://doi.org/10.1016/S0140-6736(26)00137-6 11. Stewart, DJ ∙ Bradford, JP ∙ Sehdev, S ∙ et al. New anticancer drugs: reliably assessing “value” while addressing high prices Curr Oncol. 2024; 31:2453-2480 12. Mazzone, E ∙ Thomson, A ∙ Chen, DC ∙ et al. The role of prostate-specific membrane antigen positron emission tomography for assessment of local recurrence and distant metastases in patients with biochemical recurrence of prostate cancer after definitive treatment: a systematic review and meta-analysis Eur Urol. 2025; 88:129-141 13. Spetsieris, N ∙ Boukovala, M ∙ Alafis, I ∙ et al. Abiraterone acetate plus prednisone in non-metastatic biochemically recurrent castration-naïve prostate cancer Eur J Cancer. 2021; 157:259-267 14. Raychaudhuri, R ∙ Lin, DW ∙ Montgomery, RB Prostate cancer: a review JAMA. 2025; 333:1433-1446 15. Ong, WL ∙ Romero, T ∙ Roy, S ∙ et al., the MARCAP Consortium Investigators Testosterone recovery following androgen suppression and prostate radiotherapy (TRANSPORT): a pooled analysis of five randomized trials from the Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium Eur Urol. 2025; 87:49-57 16. Tang, C ∙ Sherry, AD ∙ Hwang, H ∙ et al. Metastasis-directed therapy and standard of care versus standard of care for oligometastatic prostate cancer (WOLVERINE): a systematic review and individual patient data meta-analysis from the X-MET collaboration Lancet Oncol. 2026; 27:181-190 17. Morgan, TM ∙ Boorjian, SA ∙ Buyyounouski, MK ∙ et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part i: introduction and treatment decision-making at the time of suspected biochemical recurrence after radical prostatectomy J Urol. 2024; 211:509-517 18. Freedland, SJ ∙ de Almeida Luz, M ∙ De Giorgi, U ∙ et al., the EMBARK Study Improved outcomes with enzalutamide in biochemically recurrent prostate cancer N Engl J Med. 2023; 389:1453-1465 19. National Comprehensive Cancer Network Prostate cancer, version 5 https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf Date: 2026 Date accessed: February 16, 2026