Commenting on both RADICALS-RT and the meta-analysis, formal discussant Gert de Meerleer, MD, of the University Hospital, Leuven, Belgium, stated: “A big applause for these trials. I agree with both conclusions and congratulate both groups of authors for finding noncommercial funding.”

Dr. de Meerleer continued: “The aim is cure. You have to add early salvage radiotherapy as the keystone of choice after prostate-specific antigen (PSA) relapse following radical prostatectomy. Salvage radiotherapy is probably the modality of choice, provided it is [given] early.”

“Don’t miseducate yourself or your colleagues,” he cautioned. “Do not wait until the PSA level rises to 0.4 ng/mL, and do not take this into routine clinical practice. You have to refer the patient for radiotherapy early—at 0.2 ng/mL maximum.” 

DISCLOSURE: Dr. de Meerleer reported no conflicts of interest.