The RADICALS-RT (Radiotherapy – Adjuvant Versus Early Salvage) trial is a significant study that aimed to determine the optimal timing of radiotherapy after radical prostatectomy for men with prostate cancer. The trial compared the efficacy and safety of two strategies: 1. **Adjuvant Radiotherapy (ART):** This approach involves giving radiotherapy soon after surgery to all patients, regardless of whether there is evidence of rising PSA levels. The rationale behind ART is to eliminate any microscopic cancer cells that may remain after surgery, potentially reducing the risk of recurrence. 2. **Salvage Radiotherapy (SRT):** In contrast, salvage radiotherapy is given only if there is evidence of cancer recurrence, typically indicated by a rise in PSA levels after surgery. This strategy is more conservative, to avoid unnecessary treatment and its potential side effects for those patients who may not need it. The RADICALS-RT trial sought to answer whether immediate postoperative radiotherapy would provide better cancer control without undue side effects compared to waiting and providing radiotherapy only if PSA levels indicate a recurrence. The results from the trial indicated that for patients with postoperative PSA levels that are undetectable or very low, immediate radiotherapy did not significantly improve biochemical progression-free survival compared to the early salvage approach. Moreover, early salvage radiotherapy reduces patients’ exposure to the side effects of radiotherapy without compromising long-term cancer control. It is important to note that the trial results should be interpreted in the context of other similar studies, such as the ARTISTIC meta-analysis, which combines data from RADICALS-RT with similar trials like RAVES and GETUG-AFU 17. The combined analysis helps to provide a more comprehensive understanding of the role of adjuvant versus salvage radiotherapy in this setting. Clinical guidelines may evolve based on the results of these studies, and it’s always best to consult with a healthcare professional or oncologist to understand how the latest research applies to individual cases. Treatment decisions should be personalized, considering the patient’s circumstances, cancer characteristics, overall health, and preferences.   https://www.annalsofoncology.org/current.rss, image by Freepik