Postoperative radiotherapy can play in important role in the treatment of prostate cancer, 
but refining patient selection could improve outcomes and spare patients unnecessary toxicity. A UCSF team led by Felix Feng, MD, reported in Lancet Oncol. 2016 Oct 12 on a gene expression profile that can be used to predict which patients are most likely to benefit from radiation treatment after surgical removal of the prostate.
The team conducted the matched, retrospective study by analyzing cases from five published U.S. studies of patients who had radical prostatectomy, with or without postoperative radiotherapy. All patients in these studies had gene expression analysis of the tumor, with long-term follow-up and complete clinical and pathological data. Using complex statistical modeling, the UCSF research team developed a 24-gene Post-Operative Radiation Therapy Outcomes Score (PORTOS) that could help predict which patients were more likely to benefit from postoperative radiotherapy. The study found that men with a high PORTOS who underwent radiotherapy had a reduced incidence of distant metastasis 10 years after surgery; men with a low PORTOS did not show a similar benefit from radiation treatment.
Lancet Oncol. 2016 Oct 12. Development and validation of a 24-gene predictor of response to postoperative radiotherapy in prostate cancer: a matched, retrospective analysis.
Zhao SG1, Chang SL1, Spratt DE1, Erho N2, Yu M3, Ashab HA2, Alshalalfa M2, Speers C1, Tomlins SA4, Davicioni E2, Dicker AP5, Carroll PR6, Cooperberg MR6, Freedland SJ7, Karnes RJ8, Ross AE9, Schaeffer EM10, Den RB5, Nguyen PL11, Feng FY12.