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Abstract Background In men with a rising PSA following radical prostatectomy, salvage radiation therapy (SRT) offers a second chance for cure. Hormonal therapy can be combined with SRT in order to increase prostate tumor control, albeit with associated higher rates of treatment side effects. This trial studies the effectiveness of SRT combined with hormonal therapy using a more potent anti-androgen with a favorable side effect profile. Enzalutamide, a next generation selective androgen receptor antagonist, is approved by the Food and Drug Administration for the treatment of metastatic castrate-resistant prostate cancer (CRPC) where it has been shown to improve overall survival in combination with androgen deprivation therapy. The primary objective of this study is to evaluate the efficacy of combination SRT and enzalutamide for freedom-from-PSA-progression. Secondary objectives include time to local recurrence within the radiation field, metastasis-free survival and safety as determined by frequency and severity of adverse events. Methods/design This is a randomized, double-blind, phase II, prospective, multicenter study in adult males with biochemically recurrent prostate cancer following radical prostatectomy. Following registration, enzalutamide 160 mg or placebo by mouth (PO) once daily will be administered for 6 months. Following two months of study drug, external beam radiotherapy to 66.6–70.2 Gray (Gy) will be administered to the prostate bed over 7–8 weeks while continuing daily placebo/enzalutamide. This is followed by two additional months of placebo/enzalutamide. Discussion The SALV-ENZA trial is the first phase II placebo-controlled double-blinded randomized study to test SRT in combination with a next generation androgen receptor antagonist in men with high-risk recurrent prostate cancer after radical prostatectomy. The primary hypothesis of this study is that clinical outcomes will be improved by the addition of enzalutamide compared to standard-of-care SRT alone and pave the path for phase III evaluation of this combination. Trial registrations ClinicaltTrials.gov Identifier: NCT02203695 Date of Registration: 06/16/2014. Date of First Participant Enrollment: 04/16/2015.

Abstract Introduction Currently, there is a lack of formalized educational curricula for medical students rotating through radiation oncology electives. A curriculum including both didactics and hands-on training has been developed and implemented at numerous institutions throughout the nation. We have developed an additional module to augment this curriculum and give students experience with contouring tools used in treatment planning software. We also aim to teach a functional approach to contouring an unfamiliar target volume, a task certainly encountered during the early months of residency. Methods This module was developed using a CT image set of a prostate cancer patient who has undergone prostatectomy. The clinical target volume (CTV) for this patient was delineated and confirmed by two genitourinary radiation oncology experts. A teaching guide, in PowerPoint format, was constructed to provide educational information on prostate and pelvic anatomy, contouring resources, and a step-by-step guide to contouring this specific CTV. Results Across two institutions, 24 students completed the contouring module, and 21 completed the post-session evaluation. Out of the 21 who completed the postsession evaluation, eight students had participated in the care of a post-prostatectomy patient, and three were familiar with post-prostatectomy contouring guidelines. All students regarded this exercise as “moderately” (five students), “quite” (eight students), or “extremely” (eight students) important. The students reported their comfort/confidence level with a number of tasks. Many more students felt “moderately,” “quite,” or “extremely” comfortable (in contrast to “slight” or “not at all”) after the teaching intervention for the following questions: ability to contour a PF (four students before vs. 20 after), ability to find and use contouring resources (10 before vs. 21 after), knowledge of CT prostate/pelvis anatomy (eight before vs. 21 after), and ability to use treatment planning software (nine before vs. 21 after). Discussion In the future, we would like to expand this module to include many additional institutions. Additionally, modules for other commonly treated anatomic sites can be developed built on the same educational framework.