Topics:
Radiation Oncology • Genitourinary Cancers
Based on the recent guidelines, should prostate SBRT dose be no higher than 3625 cGy in 5 fractions?
The recently published executive summary from ASTRO/ASCO/AUA hypofractionated radiation therapy for localized prostate cancer states "Five-fraction prostate ultrahypofractionation at doses above 3625 cGy to the planning target volume is not suggested outside the setting of a clinical trial or multi-institutional registry due to risk of late toxicity. Strength of recommendation: Conditional; Quality of evidence: Moderate; Consensus: 100%." If your current practice is 4000 cGy in 5 fractions, for example, do you plan to change your regimen based on this publication?
Answer from: Radiation Oncologist at Academic Institution
In the absence of a randomized trial it is difficult to definitively conclude that higher doses are definitely superior. In addition it is very likely that the outcomes of SBRT for prostate cancer depends upon the risk group we are dealing with (low risk, favorable–intermediate ris...
Answer from: Radiation Oncologist at Academic Institution
I believe that the recommendation for the dose of 36.25Gy is due to the plethora of data coming from that dose. Those data are long term with good control rates and low toxicity. As a result, it is easy to make that recommendation. Having said that, the dose escalation study by Timmerman started at ...
Comments
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
Yet, another great thread on themednet. Since we a...
Yet, another great thread on themednet. Since we a...
Very valid points. Everyone should remember that t...
Off of the above mentioned protocol, I have common...
It should be noted that note all SBRT is created e...
I have personally used the fractionation schemes o...
Thank you! Very practical and helpful comments @Da...