Based on the recent guidelines, should prostate SBRT dose be no higher than 3625 cGy in 5 fractions?
We have delivered prostate SBRT in high volume using 3,800 cGy/4 fx since 2006. The UCSF group has also used this schedule in a large number of patients for a similar time frame. For over a decade prior to that, the exact same dose regimen was used with HDR brachytherapy and published as "safe and e...
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 risk, and unfavorab...
I thought I'd update my answer since a lot has changed since 2018, but this is still a good question. The core of my previous answer is still correct, because of two important things:
- There is a plethora of data at the 36.25 Gy/5 Fx dose that shows it to be effective and of low toxicity.
- The 36.25 Gy/...
I think that 36.25 Gy to the PTV provides a very reasonable balance between risks and benefits. However, I’m not sure if this prescription alone is sufficient to maintain the excellent control rates that standard hypofractionation yields. Currently, I utilize a treatment based on PACE-B (van As et a...
As this thread has been revived, I will weigh in. As summarized nicely by Krishnan Patel, the RCT evidence supports 40 Gy/5 fx as non-inferior to standard non-SBRT regimens, with a slight increase in side effects. Thus, that is the standard in my view until we have new RCT evidence.
Focal boost is di...