Topics:
Radiation Oncology • Genitourinary Cancers
Given results of SAKK 09/10 in which dose escalation for salvage prostate radiotherapy to 70 Gy was not superior to 64 Gy, would you ever consider a higher dose?
For higher risk patients, eg PSA >0.5 or high risk gleason score, etc, would you consider dose escalation still? Prior data had suggested benefit to dose escalation.
Answer from: Radiation Oncologist at Academic Institution
For years, the dogma was that you needed at least 66 Gy to control disease in the prostate bed in patients with a biochemical failure. The SAKK 09/10 trial seemed to challenge that notion. Even in this population of patients who were relatively favorable in the sense that they were node negative, an...
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Answer from: Radiation Oncologist at Community Practice
The trial was underpowered IMHO. They assumed a median FFBF difference of 3.8 and 5.8 years between the two arms which was an estimation based on a 2.5% improvement in FFBF per Gray increase. Yes, there is some retrospective data supporting a 2% increase per Gy but these seem like a weak foundation ...
Answer from: Radiation Oncologist at Community Practice
Agree with @Mitchell S. Anscher highlighting “one could hypothesize that the reason the trial was negative was that in most patients all of the cancer was not included in the radiation field so the dose to the irradiated portion of the cancer really did not matter.”When EMPIRE-1 was...