Prostate Dose Escolation
Low-risk
- Phase III study by Zietman (Mass Gen) showed improved bDFS with 79.2 Gy vs 70 Gy for low-risk group.
Intermediate-risk
- Phase III study by Pollock (MDA) showed improved bDFS wtih 78 Gy (isocenter) vs 70 Gy for intermediate risk group.
Institutional Review
- Instituitional review by Zelefsky (MSK) and Fox Chase (not shown)
Risk Group | RT dose | bRFS |
---|---|---|
Favorable | 70.2 | 57% |
Favorable | 75.6 | 83% |
Intermediate | 70.2 | 42% |
Intermediate | 75.6 | 50% |
Unfavorable | 70.2 | 24% |
Unfavorable | 75.6 | 42% |
- IMRT group had bRFS 96%, 86% and 81% (81.0 Gy or 86.4 Gy)
- dose escalation improved bDFS in low and intermediate risk groups
- dose escalation should be considered in high-risk group as well based on instituitional (MSK, Fox) data.
- Zietman report significant increase in grade 2 or greater rectal adverse effects (18% vs 10%) and that the genitourinary tract–related adverse effects seem to continue to accumulate with longer follow-up.
page revision: 2, last edited: 23 May 2008 14:48