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There are several
studies that prove better results with
escalation of radiation therapy dose in
treatment of localized prostate cancer. The
better results where mainly in the
biochemical progression free survival (blood
PSA levels). There was no survival benefit.
The main randomized trials are summarized in
the table below:
Prospective Studies
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www.TheBestOncologist.com
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Group/ coutry
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First author
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Journal and year
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Parameter examined
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Doses compared (GY)
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Results
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P
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UK/ MRC
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Dearnaley et al
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Lancet Oncol
2007
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bPFS 5Yr
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64
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74
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60%
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71%
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0.0007
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Dutch study
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Peeters et al.
Al-Mamgani et al.
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J Clin Oncol
2006
Red Journal
2008
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Freedom from
failure 5yr
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68
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78
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54%
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64%
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0.02
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MD Anderson
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Kuban et al.
Pollack et al.
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Red Journal
2008
JCO 2000
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Freedom from
failure 8yr
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70
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78
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59%
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78%
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0.004
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Clinical
failure 8yr
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15%
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7%
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0.014
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MGH/ Loma Linda
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Zietman et al.
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JAMA 2005
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bFFF 5 yr
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70.2
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79.2
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61.4%
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80.4%
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<0.001
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GETUG 06
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Beckendorf et al
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Red Journal 2011
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5 years biochemical relapse rate
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70
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80
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39%
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28%
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0.036
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The first
randomized study on dose escalation for
prostate cancer was published by Pollack et
al. in 2000, and a follow-up was published
in 2008. This study show that dose
escalation decrease freedom from biochemical
or clinical failure, and from clinical
failure. High risk patients and patients
with PSA > 10 ng/ml benefited more. In the
updated publication, low risk patients with
the higher dose were more free from failure.
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