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Radiation Oncology • Genitourinary Cancers
If using 26-fraction moderate hypofractionation, what dose do you use for the intraprostatic dominant nodule SIB?
The FLAME trial demonstrated a significant improvement in 5-year DFS, without any significant changes in overall toxicities, when patients being treated to 77 Gy in 35 fractions received a prostate nodule SIB to 95 Gy.
Answer from: Radiation Oncologist at Academic Institution
The definition of a nominal prescription dose for a focal boost is a confusing topic as often times the coverage at a given prescription dose is outside the realm of what is usually considered a valid prescription dose (i.e., coverage at a requested prescription dose is < 95%), and a prior thread...
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Answer from: Radiation Oncologist at Community Practice
If giving 70 Gy/28 Fx to the prostate, my default Rx for the DIL is 84 Gy/28 fx, work backward from there if I cannot meet urethra/rectal dose constraints.
Answer from: Radiation Oncologist at Academic Institution
Agree with the thorough posts above. In line with trying to avoid toxicity and the absence of data on 26-fx regimens, we currently prescribe prostate to 70.2 in 26 and DIL to 78.
Comments
Radiation Oncologist at Christus St Vincent
Thank you. This sounds like a reasonable and safe ...
Thank you. This sounds like a reasonable and safe ...
Answer from: Radiation Oncologist at Academic Institution
The NRG-GU010 micro boost doses are all aiming for BED3 of 180, so for 26 fractions, that would be 3.3 Gy/fx to a total of 85.8 Gy. In practice though, I have found it rare that we can obtain reasonable coverage at these suggested doses while meeting urethra and rectum constraints; so to help clarif...