Is it appropriate to use moderate hypofractionation for the treatment of patients with high-risk prostate cancer?  

At Fox Chase, we conducted a phase III randomized prospective clinical trial comparing conventionally fractionated IMRT with moderately hypofractionated IMRT from 2002-2008, for men with intermediate and high risk prostate cancer.  Men were randomized to 76 Gy in 38 fractions or 70.2 Gy in 26 f...

There is a lack of level of level 1 evidence since all trials to date testing non-inferiority were primarily in low or int risk and very few high risk (CHHiP trial) men and in that later trial they only received 3 to 6 mos and not 28 to 36 mos of ADT. Also the f/u is still too short to asses clinic...

The standard of care for high risk prostate cancer is tri-modality treatment incorporating brachytherapy (either LDR or HDR) for optimal dose escalation to the prostate following the results of the ASCENDE-RT Trial (Morris et al., PMID 28262473). We usually use standard 2 Gy fractions for the pelvic...