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Topics:
Radiation Oncology • Genitourinary Cancers
Would you consider modifying the dose for focal prostate boost to other fractionation schedules?
FLAME used an atypical fractionation scheme of 77 Gy in 35 fractions boosting MRI defined nodule to 95 Gy. Would you consider a 20-fraction or 28-fraction schedule? If so, how would you modify that?
Answer from: Radiation Oncologist at Academic Institution
DELINEATE was a phase II trial from the NHS which was designed to evaluate the toxicity of a simultaneous integrated boost (SIB) to the mpMRI-defined dominant intraprostatic nodule (DIL) for two fractionation schedules: conventional fractionation (cohort A) and hypofractionation in 20 fractions (coh...
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Answer from: Radiation Oncologist at Community Practice
I have done some patients with 70 in 28 fractions with 2.7 to 2.8 Gy SIB dose with same isotoxic OAR dose principle.
Answer from: Radiation Oncologist at Academic Institution
Yes. I do not think we need separate RCTs for each fractionation schedule. The principles from FLAME readily apply: you can do a focal tumor boost up to the point where you will meaningfully impact toxicity risk.I have used up to 74 Gy in 20 fractions and up to 84 Gy in 28 fractions. Using a/b=1.2 f...