Daoud MA, et al. - This study was designed to determine whether dose escalation for ≥ 76–80 Gy had an advantage in terms of biochemical disease-free survival (BDFS), distant metastasis-free survival (DMFS), or overall survival outcomes over the dose levels from 70 to <76 Gy. The BDFS and DMFS did not differ significantly between patients treated with a dose of <76 and ≥76 Gy, including elective pelvic lymph nodes irradiation combined with androgen deprivation therapy (ADT).

Methods

• A cohort of 24 patients classified with high- and intermediate-risk localized prostate cancer was studied.
• ADT was administered to all patients, starting at 4–6 months before radiation therapy and continued for a total period of 12–24 months in high-risk patients.
• In two phases, the treatment plan was provided.
• The nodal planning target volume (PTV) and the prostate PTV in the first phase received 48.6 and 54 Gy, respectively, over 27 fractions.
• Through intensity-modulated radiation therapy or volumetric modulated arc therapy with a simultaneous integrated boost technique, the treatment was applied.

Results

• Findings revealed that more than half of the patients were in T3–T4 stage; 79.1% of the patients were in the high-risk category.
• All patients received ADT.
• Acute grade II gastrointestinal and genitourinary toxicities were observed in 41.7% and 62.5%, respectively.
• For patients treated with dose levels <76 and ≥76 Gy, the rate of freedom from grade II rectal toxicity at 2 years was 89% and 83%, respectively.
• The rate of BDFS at 2 years was 90% and 85% for doses <76 and ≥76 Gy, respectively.
• At 2 years, the DMFS was 100% and 76% for dose levels <76 and ≥76 Gy, respectively.