RADAR rads.

Radiation in the TROG trial was an interesting sideshow. Browse the protocol here. All patients received treatment to the prostate and seminal vesicles but not to the pelvic lymph nodes. Centers were allowed to select from 1 of 3 dosing schemes: 66 Gy (10%), 70 Gy (40%), and 74 Gy (25%) all at 2 Gy per fraction. Or they could opt to deliver 46 Gy external beam followed by a 19.5 Gy HDR brachytherapy boost in 3 fractions (20%). Luckily these differences in dose schemes were accounted for in the trial stratification. All patients started radiation 5 months after ADT. Per this manuscript, reports of interaction of radiation dose and ADT duration are forthcoming. Though this trial accrued during the early days of IMRT, techniques specified in the protocol aren’t what we’re used to today. TBL: Stay tuned for more outcomes with radiation dose escalation in the setting of short to intermediate duration ADT. | Denham, Lancet Oncol 2018


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