“Radiation Therapy Dose Escalation for Prostate Cancer: a Rationale for IMRT.”
Pollack, A.; Hanlon, A.; Horwitz, E.M.; Feigenberg, S.; Uzzo, R.G.; Price, R.S. World J Urol. 2003 Sep;21(4):200-8.
During the pre-PSA era, radiation doses of 64-70 Gy were considered relatively modest, but standard protocol. Doses above 70 Gy were associated with a significant reduction in biochemical failure. Now, using 3D-conformal radiation through the application of intensity modulated therapy results in dose escalation with reduced rectal and bladder exposure and more accurate targeting of the prostate.
“Radiation Dose Escalation for Localized Prostate Cancer: Intensity-modulated Radiotherapy Versus Permanent Transperineal Brachytherapy.”
Wong, W.W.; Vora, S.A.; Schild, S.E.; Ezzell, G.A.; Andrew, P.E.; Ferrigni, R.G.; Swanson, S.K. Cancer. 2009 Dec 1;115(23):5596-606.
Of the 853 participants in this study, 270 received conventional dose 3-dimensional conformal radiotherapy (3D-CRT), 314 received high-dose intensity-modulated radiotherapy (IMRT), 225 received permanent transperineal brachytherapy, and 44 received external beam radiotherapy (EBRT) with a brachytherapy boost. The median follow-up was 58 months. The results of this study indicate that radiation dose escalation improved biochemical control, and IMRT, specifically, caused less acute and late genitourinary toxicity.