J Clin Oncol: Enhanced topical radiotherapy improves disease control in patients with limited prostate cancer

The dose response relationship between in-body radiotherapy (EBRT) for the treatment of limited prostate cancer has been outlined.
the dose of the whole prostate up to 80 Gy is considered safe and effective.
study aims to study whether EBRT's lesions of visible tumors can improve bio-disease-free survival (bDFS) in patients with limited prostate cancer.
This is a Phase III, multi-center, randomized controlled microBoost trial of local lesions of prostate cancer, in which 571 patients with medium- and high-risk prostate cancer were recruited between 2009 and 2015, and after a random group, patients in the standard treatment group received 77 Gy (2.2 Gy/twice) of radiation throughout the prostate.
95 Gy (up to 2.7 Gy/d) lesions intensive radiotherapy was also received in the lesions intensive group.
end point is 5 years bDFS.
secondary endpoints were disease-free survival rate (DFS), no distant metastasis survival rate, prostate cancer-specific survival rate, overall survival rate, toxicity, and health-related quality of life.
followed for 72 months.
bio-DFS was significantly higher than the standard treatment group (risk ratio 0.45, 95% CI 0.28 to 0.71, p.lt;0.001).
follow-up five years, the enhanced group and the standard group bDFS were 92% and 85%, respectively.
there was no significant difference between prostate cancer-specific survival and total survival (p.49 and 0.50, respectively).
the cumulative rates of late genitourinary and gastrointestinal toxicity in the standard group 2 and above were 23% and 12%, respectively, compared with 28% and 13% in the fortified group.
differences in quality of life associated with health in the two groups were equally small and not statistically significant.
addition, intensive radiotherapy for tumor lesions in the prostate can further improve bDFS in patients with local high-risk prostate cancer on the basis of standard in-body radiotherapy of the whole prostate without affecting toxicity and quality of life.
the study shows that lesions focused radiotherapy enhancement strategies can improve tumor control methods effectively and safely without violating the dose limits of high-risk organs.