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Rad Oncology Homepage

Fivefold difference found in Medicaid reimbursements for radiotherapy May limit access to healthcare, especially in rural areas

Trends in radiation oncology workforce potentially threaten rural patients, says study More radiation oncologists leaving, fewer coming in to rural areas

Varian showcases first preclinical findings of Flash therapy trial Reductions in radiation lung fibrosis and dermatitis

Female oncologists submit fewer charges, paid less than male Study bases findings on Medicare records

Four considerations before embarking on a carbon therapy center The next frontier in improving cancer care

Q&A with Scott Warwick, executive director of the National Association for Proton Therapy Find out what to expect at the year's biggest proton therapy industry event

New approach identifies lung cancer patients most likely to respond to chemotherapy Combines radiomics and CT image assessment

Aussies and Americans develop 3D models for assessing impacts of radiotherapy Test different levels and types of radiation

Law in Ontario prevents cremation of brachytherapy patients Experts call for eliminating the law, as it deters patients from lifesaving treatment

IBA tech plays first-time role in flash therapy demonstration Supports eventual integration of flash as clinical treatment

Doesn't affect survival rate

Higher radiation dose isn't the best option for prostate cancer

by Lauren Dubinsky , Senior Reporter
Research published in JAMA Oncology on Thursday revealed that higher doses of radiation don’t improve survival for many prostate cancer patients, compared with standard radiation treatment.

“Over the past two decades radiation oncologists have become adept at treating men to these higher radiation doses, as long as they respect normal tissue tolerances,” Dr. Jeff M. Michalski, professor at the University of Washington School of Medicine, told HCB News. “I believe we will continue to see this approach, but physicians will not be aggressively taking risks knowing that it won’t benefit their patient to increase their possibility of side effects.”

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For the study, Michalski and his team evaluated 1,500 patients with intermediate-risk prostate cancer. The patients were split into two groups – 748 received standard treatment and 751 received dose-escalation treatment.

They did observe significantly lower rates of recurrence, tumor growth and metastatic disease in the group that received high doses of radiation, but there was no significant difference in survival. After eight years of follow-up, 75 percent of the standard treatment group and 76 percent of the dose-escalation treatment group were still alive.

Since prostate cancer is common in older men, most of the deaths in the trial population were caused by things other than prostate cancer. In addition, six new therapies were approved for recurrent or metastatic prostate cancer during the study period that have been shown to improve survival.

Michalski believes that higher doses of radiation should be avoided if the clinician is unable to safely deliver it. For instance, if the patient’s rectum or bladder can be spared well enough, high doses shouldn’t be used.

“We also need to better identify the patient populations that might benefit from improvements in local therapy,” said Michalski. “The next generation of NRG trials are using genomic testing to better identify patients that are at a risk of death from prostate cancer.”

Rad Oncology Homepage


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