Great post, though one quibble I have is of 60Gy/20fx being not “high dose.” The PROFIT trial showed equal biochemical control with modern, dose-escalated conventional frac.
Thank you for reading - I agree - PROFIT great trial. My gen argument is that we should try to achieve 90% DFS for most IR cases minimizing ADT and I don't think 60/20 is quite enough. Even in PACE B, they bump it to 63 / 20. So I'm generally more on side of arguing more EQD2 dose and less ADT - 60 gets us to 85%. I discuss at more length here: https://protons101.substack.com/p/protons-101-prostate-cancer-can-we
But yes, I'm a bit of outlier and your interpretation of the data is most accepted today. Thanks again for reading and the comment.
Great post, though one quibble I have is of 60Gy/20fx being not “high dose.” The PROFIT trial showed equal biochemical control with modern, dose-escalated conventional frac.
Thank you for reading - I agree - PROFIT great trial. My gen argument is that we should try to achieve 90% DFS for most IR cases minimizing ADT and I don't think 60/20 is quite enough. Even in PACE B, they bump it to 63 / 20. So I'm generally more on side of arguing more EQD2 dose and less ADT - 60 gets us to 85%. I discuss at more length here: https://protons101.substack.com/p/protons-101-prostate-cancer-can-we
But yes, I'm a bit of outlier and your interpretation of the data is most accepted today. Thanks again for reading and the comment.