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Radiation Dose Escalation for Prostate Cancer

Sir Charles Gairdner Hospital Perth, Australia

To the Editor:Valicenti et al¹ analyzed data pooled from four Radiation Therapy Oncology Group trials in prostate cancer and found better survival with higher doses in high-grade prostate cancer. Although this is an interesting trend, we do not believe they are justified in concluding that higher-dose treatment offers a survival benefit. The analysis may be confounded by selection and staging biases. In the later trials, higher doses of radiation were allowed and patients were also likely to be more accurately staged. The Radiation Therapy Oncology Group has previously shown that differences in staging of prostate cancer can translate into survival differences.² The effect of increasing radiation dose on survival can be assessed only in randomized trials that are specifically designed to address this issue.

REFERENCES

1. Valicenti R, Lu J, Pilepich M, et al: Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the Radiation Therapy Oncology Group trials. J Clin Oncol 18: 2740-2746, 2000[Abstract/Free Full Text]

2. Asbell SO, Martz KL, Pilepich MV, et al: Impact of surgical staging in evaluating the radiotherapeutic outcome in RTOG phase III study for A2 and B prostate carcinoma. Int J Radiat Oncol Biol Phys 17: 945-951, 1989[Medline]

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Elsaleh, H. Articles by Bydder, S. Search for Related Content PubMed PubMed Citation Articles by Elsaleh, H. Articles by Bydder, S. Social Bookmarking                            What's this?