ABSTRACT
PURPOSE: The outcome of radiotherapy (RT) for prostate cancer (PCA) depends on the delivered dose. While the evidence for dose-escalated RT up to 80â¯gray (Gy) is well established, there have been only few studies examining dose escalation above 80â¯Gy. We initiated the present study to assess the safety of dose escalation up to 84â¯Gy. METHODS: In our retrospective analysis, we included patients who received dose-escalated RT for PCA at our institution between 2016 and 2021. We evaluated acute genitourinary (GU) and gastrointestinal (GI) toxicity as well as late GU and GI toxicity. RESULTS: A total of 86 patients could be evaluated, of whom 24 patients had received 80â¯Gy and 62 patients 84â¯Gy (35 without pelvic and 27 with pelvic radiotherapy). Regarding acute toxicities, noâ¯> grade 2 adverse events occurred. Acute GU/GI toxicity of grade 2 occurred in 12.5%/12.5% of patients treated with 80â¯Gy, in 25.7%/14.3% of patients treated with 84â¯Gy to the prostate only, and in 51.9%/12.9% of patients treated with 84â¯Gy and the pelvis included. Late GU/GI toxicity of grade ≥â¯2 occurred in 4.2%/8.3% of patients treated with 80â¯Gy, in 7.1%/3.6% of patients treated with 84â¯Gy prostate only, and in 18.2%/0% of patients treated with 84â¯Gy pelvis included (log-rank test pâ¯= 0.358). CONCLUSION: We demonstrated that dose-escalated RT for PCA up to 84â¯Gy is feasible and safe without a significant increase in acute toxicity. Further follow-up is needed to assess late toxicity and survival.