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Conventional and High-Dose Radiation in Treating Early Prostate Cancer

Bhadrasain Vikram, MD
JAMA. 2010;304(2):155-156. doi:10.1001/jama.2010.927.
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To the Editor: Dr Talcott and colleagues1 described patient-reported outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer. Neither the article nor the accompanying Editorial by Dr Pasche and colleagues2 addressed 2 key findings.

First, patients receiving higher-dose radiation did not live any longer than those who received the lower dose. It is fortunate, as the Editorial noted, that the former patients did not report worse toxicity, but that does not make it acceptable to continue treating patients with the higher dose when it neither prolongs survival nor reduces symptoms (but costs substantially more because protons or intensity-modulated radiation therapy must be used). By simply noting that “ . . . many patients now receive higher-dose radiation” but failing to comment, the Editorial implies that this practice is acceptable.

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References

July 14, 2010
James A. Talcott, MD, SM; Anthony L. Zietman, MD
JAMA. 2010;304(2):155-156. doi:10.1001/jama.2010.928.
July 14, 2010
Boris Pasche, MD, PhD; Robert A. McNutt, MD; Phil B. Fontanarosa, MD, MBA
JAMA. 2010;304(2):155-156. doi:10.1001/jama.2010.929.
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