Proton radiation, with"boosting" the leison areas?

[CBRD]

My radiologist is prescribing that I have 29 sessions, and he wants to increase the dosage of the proton radiation specifically at the lesion areas. I've never heard of this protocol. Is there any data or clinical studies to suggest that this "boosting" addition will decrease the risk in any meaningful way of a reoccurrence within the prostate, and regardless, that it doesn't come with an increase in side effects or risk of secondary cancer?

[GP24]

The new radiation systems allow for increased doses to specific areas within the prostate. I would get that done to avoid reoccurrence. There are studies, but I currently do not remember them. Sometimes they use a brachytherapy boost added to the radiation.

[WisdomSeeking]

You may look at this post by Tall_Allen on his blog:

Higher dose improves results in high-risk patients

prostatecancer.news/2024/01...

[CBRD in reply to WisdomSeeking]

I'm G4+3, and no sign of spread beyond the prostate per PMSA. Not sure if this makes a difference?

[GP24 in reply to CBRD]

Gleason 4+3 belongs in the high risk group. I would try not to get a high dose to the entire prostate but lesions within the prostate should be treated with a higher dose if possible. A recurrence after RT is difficult to treat, I would try to avoid that.

[Tall_Allen]

The FLAME trial proved that results are better with boosting, with no detriment to the side effect profile. You can read about it here:

prostatecancer.news/2021/01...