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Let’s poke the bear a little. One of our residents asked me to explain some of the fine details and well, I can’t. I bolded their specific questions.
Clinicians may counsel patients with prostate cancer that proton therapy is a treatment option, but it has not been shown to be superior to other radiation modalities in terms of toxicity profile and cancer outcomes. (Conditional Recommendation; Evidence Level: Grade C
My thoughts on this depend on what is grade C, recommending protons at all, or the idea that they have not shown superiority. One of those statements is not an opinion and supported by level one evidence at this point.
Clinicians should offer moderate hypofractionated EBRT for patients with low- or intermediate-risk prostate cancer who elect EBRT. (Strong Recommendation; Evidence Level: Grade A)
I typically do use it, but come on, there is no measurable advantage in terms of efficacy or toxicity (if anything a toxicity cost). It feels like at least one should be true to make something the preferred treatment.
Clinicians may counsel patients with prostate cancer that proton therapy is a treatment option, but it has not been shown to be superior to other radiation modalities in terms of toxicity profile and cancer outcomes. (Conditional Recommendation; Evidence Level: Grade C
My thoughts on this depend on what is grade C, recommending protons at all, or the idea that they have not shown superiority. One of those statements is not an opinion and supported by level one evidence at this point.
Clinicians should offer moderate hypofractionated EBRT for patients with low- or intermediate-risk prostate cancer who elect EBRT. (Strong Recommendation; Evidence Level: Grade A)
I typically do use it, but come on, there is no measurable advantage in terms of efficacy or toxicity (if anything a toxicity cost). It feels like at least one should be true to make something the preferred treatment.
