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ProtecT (cribriform 2° analysis): in cribriform-negative pts (87%), radical Rx gave no significant 15yr metastasis cut vs active monitoring; morphology may gate surveillance.
Prostate carried the day. ProtecT's cribriform 2° analysis backs morphology-gated surveillance: cribriform-negative men (87%) got no significant 15yr metastasis benefit from radical surgery or RT+ADT, and their GG2 matched GG1 risk. ESTRO's Delphi consensus separately codifies primary prostate SBRT selection, dose, and contouring where trials still disagree.
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- ESTRO Prostate SBRT Consensus Recommendations15-expert ESTRO Delphi consensus on optimising primary prostate SBRT: patient selection, contouring, dose/fractionation, follow-up, and delivery technique.
- ProtecT (secondary analysis: cribriform morphology)Cribriform-negative pts (87%): radical Rx gave no significant 15yr metastasis reduction vs active monitoring; cribriform-negative GG2 matched GG1 risk.
- NRG Oncology/RTOG 0848OS primary EP not met (HR 0.96, 90% CI 0.79-1.18) adding adjuvant CXRT to gemcitabine; node-negative subgroup OS benefit on interaction (P=.0063).
- TROG 08.03 RAVES QOL SubstudyAt 5yr, 16% vs 2% severe urinary leakage aRT vs no RT (p=0.01); sRT timing had no QOL effect.
- STAMPEDE (abiraterone ± enzalutamide, high-risk non-metastatic)MFS HR 0.53 (6yr 82% vs 69%) and OS HR 0.60 adding 2yr abiraterone to ADT in high-risk M0 prostate (85% also had RT).
- TREASUREmOS 6.7 vs 13.4mo (HR 1.55, ns) adding consolidative TRT to atezo maintenance; halted early for SAEs 61% vs 18%.
- EANO Consensus Statement on Radiation NecrosisDelphi consensus (20 experts): 53/57 statements reached ≥80% agreement; perfusion MRI + amino-acid PET to distinguish RN from recurrence, bevacizumab for steroid-refractory RN.
- HYDRANo PFS difference vs conventional RT for either MHFRT type, but dose-escalated MHFRT alone raised late G2+ GI + bowel-QoL decrement; isodose 60/20 clean.
- ASTRO 2024: SBRT for Unfavorable Intermediate-Risk Prostate CancerModern 5-fraction SBRT (1-2% bothersome toxicity vs 10-30% for 2D-era 45fx) is now NCCN-endorsed for UIR prostate; focal-boost de-escalation is next.
- SUPREMO10yr chest-wall recurrence 1.1% vs 2.5% (HR 0.45), no DFS/OS gain, but trial prohibited RNI so tests incomplete PMRT.
- ESTRO Oral Cavity CTV Delineation GuidelinesNew consensus recipe for post-op CTV: recreate pre-op GTV-P +10mm composited with surgical defect/flap +5mm; standardizes OCSCC delineation at EQD2 60 Gy.
- 10-yr SBRT for Prostate Cancer (Meier Nonrandomized Trial)10-yr OS 84%, RFS 90% (94% LR, 86% IR); late G3 GU/GI ≤1.5%, no G4-5; 40Gy/5fx SBRT, no ADT, 21 centers