An attempt to optimize treatment strategy using a novel risk categorization of prostate cancer

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There are many options in radiotherapy for prostate cancer, including external beam radiotherapy (EBRT), low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy. However, it is still unclear which patient-group is suitable for which option or its optimal radiation dose. We developed an original risk-grouping method named PRIX (Prostate Cancer Risk Index). In EBRT, PRIX 0 group did not required radiation dose-escalation, while PRIX 1-6 needed it. In brachytherapy, both LDR and HDR showed good results in PRIX 0. HDR also showed satisfactory results in PRIX 1-6, which implied thatescalating the biological effective dose by hypofractionation was associated with better results. We are planning next clinical trials, including LDR brachytherapy for PRIX 1, stereotactic radiotherapy using CyberKnife, and hypofractionated intensity-modulated radiotherapy, based on these findings obtained by this study.