8 They found that higher doses decrease the risk of biochemical recurrence by about 1.8%/Gy of radiation (or about 18% risk reduction for an extra week of conventionally fractionated radiation). 6, 7 A meta-analysis of five of these trials was done by Viani and colleagues. There have been five RCTs examining the benefit of dose escalation in prostate cancer using higher external beam doses, 1 – 5 and two looking at delivering biologically higher doses using a brachytherapy boost. In the hierarchy of evidence-based medicine, randomized controlled trials (RCTs) are considered the best “unfiltered information,” while systematic reviews and evidence-based guidelines are considered the best “filtered information.” The higher the quality of our scientific data, the less likely we are to make “incorrect” recommendations put another way, the recommendations will be closer to the truth. ![]() Evidence-based medicine is the practice of identifying and synthesizing the highest quality of data to best inform our clinical decision-making. Higher quality inputs lead to better outcomes. Evidence of biological dose escalation in prostate cancer
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