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July 14, 2010

Conventional and High-Dose Radiation in Treating Early Prostate Cancer—Reply

JAMA. 2010;304(2):155-156. doi:10.1001/jama.2010.929

In Reply: In response to Dr Vikram, our Editorial was designed to present an overall summary of the JAMA cancer theme issue, and therefore included only a brief summary of the novel information in each research article, rather than a detailed discussion of study methods, limitations, or interpretation, or specific comments on the implications of the study findings for clinical practice, patient outcomes, or the health care system.

However, the notable findings in the study by Talcott et al1 and the earlier report by Zietman et al2 were that (1) at 5 years, a significantly higher proportion of men remained free of biochemical failure in the higher-dose radiation group (80.4%) vs the conventional-dose treatment group (61.4%) and that (2) at a median of 9.4 years following treatment, there were no significant differences in key functional parameters between conventional-dose and high-dose treatment, such as urinary obstruction, urinary incontinence, bowel problems, and decreased sexual function. Furthermore, at a median follow-up time of 8.9 years, long-term cancer control was still significantly higher in the high-dose vs conventional-dose treatment groups.3

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