Patterns of Failure Following External Beam Radiotherapy With or Without an Additional Focal Boost in the Randomized Controlled FLAME Trial for Localized Prostate Cancer

Focal boosting up to 95 Gy in the FLAME trial improved rates of local failure and of regional + distant metastatic failure (rdMF) for patients with localized, mainly high-risk prostate cancer. Dose-response analyses showed the beneficial effect of higher doses to the tumor on rdMF and local failure, even when the boost dose of 95 Gy cannot be achieved because of dose constraints for organs at risk.