Radiation Therapy Continuation for Prostate Cancer
This patient should continue with the remaining 5 fractions of radiation therapy to complete the prescribed 7,000 cGy total dose, with each remaining treatment delivering 250 cGy per fraction as currently scheduled. 1
Current Treatment Status
The patient has completed:
- 23 of 28 prescribed fractions 1
- 5,750 cGy delivered (82% of total prescribed dose) 1
- 5 remaining fractions needed to reach the 7,000 cGy target 1
Rationale for Completing Full Course
For patients with prostate cancer receiving definitive radiation therapy, doses between 78 and 80+ Gy provide improved PSA-assessed disease control, particularly for intermediate- or high-risk disease. 1 The prescribed 7,000 cGy (70 Gy) falls within the evidence-based range of 75.6 to 79 Gy in conventional fractionation that demonstrates appropriate disease control. 1
The current fractionation scheme of 250 cGy per fraction is consistent with standard practice for prostate cancer with pelvic lymph node irradiation. 1
Treatment Completion Protocol
Continue daily fractions of 250 cGy until reaching 28 total fractions: 1
- Maintain the current treatment schedule without interruption
- Each remaining session delivers 250 cGy to the reference point (Prost_SV_Pelv) 1
- Final cumulative dose will be 7,000 cGy as prescribed 1
Critical Monitoring During Remaining Treatment
Weekly assessment is mandatory during the remaining treatment course: 1
- Monitor vital signs and weight at each visit 1
- Check blood counts regularly 1
- Assess for acute toxicity symptoms 1
Prophylactic supportive care should be maintained: 1
- Continue antiemetics on a prophylactic basis 1
- Provide antidiarrheal medications as needed 1
- Ensure adequate hydration throughout treatment 1
Important Considerations
Treatment interruptions should be avoided for manageable acute toxicities. 1 Careful patient monitoring and aggressive supportive care are preferable to treatment breaks, as interruptions can compromise disease control outcomes. 1
Image-guided radiation therapy (IGRT) should be utilized for daily prostate localization to improve oncologic cure rates and reduce side effects. 1 This includes techniques such as CT, ultrasound with implanted fiducials, or electromagnetic targeting/tracking. 1
Post-Treatment Follow-Up
After completing the full 7,000 cGy course, the patient will require: