Trial reportEuropean urology2022
Patterns of Failure Following External Beam Radiotherapy With or Without an Additional Focal Boost in the Randomized Controlled FLAME Trial for Localized Prostate Cancer.
Trial report in European urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01168479 (FLAME), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
FLAME: Single Blind Randomized Phase III Trial to Investigate the Benefit of a Focal Lesion Ablative Microboost in Prostate Cancer
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- The Determinants of Toxicity in the Treatment of Prostate Cancer With a Focal, Intraprostatic "Microboost".International journal of radiation oncology, biology, physics · 2025Pooled it
- Focal radiotherapy boost to MR-visible tumor for prostate cancer: a systematic review.World journal of urology · 2024Pooled it
- Prostate and pelvic SABR with or without a focal boost: results from a multicenter phase II prospective clinical trial.Clinical and translational radiation oncology · 2027Article
- Ultrahypofractionation of localized prostate cancer-an updated statement of the prostate cancer working group of the German Society of Radiation Oncology (DEGRO).Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Trial protocol: RadTARGET, a multicenter phase II randomized controlled trial evaluating focal radiotherapy boost with de-intensification of dose to non-suspicious prostate in patients with intermediate- or high-risk prostate cancer.Clinical and translational radiation oncology · 2026Article
- External beam focal boost radiotherapy to intraprostatic lesions in prostate cancer: a scoping review.Physics and imaging in radiation oncology · 2026Review
- Assessing inter-observer variability in prostate and GTV segmentation on mpMRI: A comparison between radiation oncologists and AI-based method.Journal of applied clinical medical physics · 2026Article
- A prescription-free, radiobiology-based framework for automated VMAT planning: A feasibility study in primary prostate cancer radiotherapy.Medical physics · 2026Article
- Current state of the art of new prostate MRI technologies and potential future developments.BJR open · 2026Review
- PrecisionPro Fusion: Clinical validation of an automated, rigid, Prostate-Specific MRI-CT Fusion system for prostate radiotherapy planning.Technical innovations & patient support in radiation oncology · 2025Article
- Dose Intensification to the Dominant Intraprostatic Lesion During Prostate Stereotactic Body Radiation Therapy Delivered on a Magnetic Resonance Imaging Linear Accelerator: Feasibility and Early Clinical Outcomes.Advances in radiation oncology · 2025Article
- Ultra-hypofractionated radiotherapy with focal boost for high-risk localized prostate cancer (HYPO-RT-PC-boost): in silico evaluation with histological reference.Acta oncologica (Stockholm, Sweden) · 2025Article
- Integration of prostate-specific membrane antigen-PET and multiparametric MRI for gross tumour volume definition in localised and locally advanced prostate cancer treated with image-guided radiotherapy.Current opinion in urology · 2025Review
- Multidisciplinary Consensus Prostate Contours on Magnetic Resonance Imaging: Educational Atlas and Reference Standard for Artificial Intelligence Benchmarking.International journal of radiation oncology, biology, physics · 2025Article
- Narrative review of focal boost to intraprostatic dominant lesion in intensity-modulated radiation therapy for localized or locally advanced prostate cancer.International journal of clinical oncology · 2025Review
- The Early Detection, Diagnostic Evaluation, and Local Treatment of Prostate Cancer: A Paradigm Shift.Deutsches Arzteblatt international · 2025Review
- Propensity Score Matched Analysis of External Beam Radiotherapy With or Without Focal Boost to Intraprostatic Lesions in Prostate Cancer.The Prostate · 2025Article
- MRI-guided biopsy reduces biochemical recurrence in prostate cancer patients undergoing radiation therapy: a single-center study from Thailand.Scientific reports · 2025Article
- Microboost in Localized Prostate Cancer: Analysis of a Statewide Quality Consortium.Advances in radiation oncology · 2024Article
- Histopathology-validated gross tumor volume delineations of intraprostatic lesions using PSMA-positron emission tomography/multiparametric magnetic resonance imaging.Physics and imaging in radiation oncology · 2024Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFocal dose escalation in external beam radiotherapy (EBRT) showed an increase in 5-yr biochemical disease-free survival in the Focal Lesion Ablative Microboost in Prostate Cancer (FLAME) trial.
objectiveTo analyze the effect of a focal boost to intraprostatic lesions on local failure-free survival (LFS) and regional + distant metastasis-free survival (rdMFS). DESIGN, SETTING, AND
participantsPatients with intermediate- or high-risk localized prostate cancer were included in FLAME, a phase 3, multicenter, randomized controlled trial.
interventionStandard treatment of 77 Gy to the entire prostate in 35 fractions was compared to an additional boost to the macroscopic tumor of up to 95 Gy during EBRT. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: LFS and rdMFS, measured via any type of imaging, were compared between the treatment arms using Kaplan-Meier and Cox regression analyses. Dose-response curves were created for local failure (LF) and regional + distant metastatic failure (rdMF) using logistic regression. RESULTS AND LIMITATIONS: A total of 571 patients were included in the FLAME trial. Over median follow-up of 72 mo (interquartile range 58-86), focal boosting decreased LF (hazard ratio [HR] 0.33, 95% confidence interval [CI] 0.14-0.78) and rdMF (HR 0.58, 95% CI 0.35-0.93). Dose-response curves showed that a greater dose to the tumor resulted in lower LF and rdMF rates.
conclusionsA clear dose-response relation for LF and rdMF was observed, suggesting that adequate focal dose escalation to intraprostatic lesions prevents undertreatment of the primary tumor, resulting in an improvement rdMF. PATIENT SUMMARY: Radiotherapy is a treatment option for high-risk prostate cancer. The FLAME trial has shown that a high dose specifically targeted at the tumor within the prostate will result in better disease outcome, with less likelihood of regional and distant disease spread. The FLAME trial is registered on ClinicalTrials.gov as NCT01168479.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.