Yeah, so I think over this year, we’ve had lots of good publications about ultra-hypofractionation or SBRT, so shortening radiotherapy, including a lovely presentation at ESTRO this year from the Scandinavian hypo study, which tested seven fractions versus 39 and showed very, very good long-term outcomes in terms of cancer control. I think this year we’ve also learned more about the bladder side effects I was talking about, about how to prevent them, which patients are most likely to get them...
Yeah, so I think over this year, we’ve had lots of good publications about ultra-hypofractionation or SBRT, so shortening radiotherapy, including a lovely presentation at ESTRO this year from the Scandinavian hypo study, which tested seven fractions versus 39 and showed very, very good long-term outcomes in terms of cancer control. I think this year we’ve also learned more about the bladder side effects I was talking about, about how to prevent them, which patients are most likely to get them. And of course, we know also for men with very high-risk prostate cancer, they may also benefit from the addition of extra hormone treatments to improve their cure rate. So I think there’s lots of great advances on the horizon for men with prostate cancer. So in terms of future directions for prostate radiotherapy, I think there are lots of exciting directions. So firstly, of course, we’ve come down from eight weeks to four weeks to five days. So the natural question is, can we go down below five days and still cure prostate cancer? So there are multiple trials recruiting right now across the world, looking at just two days of radiotherapy. So painless outpatient treatment done and dusted and cured in two days, which would be a wonderful thing. So we’ve got lots of work to do, but that’s one exciting avenue. And the other is to really challenge the dogma that we need to treat the whole prostate for the whole dose. Now we have MRI, we can see much more clearly where the cancer is. Why don’t we try and give more dose to where the cancer is and less dose where there might just be microscopic disease so that’s a suite of de-escalation studies including the Destination One and Two studies which are running across the world now to try and answer that question.
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