title: [Standards, options, and recommendation for external radiotherapy of prostatic cancer: evaluation of the effect of dosage].
abstract: BACKGROUND
  The "Standards, Options and Recommendations" (SOR) collaborative project was initiated in 1993 by the Federation of the French Cancer Centres (FNCLCC), with the 20 French Regional Cancer Centres, several French public university and general hospitals, as well as private clinics and medical speciality societies. Its main objective is the development of serviceable clinical practice guidelines in order to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review, followed by critical appraisal by a multidisciplinary group of experts. Draft guidelines are produced, then validated by specialists in cancer care delivery.
  
  
  OBJECTIVE
  Produce clinical practice guidelines for the radiotherapy of prostate cancer using the methodology developed by the Standards, Options and Recommendations project.
  
  
  METHODS
  The FNCLCC and the French Urology Association (AFU) designated the multidisciplinary group of experts. Available data were collected by a search of Medline and lists selected by experts in the group. A first draft of the guidelines was written, they validated by independent reviewers.
  
  
  RESULTS
  The main recommendations are: 1/ a minimal dose of 70 Gy must be used, whatever the prognostic factors; 2/ it appeared that patients with favourable prognostic indicators (stage T1-2, PSA < or = 10 micrograms/L and Gleason score < or = 6) do not benefit from a dose escalation effect for doses over 70-74 Gy; 3/ patients with intermediate prognosis are the ones who benefit most from the dose escalation effect over 74 Gy, provided they receive exclusive radiation therapy; 4/ whenever possible, patients should be included in controlled trials designed to assess the effects of dose escalation and hormonotherapy.
authors.affiliation: Centre Léon Bérard, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Pommier
authors.forename: A
authors.initials: A
authors.lastname: Villers
authors.forename: A
authors.initials: A
authors.lastname: Bataillard
authors.forename: D
authors.initials: D
authors.lastname: Brune
authors.forename: B
authors.initials: B
authors.lastname: Fervers
authors.forename: J M
authors.initials: JM
authors.lastname: Bachaud
authors.forename: N
authors.initials: N
authors.lastname: Berger
authors.forename: A F
authors.initials: AF
authors.lastname: Bertrand
authors.forename: R
authors.initials: R
authors.lastname: Bouvier
authors.forename: A
authors.initials: A
authors.lastname: Daver
authors.forename: E
authors.initials: E
authors.lastname: Fontaine
authors.forename: O
authors.initials: O
authors.lastname: Haillot
authors.forename: J L
authors.initials: JL
authors.lastname: Lagrange
authors.forename: V
authors.initials: V
authors.lastname: Molinié
authors.forename: J P
authors.initials: JP
authors.lastname: Muratet
authors.forename: P
authors.initials: P
authors.lastname: Pabot du Chatelard
authors.forename: M
authors.initials: M
authors.lastname: Peneau
authors.forename: D
authors.initials: D
authors.lastname: Prapotnitch
authors.forename: V
authors.initials: V
authors.lastname: Ravery
authors.forename: P
authors.initials: P
authors.lastname: Richaud
authors.forename: D
authors.initials: D
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Soulié
mesh_terms: D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods / Q000592:standards*; D011879:Radiotherapy Dosage / Q000592:standards