After the amendment starting sorafenib at a lower dose and allowing for escalation, two patients (9%) were able to escalate to 400 mg twice a day of sorafenib, and they eventually required dose delays, but no reductions.
Protection of the hosts' bone marrow should allow for dose escalation that may be useful for eradicating minimal residual disease in a post-transplant situation.
Enhanced diagnostic technologies can potentially be incorporated into antimicrobial stewardship practices to allow for de-escalation of unnecessary antibacterials.
However, the requisite level of quantification at sufficiently high spatial resolution may not allow for significant dose escalation to lung lesions without the explicit management of inter-fraction and intra-fraction motion.
These above efforts have allowed for dose escalation of the prostate while minimizing early and late treatment toxicity [ 9- 17, 17].
This greater accuracy of target volume definition facilitates a reduction in the radiation dose to normal tissues, allowing for dose escalation to the tumour.
Studies using hyperfractionated radiotherapy without dose escalation or even with lower total doses in the hyperfractionated arm of the study were excluded, because these studies did not exploit the inherent radiobiological advantage of hyperfractionation that allows for dose escalation.
Planning to tighter margins (in SABR vs 3D conformal radiotherapy) clearly offers clinical gains in terms of reducing the volume of irradiated lung, and consequential acute and late toxicity, and allows for dose escalation to the target.
In addition to the study limitations discussed above, the ability to evaluate effects of golimumab dose on safety was also limited by the GO-AFTER study design that allowed for dose escalation and yielded markedly differing lengths of follow-up for golimumab 50 mg (319 pt-years) versus 100 mg (645 pt-years).
Dosimetric comparisons of intensity-modulated RT (IMRT) to conformal RT (CRT) techniques have shown that IMRT treatment planning reduces the volume of bladder and rectum exposed to high RT doses and allows for dose escalation to the target volume without exceeding bladder and rectum constraints 10, 11.
This is substantially smaller than the conventional safety margin of 5 or 10 mm, respectively, and might allow for an additional dose escalation especially in the upper lung zone.
