
The FLAME trial underscores the efficacy of MR-guided external beam radiation therapy (EBRT) focal boost in localized prostate cancer, enhancing biochemical disease-free survival (bDFS) without escalating toxicity. Seven studies reviewed demonstrate feasibility, effectiveness, and tolerability, with 5-year bDFS rates ranging from 69.7% to 100%. Safety profiles indicate low-grade gastrointestinal and genitourinary toxicities. Addressing heterogeneities in fractionation and delivery methods, the review advocates for increased implementation of MR-guided focal boost, particularly with advancements in technology and further investigation.
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