We would like to congratulate Ohri et al. with their recent systematic review, addressing both the timing and dose of salvage radiotherapy (SRT) for prostate cancer. Their model confirms previous reports that the therapeutic ratio of SRT might be improved by initiating treatment at low prostate specific antigen (PSA) levels. More interestingly, they confirmed the data of King et al. that biochemical control rates increase with increasing SRT doses. The potential downside of dose-escalation is a higher rate of genitourinary (GU) and gastrointestinal (GI) toxicity. For example, it is estimated by Ohri et al. that dose-escalation above 72 Gy would result in an unacceptably high-rate of grade 3 toxicity (>20%), which would hamper dose-escalation when conventional radiotherapy techniques are used. However, the model of Ohri et al. is limited to papers reporting doses up to 70 Gy using conventional radiotherapy techniques. As the authors mention, the case for dose-escalation might be strengthened if modern treatment techniques are able to reduce long-term morbidity. Recently, two papers were published with a follow-up of 5 years exploring the potential benefit of intensity-modulated