Do you boost involved mesorectal nodes in node positive prostate cancer?
How high would you try to boost those involved nodes if they are in a favorable location with respect to his rectum and small bowel?
Answer from: Radiation Oncologist at Academic Institution
This is an interesting question which has been at least partially addressed here: https://www.themednet.org/question/431. We utilize a similar paradigm of neoadjuvant ADT followed by pelvic RT of 46-50 Gy to elective nodal targets. We then try to boost the grossly involved nodes to a ...
Comments
Radiation Oncologist at Yale This is very helpful!!
If the nodal disease disap...
Radiation Oncologist at CommonSpirit Any role for treating the mesorectum electively wi...
Radiation Oncologist at Nebraska Methodist Hospital I have the same question regarding PSMA positive m...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center I personally take the co-planar mesorectum + some ...
Answer from: Radiation Oncologist at Community Practice
For pelvic nodes, we would usually treat with a SIB dose of 55 to 57.5 Gy in 25 fractions (pelvis gets 45 Gy in 25 fractions). This is is equivalent to dose in upper 60s at 2 Gy per fraction based on what a/b value you used for calculation.
Comments
Radiation Oncologist at University of Colorado School of Medicine What bowel constraint do you use? V55<5cc, and ...
Radiation Oncologist at Varian Medical Systems/Allegheny health network Yes, 55 Gy < 5 cc with maximal point dose is th...
Answer from: Radiation Oncologist at Community Practice
Regarding the nodal volumes, not dose, please see this PSMA PET patterns of failure analysis by Kilian Schiller: PMID 32451312. The population is post op not intact, still food for thought.
Answer from: Radiation Oncologist at Community Practice
I like to give obvious (+) LNs the same dose as I give the primary if no major DVH issues, certainly >=70 Gy at least (Sniper shooting single (+) LNs w CyberKnife to 40Gy/5 fx is satisfying too in some circumstances). Gross disease does not deserve to live, no matter where it resides...
This is very helpful!! If the nodal disease disap...
Any role for treating the mesorectum electively wi...
I have the same question regarding PSMA positive m...
I personally take the co-planar mesorectum + some ...