Do you make any modifications to your treatment plan for older patients undergoing prostate SBRT?

For example, do you change your prescription dose, treatment schedule, or OAR constraints? Have you noticed increased toxicity in older patients, e.g. >75 years old?

1 Answer

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Radiation Oncology · David Geffen School of Medicine at UCLA

Answered on

At UCLA, we do not make treatment modifications of prescription dose or change our dose constraints for OAR in our elderly patients (> 75 y.o.) undergoing prostate SBRT. We have not noticed a difference in toxicity in older patients. Admittedly, this has not been studied in our cohort of patients in a controlled way. Since significant toxicity is a rare event in our hands, a rigorous review would be required to definitively determine if such dose or OAR modifications would be required in this patient group. So, clinically we have not noticed tolerance issues in the elderly. When we do modify dose in any of our patients, it is usually OAR constraints due to anatomic presentation related to size or configuration of the prostate gland in its relationship to the rectum or bladder.

Michael Steinberg, MD

UCLA Radiation Oncology