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For a patient with localized, high-risk prostate cancer (Gleason >8, staged with PSMA PET), is prostate SBRT a reasonable treatment choice, and if so, what duration of ADT would you utilize in this setting?

Patient in his 70s, PSA 5.2, Gleason score 8 in 3/12 cores and 6 in 2/12 cores, with a history of aortic aneurysm (and concerned about vascular effects of ADT).
2 Answers
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Radiation Oncology · UC San Diego
Answered on

Yes, I offer SBRT as a reasonable option for high-risk prostate cancer. This is admittedly an extrapolation from PACE-B, which studied treatment of intermediate-risk cancer, but it seems justified in my view. Safety is well established. Efficacy is supported by PACE-B, with an asterisk coming from N...

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · University of New Mexico School of Medicine
Answered on

I agree with the other answers. SBRT seems a reasonable choice. There is no direct randomized study that validates this choice, but sufficient data from non-randomized studies to justify the choice. I would offer the opportunity to enroll the patient in the NRG-GU013 study, which is randomizing high...

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