How do you contour proximal SV for definitive prostate EBRT?

Topics: Radiation Oncology • Genitourinary Cancers

RTOG 0815 protocol says 1 cm from base of SV in any direction. Some contour the SV visible in the slices within 1 cm sup/inf from base of SV.

Per Kestin et al. IJROBP 2002 (PMID: 12377319 DOI: 10.1016/s0360-3016(02)03011-0). For Low risk, 1cm seems appropriate and for intermediate/high, they recommended covering proximal 2-2.5 cm.

Answer from: Radiation Oncologist at Academic Institution

Few people may know where the idea of the proximal seminal vesicle CTV came from. After the RTOG had completed it's 9406 phase II dose-escalation study with 3DCRT, we began the 0126 phase III trial of 70.2Gy vs 79.2Gy with 3DCRT. For the intermediate-risk patients, the predecessor 9406 study had a c...

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Radiation Oncologist at UC San Diego
This history is gold. Thank you so much for taking...

Answer from: Radiation Oncologist at Community Practice

It is a case by case basis, and always a risk/benefit ratio. I don't treat low-risk disease, and I put a decent number of favorable intermediate on AS based on MRI and genomics. So really, the people I treat I believe had significant enough disease that warrants curative therapy.What the Kestin et a...

Answer from: Radiation Oncologist at Academic Institution

Alright, answering my own question to create a record for users of this forum. I conducted a super-unscientific poll on Twitter: see here. 77 responses. Only 1 cm, any direction: 43%. All SV on slice, 1 cm sup: 57%. See the comments and re-tweets for various opinions. There appears to be a f...

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