Mednet Logo
HomeRadiation OncologyQuestion

How would you approach an isolated prostate recurrence of high-risk prostate cancer following definitive EBRT?

7
4 Answers
Mednet Member
Mednet Member
Radiation Oncology · Beth Israel Deaconess Medical Center/Harvard Medical School

It is important to know:

1) time from cessation of hormones and time to recurrence. Better to also have T levels.

2) velocity of PSA rise.

3) absolute PSA value

Longer disease free interval, slow PSA kinetics and low PSA suggests prostate only recurrences.

I have also begun to incorporate Aximun s...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · Northern Nevada Radiation Oncology

I do the same thing.

As part of my workup I have used Carbon Acetate PET/CT in Phoenix. PSMA is not PSA membrane specific (for cofirmation see how the parotids and major vessels light up) and not as specific as Carbon Acetate PET/CT. This area of PET/CT is in flux.

My preference was HDR brachy but n...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · University of North Carolina

May I suggest a review article on this issue:

Tetreault-Laflamme A, Crook J: "Options for Salvage of Radiation Failures for Prostate Cancer" Seminars in Radiation Oncology 27:67-78, 2016

It is not to disagree with the comments of others, but there are other options beyond re-irradiation with brachythe...

Register or Sign In to see full answer

Mednet Member
Mednet Member
Radiation Oncology · University of New Mexico School of Medicine

I agree that the workup is critical to do everything you can to assure that you have a prostate only failure. With regard to imaging, that playing field is altering rapidly. After that, I treat with interstitial seed implantation following the RTOG 0526 (http://www.brachyjournal.com/article/S1538-47...

Register or Sign In to see full answer