How would you approach definitive nonsurgical management for biopsy-proven, localized small cell carcinoma of the prostate?

Rare disease and one patient we treated with cis plus etoposide with RT added with second cycle. Because of concern about unsampled mixed high grade histology we planned to treat to 70 Gy. No PCI as isolated brain relapse for pelvic small cell is not same as for small cell of lung

This is a rare disease where physicians will never have randomized trial data. However, multiple database studies have demonstrated survival benefit of adding local therapy (usually EBRT) in non-metastatic patients, especially fit enough for systemic therapy:

2014 - https://www.ncbi.nlm.nih.gov/pubme...