How would you treat a patient with RP and salvage XRT now with a PET PSMA positive node?

The question is a bit unclear, but I will assume that this patient has already had RP and salvage RT to the prostate bed only and now presents with a PSA of 4 and the PSMA-PET is positive in the pelvic nodes. In this situation, I generally recommend long-term ADT plus RT to the pelvic nodes, but I w...

If they are receiving ADT, I usually tx only the PSMA positive in with SBRT.

We have done about 12 patients in this scenario and using a 5 x 700 regimen delivered every other day has had minimal use and to date, no local failures but caution that it needs more maturity as we are only recently gettin...

Usually, recommend ADT if not already on it. Offer conventional frac to 45 Gy to pelvis with SIB boost to pet positive node to 55-60 Gy (as long as bowel tolerance met). For certain patients where traveling is an issue and in cases where they accept potential for some more acute toxicity, have done ...