Is salvage SBRT an option for focal recurrence of PCa after prior proton therapy for intermediate-risk disease?
What volumes would you treat, and what dose do you recommend?
Rising PSA 7 years after proton therapy. PSA now 2.6. PSMA PET positive only in one quadrant of the prostate gland.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · UC San Diego
Answered on
Yes, it is an option. There is a great need for randomized trials in the setting of local-only recurrence after definitive RT, and we do not know the optimal approach. The MASTER systematic review and meta-analysis is a good summary (Valle et al., PMID 33309278). I do not think that protons vs. phot...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · Virginia Commonwealth University Medical Center
Answered on
I am not aware of any data indicating that prior proton therapy is a contraindication to reirradiation for a focal intraprostatic recurrence. I would approach this patient as I would a patient who has recurred after photon irradiation. I would get an MRI in addition to a PSMA PET to help define the ...
Join for free or sign in to see the full answer