Is there a role for prostate cancer lesion boost with EBRT in the setting of combination EBRT+ brachytherapy?

Topics: Radiation Oncology • Genitourinary Cancers • Prostate Cancer

In the setting of EBRT alone, a "FLAME"-style boost may increase bPFS. Does anyone have experience with increasing the EBRT dose in combination EBRT+LDR therapy for prostate cancer?

If an MRI and/or PSMA PET scan reveals a prostate lesion, is there a role for boosting the EBRT dose above 45 Gy/25fractions to the lesion in the setting of a planned Brachytherapy boost?

What constraints would you use for the bladder, urethra, and rectum?

Answer from: Radiation Oncologist at Academic Institution

I’m not sure if I see a significant rationale for employing an EBRT focal boost in addition to a whole-gland brachytherapy boost. If one were to want to deliver more dose with this treatment paradigm, it seems more dosimetrically efficient to boost the area with brachytherapy. Prior work has a...

Comments

Radiation Oncologist at University of Toronto
I agree with Dr. @Patel. Brachytherapy is the more...

Radiation Oncologist at Community Health Network
I have done hundreds of cases of combined EBRT and...

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