What criteria do you use when considering treating the pelvic nodes in a salvage prostatectomy case versus covering only the postoperative bed?
Would a specific Gleason score, age, pathological feature, or PSA be an indication for covering the pelvic nodes? Would giving concurrent ADT affect you decision?
Answer from: Radiation Oncologist at Academic Institution
Since we don't have any high level evidence with which to guide us, this is a question with which I am constantly struggling, too, and frankly my practice has changed over the years. In general, I will consider irradiating the pelvic nodes in patients with Gleason 8-10 tumors, seminal vesicle invasi...
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Answer from: Radiation Oncologist at Community Practice
I think it's reasonable to approach post-op patients, certainly in the modern era of robotic surgery, much the same as you would de novo patients when it comes to addessing nodal RT. So, in general, in my practice I consider nodal RT for anyone that has bGS (and sGS) 7 or above and a iPSA of 7 or g...
Answer from: Radiation Oncologist at Community Practice
The lack of high level data actually drove @Mitchell S. Anscher and I to ask 1,000 radiation oncologists around the world how they decide. Here's what we found: https://www.ncbi.nlm.nih.gov/pubmed/24390275 The manuscript is worth the read as it drills down into the variety of criteira that folk...