What dose do you recommend for salvage radiotherapy after biochemical recurrence in prostate cancer?
A recent study http://www.ncbi.nlm.nih.gov/pubmed/27480153 showed an improvement in bichemical failure with higher doses. How much impact do the patient's clinicopathologic features and your ability to meet constraints for bladder, rectum, and bowel play a role in the decision?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
We normally give dose of 66.6 Gy which should be sufficient for microscopic disease. In patients where there is imaging suggesting recurrence or the pre-RT PSA is high then we consider going to 70 Gy for a high volume of disease while taking normal tissue dose into account.
There is data for dose esc...
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Mednet Member
Radiation Oncology · University of Miami Miller School of Medicine
Answered on
The only RCT testing dose-escalation in the salvage setting is the SAKK 09/10 (64Gy vs 70Gy). 70Gy was associated with low rates of acute grade 2-3 GU and GI toxicity, and minor impact in QoL. Biochemical control data to be reported soon.
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