Would you offer a third course of palliative radiation after two courses of 8 Gy in 1 fx?  

If a patient with metastatic castrate resistant prostate cancer had a hip lesion first treated with 8 Gy in 1 fx 4 years ago, then received another 8 Gy in 1 fx 2 years ago, and is now having very poor quality of life with renewed right hip pain, would you offer any additional RT? The patient has been treating with Pluvicto and Xofigo previously.

If you would re-treat, what dosing or technique would you use?