Would you offer a third course of palliative radiation after two courses of 8 Gy in 1 fx?
If a patient with metastatic castration-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 treated with Pluvicto and Xofigo previously.
If you would re-treat, what dosing or technique would you use?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Medical College of Wisconsin Affiliated Hospitals
Answered on
Hip pain can mean different things - is it the ilium, ischium, acetabulum, femur, or L-spine causing the pain?
If it is the exact same bone as previously treated, a third fraction of 8 Gy can generally be safely given over the course of 4 years, especially if pain relief each time has lasted ~2 years...
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Mednet MemberInvited Expert
Radiation Oncology
Answered on
There are rarely definitive answers to questions like these, but I’ll do my best to detail some of my thoughts on how I would approach this situation, since I was asked to fill this request. I would usually have a conversation with a patient about the risks and benefits, and then utilize a shared, i...
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