Would you offer hypofractionation to a patient in the salvage/adjuvant post-prostatectomy setting outside of a clinical trial?
Given GU003 presented at ASTRO 2021- how does this impact your recommendations for adjuvant and salvage prostate RT?
Answer from: Radiation Oncologist at Academic Institution
No unless operating in a resource-scarce environment. My colleagues and I have been using 2.5 Gy for almost a decade at the Durham VA. The results have been recently published.NRG trial (GU003-Mark Buyyounouski PI) comparing 66.6/1.8 Gy to 62.5/2.5 Gy has been accruing very quickly and will close ve...
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Answer from: Radiation Oncologist at Academic Institution
At Fox Chase, we do not offer hypofractionated IMRT for adjuvant and salvage post-prostatectomy patients except on a clinical trial (NRG GU003). We have been treating men with intact prostates for more than 15 years with hypofractionated IMRT, but we are awaiting the results from this clinical...
Answer from: Radiation Oncologist at Academic Institution
I agree with Drs. @W. Robert Lee, @Eric M. Horwitz and @Sameer R. Keole. The reported follow-up from GU003 as presented at ASTRO just isn't long enough to be confident that we won't see an increase in late effects in the hypofractionation arm in this trial in the future. As my mentors were fond of s...
Answer from: Radiation Oncologist at Academic Institution
This is a very good question. In my opinion, this should only be done in a study. At Mayo Clinic, we have opened a 5-fraction post-prostatectomy study.