Would you offer hypofractionation to a patient in the salvage/adjuvant post-prostatectomy setting outside of a clinical trial?
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...
I agree with Drs. @Dr. First Last, @Dr. First Last and @Dr. First Last. 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 sa...
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 trial...
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.