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Radiation Oncology • Genitourinary Cancers
Do you account for prostate shrinkage during XRT if ADT is started concurrently?
Recent data from Spratt has suggested improved outcomes with concurrent vs neoadjuvant ADT. However, during the first 1-2 months there is expected prostate shrinkage, which could result in increased doses to rectum or bladder if this occurs during treatment if ADT is given concurrent with RT. How do you account for this?
Answer from: Radiation Oncologist at Community Practice
This is a common question since we reported the study results, and a valid one for sure. Stay tuned for an even larger meta-analysis of many more RCTs that further dives into the oncologic superiority of adjuvant compared to neoadjuvant ADT. However, to your question, what about toxicity?Here are my...
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Answer from: Radiation Oncologist at Academic Institution
Start ADT, wait 8 weeks or thereabouts, planning scans, and start RT.
Answer from: Radiation Oncologist at Community Practice
My experience from years of pubic arch studies both before and after androgen deprivation is that in a majority of patients, most of the cytoreduction is done in 2 to 2.5 months from initiation of androgen deprivation. So I usually wait 3 months to plan. I am sure there are a few who continue to shr...