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Do you offer prostate RT to men with 0-3 bone metastases on conventional imaging when PSMA PET shows a very high number of M1 lesions?
STAMPEDE answer is yes, intuitively it seems there must be a line somewhere though.
For patients staged only with PET that is widely M1, should a CT A/P and bone scan be ordered to determine if the patient may have a survival benefit from prostate RT?
Answer from: Radiation Oncologist at Academic Institution
Great question, as we are seeing this clinical scenario more and more in practice. I don't think we have a clear answer on this, and I am curious to know how others would approach this case. There are a few points I'd like to discuss. Many of the CHAARTED low-volume patients are expected t...
Answer from: Radiation Oncologist at Community Practice
This is definitely a case-by-case decision based on many patient-related factors and the exact degree and location of disease burden (is it high volume because there are 6 lesions and not 5?, bulky pelvic nodes, etc), but often yes based on PEACE-1 showing the reduced risks of GU complications and t...
Comments
Radiation Oncologist at Lafayette Radiation Center
Case by case. Never say never. Next generation seq...
Case by case. Never say never. Next generation seq...
Answer from: Radiation Oncologist at Academic Institution
I believe the PSMA scan is more sensitive than conventional imaging, so I wouldn't treat with the intention that OS will be impacted. PEACE-1 is another trial that looked at this, presented at ASCO 2023.
Summary: Prostate-only RT doesn't appear to impact OS in 'low-volume' patients, though there is...
I don’t think we fully understand why prosta...
A broader point and then a finer one: I see a lot...
You raise an excellent point
Not sure which comments are directed where. The qu...